Disparities in Health Care — From Politics to Policy

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Steinbrook, Robert (2004) Disparities in Health Care — From Politics to Policy. New England Journal of Medicine, 350 (15). pp. 1486-1488.


On December 22, 2003, as many Americans began their Christmas holidays, the DHHS released two comprehensive reports about health care, the National Healthcare Quality Report and the National Healthcare Disparities Report.Four years earlier, Congress had passed a law requiring the AHRQ, which is part of the DHHS, to report annually on both the overall quality of health care and disparities in health care among racial and other groups. It is standard procedure for government reports to go through a clearance process before their public release. The review may involve substantial back and forth among many officials, and it usually escapes public scrutiny. Moreover, federal reports, particularly those that are released during holiday periods, often attract little attention. Within weeks, however, it became widely known that although the December report on disparities in health care contained essentially the same tables of data as the report that AHRQ officials had submitted for approval six months earlier, it otherwise differed markedly from the July version. Democratic staff members in the House of Representatives who work for Representative Henry A. Waxman (D-Calif.), the ranking minority member of the House Committee on Government Reform, called attention to these differences by making public an internal AHRQ draft of the executive summary from June 2003. They issued a report on the changes as “a case study in politics and science.”