Is this racial disparity the fault of the doctors at the "safety-net hospitals," then? Maybe they're treating their minority patients differently. Or maybe they just have less-sterling credentials than the doctors at major medical centers. Or maybe their poor outcomes stem from the fact that their patient population is unhealthier to begin with.

Or, maybe doctors at 'lesser' facilities don't have the equipment, testing facilities and time that doctors at 'better' facilities do? If you have to churn patients through at a high rate and don't have time (or your patients can't afford) for extensive testing, you are bound to have worse diagnosis/recovery rates. It's not the fault of the doctors, it's the system itself. A study of the same factors by income would yield similar results, I think, perhaps because racially 'disadvantaged' groups would be more likely to be in a lower socio-economic range. The trick is in deciding which is the primary casual factor and that's a much bigger and more complex issue.

Yep, it is 2010; and in so many ways it may as well be 1750 or something.

Not wanting to disparage the thought out response of dg in any way, just a so many things still so primative factor that I felt a need to express in a more simpler way.

While acknowledging the complexity of the problem, the main way of tackling it has to be education, education, education.

Educate people in ways that are meaningful to them about what good health is, educate them about eating healthily on a low income, educate them about what they can expect vis a vis healthcare, educate the doctors in Med School about the cultural complacency pratfalls that lie ahead. Whether the issue is horrendous women's rights abuses, LGBT abuses, racial abuses, they can only continue in a culture of ignorance.

Diagnostic competence and income for medical providers is strongly linked. It costs about three times as much to go to a highly competent diagnostician as it does to get "ordinary" medical care. And "ordinary" medical care clearly has huge social disparities to start with.

Despite the article's extreme hedging on the supposed difficulties of these sorts of studies, an international comparison of different countries would probably show the general outline of why things are so bad in the US very quickly. Of course, that would require looking at other countries and that would be socialism or worse....

It might even show that there is a strong connection between universal health care, costs and quality.

the most shocking thing here is that anybody would be surprised that the growing inequalities in American society (something that has been politically driven for the last thirty years) extend to sacred cows like the medical institutions like the AMA.

FWIW, doctors are one of the larger monetary contributors to far right groups like the John Birch society.... the notion that the medical profession is strongly rooted in public service is a myth. That stopped being true about the time they started colluding with the insurance companies to make US medical care a highly priced private commodity.