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    Urologist's 'declaration' calls for health care equality in U.S.

    Medicare, Medicaid patients at greatest risk in the face of funding cuts

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    Bob Gatty
    Washington—Willie Underwood, III, MD, MSci, MPH, came to Washington in late September with a bold plan: nothing less than a new "Declaration of Health for the United States."

    Dr. Underwood, a member of AUA's Legislative Workgroup and one of the association three delegates to the American Medical Association House of Delegates, was part of a panel discussion at the Congressional Black Caucus Foundation's (CBC) legislative conference. The forum was titled, "Turning the Page on Disrespect, Discrimination, and Disparities: An Agenda of Change and Hope."

    His assignment was to help the CBC develop its recommendations to Congress for national health care reform, so Dr. Underwood, a long-time champion of initiatives to remove racial disparities in health care, presented the following Declaration of Health for the United States:

    "We the people, in order to challenge the United States to uphold its creed of national equality, as stated in the Declaration of Independence...

    'We hold these truths to be self-evident, that all men [and women] are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness'

    ...are seeking national implementation of a universal health statute:

    All Americans are entitled to the fundamental human right of the highest quality of health possible and deserve to live in a country that provides a health system that is equitable, high quality, and cost efficient. To this end, this national health system will:

    • be accessible to all, regardless of race, ethnicity, gender, age, sexual orientation, socioeconomic position, geographic location, disability, or primary language
    • have universal standards of health care delivery and outcomes for all
    • facilitate a diverse health services work force that is balanced by race, ethnicity, gender, age, sexual orientation, socioeconomic position, geographic location, physical disability, and primary language
    • include a nationally instituted electronic health record information system that is protected and safeguarded from abuse
    • balance the health needs of all persons with the interests of the providers, health insurance companies, hospitals, pharmaceutical companies, and the government
    • be supported and sustained by government, the people, and employers to ensure that all persons receive necessary health services."

    "In our Constitution, the right of due process is an inalienable right," Dr. Underwood explained later. "It is not debatable. But what should that include? We say that our inalienable rights include a system of providing equal, excellent quality of health care to everyone, regardless of who they are. So, our constitution for health care defines what we believe to be true."

    Dr. Underwood realizes that the political environment in Washington will be changing as a result of this month's elections and that health care reform and financing will be at the forefront of the national debate. However, he said, at the core of that discussion should be the concepts contained in his "declaration of health."

    Dr. Underwood, who has served the inner city community in Detroit for many years and who is now moving to a new position in the Roswell Park Cancer Institute in Buffalo, NY, understands that the critical health issue before the new administration and Congress will be cost, ie, finding ways to pay the tab.

    So AUA intends to be a player.

    "When 50% of a urologist's practice are Medicare patients, you are in jeopardy because of the financial situation today," Dr. Underwood said. "For minority physicians, who are most likely to treat minority patients who are more likely to be Medicare or Medicaid patients, the situation is even worse."

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    Bob Gatty
    Bob Gatty, a former congressional aide, covers news from Washington for Urology Times.

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