Hispanics watching health care debate closely

OAKLAND, Calif. — Perched at the edge of an exam table, Delmira Maravilla is anxious for a check-up — and for a timeline on the president's promise of health care for all Americans.

She's paying out of pocket for the exam, and like one-third of Hispanics, the mother of nine doesn't have health insurance.

Latinos like this immigrant from El Salvador have much to gain if the legislation taking shape in Washington passes. Among the major ethnic groups, they are the least likely to have health coverage through work. And Hispanics often face language and cultural hurdles to getting good-quality health services. They're far less likely to have a regular health-care provider, and to get the kind of routine screening that prevents serious health problems.

Maravilla knows how easily her family's carefully calculated budget can be overwhelmed by the cost of health care: her 6-year-old daughter's recent fall against the edge of a table set her back a devastating $1,500 in emergency room bills. Any accident, any unexpected illness, can be catastrophic, she said.

"I would be so much calmer, less worried, if I knew I had health insurance for my family," she said. "Health problems happen to everyone, but it's too expensive for us who are poor."

Experts say health disparities among ethnic groups are great, with one in three Hispanics and one in five African-Americans not having health insurance, compared with one in eight whites. And as the recession deepens, the gap is growing along with rising unemployment and cuts to work-sponsored insurance.

"We can't have the status quo. It's just a disgrace. I don't know what other words to use," said Elena Rios, president of the National Hispanic Medical Association, a nonprofit group that represents Hispanic doctors.

Rios was among the advocates calling on legislators to consider measures designed to bolster care for Hispanics through preventive medicine, health education and increased diversity in the medical field.

Jane Garcia, the CEO of La Clinica de la Raza where Maravilla gets her checkups, sees the need for reform every time she makes her rounds.

About 71 percent of her patients are Latino; 44 percent are uninsured, and that number has been going up. New patients range from the recently unemployed to undocumented immigrants who can no longer get care in neighboring Contra Costa County, where supervisors squeezed by a budget shortfall voted to cut services to them.