Disparities and Inequities in US Health Care: Alive and Sick

Disparities and inequities based on ethnic and racial differences have been a part of health care in America from the time of its founding. These disparities have persisted through recurrent efforts to reform our health care system. This article brings historical perspective to what has become a systemic part of US health care; examines the extent of disparities today as they impact access, quality, and outcomes of care; and considers what can be done within our polarized political environment to eliminate them. It is hoped that this can help to spark dialogue within our discipline on these matters of critical importance. A single-payer national health insurance program, whereby all Americans can access affordable care based on medical need instead of ability to pay, can help to move our current nonsystem toward health equity. This change can bring improved health care to all Americans with simplified administration, cost containment, and less bureaucracy. It can be financed through a progressive tax system whereby 95% of Americans pay less than they do now and receive more in return.