Addressing Racial Inequality in Health Care

Sara Rosenbaum and Joel Teitelbaum approach the disparities issue from another angle, asking how the law might become an important instrument to push policy change along. They see law as a powerful instrument in American life and examine how classic civil rights law can be revised and expanded to address discrimination in health and health care, using health financing agencies and associated regulations to convey a strong message. These authors also examine a legal strategy addressing health disparities more directly by eliminating the requirement that individuals demonstrate discrimination, and instead propose rules and standards for reducing disparity. They examine the pros and cons of these alternative legal approaches, alone and in combination. Implementing these ideas, of course, entails many challenges and provides no fast remedy, but disparities will be with us for generations and we need to seek more than a quick fix.

Rosenbaum and Teitelbaum's legal approach to reducing disparities is also innovative in that they suggest approaching remedies through the lens of unequal quality rather than relying on more traditional civil rights strategies of unequal access. This chapter therefore provides a transition to the third section, examining quality in health care and how it can be improved.