With so much focus on national health reform, this article reminds readers of both the challenges of and opportunities for equity in its implementation.

The major reform proposals’ intent to increase coverage may address some of the racial and ethnic disparities that continue to exist in the U.S. health care system. The authors cite that by 2050, racial and ethnic minority groups will be the majority. This growing demographic often does not have health insurance, and are at higher rates of disease, poor heath and limited health care access. Yet, while reform proposals may increase the quantity of those covered, the authors wonder about the quality offered, citing the health care system may be unable or unwilling to provide adequate health care to newly-covered minority members.

The authors cite three models upon which the health care system must build to both measure and improve the quality of care given to minorities. Additionally, new health care legislation provides an opportunity to further expand these initiatives and implement new ones. The authors argue that four things must happen for health care reform to adequately address disparities:

1. New health care plans must meet nationally-set quality benchmarks that are rigorously implemented.
2. The system must better track the specifics of patients’ race and ethnicity in addition to the care they receive.
3. Disparities should be addressed through meaningful incentives provided to providers.
4. A safety net must be established and supported with substantial investments.

Carefully and conscientiously crafted, health reform positions the health care system for significant change and improvement in addressing inequality in health and health care.