By John Ostapkovich

PHILADELPHIA (CBS) – The Affordable Care Act (Obamacare) is rewriting the insurance landscape but may still not bring equal results to patients.

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“The Affordable Care Act will affect access to care, but to reduce disparities we have to go beyond access, and we also need to improve the care that we deliver to people,” says Dr. Marshall Chin of the Robert Wood Johnson Foundation’s healthcare disparities project, now 9 years old.

He wants to draw attention to how things like language and home circumstances from a dangerous neighborhood to no nearby food stores stack the deck against entire groups of patients.

“Healthcare organizations, insurers, are starting to collect race-ethnicity-language data. People expect that over time it’ll be used for public report cards so we can see whether these disparities exist and that, then, encourages action.”

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Some of that action comes from patients who, after all, can help themselves by going to the places that give people like them the best outcomes.

Dr. Chin says an African-American in Chicago has five times the chance of losing a limb to diabetes than a white. It’s not that medical personnel are bigoted, says Dr. Chin, but they may not be aware that one-size-fits-all is not effective medicine.

He cites a program at Penn with high-blood pressure mentors.

“This was an African-American oftentimes, from Philadelphia, who had high blood pressure but had successfully controlled their blood pressure. So they would call the patients and help coach them on ways to be more successful on ways to reduce their blood pressure and the intervention was shown to be successful.”

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