Thoughts on Warren's plan to reward hospitals that have lower maternal mortality rate among African-American women

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Sen. Elizabeth Warren wants to drive down the maternal mortality rate among African-American women -- and she has a plan to get it done.

Speaking in Houston on Monday, the Massachusetts Democrat suggested that medical providers should be rewarded with "bonus" funds for reducing those numbers, which are three or four times higher than for white women.

"And if they don't," the presidential candidate said, dropping the carrot to wield a stick, "then they're going to have money taken away from them. I want to see the hospitals see it as their responsibility to address this problem head-on and make it a first priority. The best way to do that is to use money to make it happen, because we gotta have change and we gotta have change now."

Warren's plan, which she discussed for the first time at the She the People conference in Texas, was greeted with sustained applause in a room largely filled by women of color -- a constituency that will likely be key in deciding the 2020 Democratic presidential nomination. The audience quickly warmed to the senator, then sent her off with a standing ovation as she rolled through her growing suite of detailed policy proposals. Perhaps more than any other candidate in the field, Warren has offered comprehensive plans to match her campaign rhetoric, a dedicated strategy her aides and allies believe will ultimately translate into success in the polls.

Warren also spelled out the stakes in a series of tweets, crediting activists for pushing the issue into the mainstream of national politics, then offering her plan: "Hit health care providers in their wallets," she tweeted. "Make it unacceptable for providers to tolerate our high rates of moms dying—especially black moms."

"We've done this in other areas of health care. Let's do it here," Warren added in a subsequent post. "If providers deliver quality care to black moms, they'll make more. If they don't, they'll make less. Don't just observe and debate racism in health care. Make providers pay until this crisis is fixed."

Asked what she would do to address a "crisis that persists independent of education and income," Warren -- in an answer that lasted for more than four minutes and was repeatedly interrupted by cheers -- said that "doctors and nurses don't hear African American women's medical issues the same way that they hear the same things from white women. We gotta change that and we gotta change it fast because people's lives are at stake."

Both Warren and the questioner pointed to the fact that those disproportionately high mortality rates transcended the economic status of the women in danger. The issue recently made headlines outside of medical and political spheres after tennis great Serena Williams went public with her own near-deadly experience in childbirth, saying both a doctor and nurse dismissed her concerns over potentially life-threatening blood clotting -- conditions that were subsequently confirmed with a CT scan.

"I was like, listen to Dr. Williams!," she recalled in an interview with Vogue magazine. The story, and the fact that even one of the most famous women and athletes on the planet endured it, put the spotlight on an issue advocates have been agonizing over for years.

Warren put her own stamp on it, making clear what she believes is at the root of the problem.

"Even after we do the adjustments for income, for education this (problem) is true across the board," she said. "This is true for well-educated African American women for wealthy African American women, and the best studies that I've seen put it down to just one thing: prejudice."

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I am curious what the professional's thoughts are on this especially OBGYN physicans.

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Difference in outcomes does not at all prove prejudice . It’s a flawed premise from the start
 
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Difference in outcomes does not at all prove prejudice . It’s a flawed premise from the start
True, but the idea itself isn't bad.

For one reason or another, AA women do have a significantly higher mortality rate associated with pregnancy. I like the idea of using the carrot as opposed to the stick to try and work on that.
 
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True, but the idea itself isn't bad.

For one reason or another, AA women do have a significantly higher mortality rate associated with pregnancy. I like the idea of using the carrot as opposed to the stick to try and work on that.
I certainly thought I read a threat of a stick in there.

If there are no proven bad actors there shouldn’t be any talk of sticks. How about ending CON and just publishing mortality rates by morbidity?
 
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But isn't that the point? There's a specfic racial disparity that needs emphasis
Because it’s not just the same thing, it’s the same accounting crap but now with racial emphasis
 
But isn't that the point? There's a specfic racial disparity that needs emphasis
Nope. Not proven yet. Show the disparity is hospitals doing something wrong and then it must be addressed.

Disparity does not equal discrimination
 
Racial emphasis because there is a different outcome based on race. Not sure why you don’t understand that.
I'm saying that I don't think it has been shown that how the hospitals treat patients is the reason for differences between racial outcomes. Do you believe that's been proven? You believe these women are dying at different rates because the hospitals are treating them so poorly?
 
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I'm saying that I don't think it has been shown that how the hospitals treat patients is the reason for differences between racial outcomes. Do you believe that's been proven? You believe these women are dying at different rates because the hospitals are treating them so poorly?
Heck yeah. I’ve seen it with my own eyes. Except then, there was no systematic accountability.

I don’t think the intent was harm so much as the outcome was irrelevant.
 
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Let’s ponder differences with regard to health between AA women and women of other ethnicities. One stark fact is that AA women in the US have markedly higher obesity/overweight rates than women of other ethnic groups. Has anyone concluded that this has little effect on or association with the higher maternal mortality rates?
 
It sure seems like the same trap but now with a smidge of racial virtue signalling

Lol you’ll get banned for spouting things like "virtue signaling". Just letting you know
 
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Lol you’ll get banned for spouting things like "virtue signaling". Just letting you know
never even been on probation and I've been pretty consistent the whole time. thank you for looking out though
 
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This seems like an issue that should be addressed in some way shape or form, but it really doesn't sound like a good idea in practice. Wouldn't this just be an incentive for physicians to not practice in areas that have high AA populations to avoid the risk?
 
Great way to run providers in areas with high AA patients away, leading to them having even worse patient outcomes.
 
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