Tuesday, January 10, 2012

The Case for a Second Term

via Advocate, by Andrew Harmon

WASHINGTON — In a public relations video released late last month, U.S. Secretary of Health and Human Services Kathleen Sebelius enumerated the accomplishments and key news from her agency in 2011.

Two notable developments did not make the final cut. The first was her controversial decision in December overruling a Food and Drug Administration recommendation that Plan B One-Step, an emergency contraceptive, be available without prescription to people under 17.

The second was far less headline-grabbing — if perhaps far more impactful and not the type of achievement that HHS has otherwise shied away from touting.

Under Secretary Sebelius, HHS has taken a hard look at the breathtaking disparity in health care access that LGBT Americans face.

How those who do have access to care are treated in the system seems to vary widely: One striking survey released in 2010 by Lambda Legal reported high rates of myriad negative experiences among gay and transgender respondents, including health care professionals using abusive language or even refusing to touch patients.  

With LGBT antidiscrimination legislation and a bill to repeal the Defense of Marriage Act not expected to move anytime soon in a divided Congress, leadership on LGBT health issues from the executive branch has proved crucial.

Some of that progress, as outlined by Sebelius in an October address to the National Coalition for LGBT Health, easily translates into media attention.

For example, an Obama administration mandate that forbids hospitals receiving Medicare or Medicaid funds from discriminating on the basis of sexual orientation or gender identity in their visitation policies is “due in no small part” to people like Janice Langbehn who have experienced the tragic consequences of unjust rules, White House officials wrote nearly a year ago when the rule went into effect.

In 2007, Langbehn was kept from her dying partner’s side in a Miami hospital along with the couple's children.

President Obama awarded Langbehn the Presidential Citizens Medal in October for her advocacy on the issue ever since.

Putting a face on other positive steps forward can be difficult.

Questions on sexual orientation and gender identity, for instance, have historically been excluded from federal health surveys that factor other demographics such as race and ethnicity, as detailed by a groundbreaking report in 2011 by the Institute of Medicine.

Collecting such information on surveys is essential to establishing research priorities and sound health care policy, experts widely agree.
HHS released a two-year data collection plan last year to help close the gap.

“The Department of Health and Human Services decision to collect health data on the LGBT population will allow public health professionals to understand for the first time patterns and risks for disease among LGBT people, as well as how to design the most effective interventions,” said Ilan Meyer, an expert on LGBT health and a senior scholar of public policy at the Williams Institute.

Other agencies, such as the Department of Justice and the Bureau of Labor Statistics, have also moved to incorporate LGBT data collection.

In a recent interview with The Advocate, Secretary Sebelius spoke about the year in LGBT health at HHS, the impact of a U.S. Supreme Court ruling on the Affordable Care Act expected later this year, and how marriage rights (or lack thereof) may affect the health of LGBT Americans.

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