Mensah Michael O, Sommers Benjamin D
Department of Health Policy & Management, Harvard School of Public Health / University of California, San Francisco, 677 Huntington Ave, Room 406, Boston, MA, 02115, USA.
Harvard School of Public Health / Brigham & Women's Hospital, 677 Huntington Ave, Room 406, Boston, MA, 02115, USA.
J Gen Intern Med. 2016 Nov;31(11):1369-1372. doi: 10.1007/s11606-016-3784-1. Epub 2016 Jul 18.
This perspectives article considers the potential implications an affirmative action ban would have on patient care in the US. A physician's race and ethnicity are among the strongest predictors of specialty choice and whether or not a physician cares for Medicaid and uninsured populations. Taking this into account, research suggests that an affirmative action ban in university admissions would sharply reduce the supply of primary care physicians to Medicaid and uninsured populations over the coming decade. Our article compares current conditions to the potential effect of an affirmative action ban by projecting how many future medical students will become primary care physicians for Medicaid and uninsured patients by 2025. Based on previous evidence and current medical student training patterns, we project that a ban could deny primary care access for 1.25 million of our nation's most vulnerable patients, considerably worsening existing healthcare disparities. More broadly, we argue that the effects of eliminating affirmative action would be fundamentally contrary to the Association of American Medical Colleges' stated goal of medical education-"to improve the health of all."
这篇观点文章探讨了平权行动禁令可能对美国患者护理产生的潜在影响。医生的种族和族裔是专业选择以及医生是否为医疗补助计划和未参保人群提供护理的最强预测因素之一。考虑到这一点,研究表明,大学招生中的平权行动禁令将在未来十年大幅减少为医疗补助计划和未参保人群提供初级护理的医生数量。我们的文章通过预测到2025年有多少未来医学生将成为为医疗补助计划和未参保患者提供初级护理的医生,将当前情况与平权行动禁令的潜在影响进行了比较。根据以往的证据和当前医学生的培训模式,我们预计禁令可能会使我国125万最脆弱的患者无法获得初级护理,从而使现有的医疗差距大幅恶化。更广泛地说,我们认为取消平权行动的影响将从根本上违背美国医学院协会所宣称的医学教育目标——“改善所有人的健康”。