TRUMAN MEDICAL CENTERS
DISPARITIES:Why and What to do About Them?
John W. BlufordPresident/CEO
Truman Medical Centers
Presented to The Institute for Healthcare Disparities
1st Annual National Best Practices Conference
April 17, 2009
1st Annual Conference
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USA Public Policy Overview
• 1860s Bureau of Refugees, Freedmen, and Abandoned Lands
• 1940s Hill-Burton Act The Hospital Survey & Construction Act, 1946
• 1960s Medicare & Medicaid
• 1960-70s OEO Neighborhood Health Centers
• 1973 Health Maintenance Organization Act
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During Slavery
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USA Public Policy
Bureau of Refugees, Freedmen, and Abandoned Lands(“Freedmen’s Bureau”) – 1860s
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Black Hospitals in the U.S.Founded Closed
Freedmen (Howard U.) 1862
George W. Hubbard (Meharry) 1884
Provident, Chicago 1891 1987
Provident, Baltimore 1894 1986
Mercy-Douglas, Philadelphia 1910 1973
Homer G. Philips, St. Louis 1939 1979
Mound Bayou, Mississippi 1941 1983
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USA Public PolicyHill-Burton Act - 1946 (The Hospital Survey & Construction Act)
• Intent– Build & Modernize Hospitals– Separate-but-Equal Funding– Provide Uncompensated Care
• Actual– $4+ Billion Spent from 1946-1978– Unequal Allocation of Resources
Harold H. Burton U.S.
Senator, Ohio Mayor
Lister Hill U.S. Congressman,
Alabama
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Good Samaritan-Waverly HospitalRichland County, South Carolina
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As Opposed to: Major Teaching Hospitals Providing Care for Minorities
• Cook County – Chicago
• Charity – New Orleans
• Grady Memorial – Atlanta
• Jackson Memorial – Miami
• Harlem – New York
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USA Public Policy
• Medicare / Medicaid – 1960s
• Health Maintenance Organization Act – 1973 (HMO Act of 1973)
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What to do about Disparities as an Industry
• Invest in Quality Improvement – “Patient Centered”
• Diversify Governance
• Enhance Community Benefit Reporting
• Focus on Public Health Issues
• Enhance Wellness & Prevention Outreach
• Enhance Diverse Workforce Opportunities
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WHY? Because We Care. We are in the business of caring.
To be effective, we must crossSocial – Economic – Cultural
barriers.