By M. Ryan Barker, MSW, MPPA, Director of Health Policy for Missouri Foundation for Health

In the year of a presidential election it is always interesting for a policy wonk like me to listen to the candidates and hear how they frame the issues that are being debated.

I take particular interest in issues related to our health care system. One of the most thought-provoking is the conflicting statements that are often made about the U.S.’s health care system compared to other nations throughout the world. I’ve heard candidates say that the U.S. health care system is the best in the world, while others point out our health rankings compared to other industrialized nations or the health disparities that exist in the U.S. The ironic thing is that both sides are correct. We have the best health care system in the world, if you have the means to afford it and access it.

Last month, the Missouri Foundation for Health (MFH) released a new report, Responding to LGBT Health Disparities (ed. note: link will open a pdf file). The report examines disparities in Missouri for the lesbian, gay, bisexual, and transgender (LGBT) population related to health insurance, access to care, quality, cultural competency, preventive care, and the social and economic environment in which individual’s live, work and play. The report also includes a variety of policy options for how the state can eliminate these disparities.

MFH focuses on health disparities because one of our goals is quality, affordable health care for all Missourians. We believe that health care quality and access should not be tied to how much money people make, where they live, the color of their skin, their immigration status, their gender, their disabilities, or their sexual orientation.

Here are a few data highlights from the report:

• LGBT Missourians are more than twice as likely to go without needed medical care or surgery compared to the general population.
• Sexual and gender minorities in Missouri are 1.5 times more likely to be uninsured than the general population.
• Missouri’s Medicaid coverage explicitly excludes transgender transition care, but surgery is required for a transgender person to change the gender marker on state identification documents.
• More than one third of gay and lesbian young people have not disclosed their sexual orientation to their doctors.
• More than two thirds of health care organizations do not require that physicians attend cultural competency training that includes LGBT health issues.
• The average medical student spends fewer than 5 hours learning about LGBT health issues, and the majority of that time is dedicated to HIV/AIDS.

While policymakers trade barbs during this election season, we should all work to remind them that health care is about individuals and families and communities. It is about working together to provide care when someone may be at their most vulnerable. We must set aside differences and find ways to make our health care system work for all Missourians.