How to fix racial disparities in medical care.

Over and over, this theme recurs: Universal quality-improvement plans coupled with publicly reported measures are the best way to cut health disparities. We need not dwell on race or class, which only causes disagreement and alienates political support. Universal screening of group B streptococcal infections during pregnancy eliminated racial disparities in newborn infections, racial disparities of deadly pneumococcal infections in children disappeared over the past decade after universal Prevnar vaccination began, and a Medicare-backed reporting plan increased proper kidney dialysis from only 46 percent among whites and 36 percent among blacks to roughly 85 percent among all comers. In fact, these kinds of race- and class-blind interventions are arguably the only ones proven to reduce disparities on a meaningful scale.

Of course, compassionate and individualized care is important. But to some extent, these programs undercut the notion that minorities just need special kinds of communication or culturally sensitive care to bridge the treatment gap. Public reporting and universal standards succeed by doing just the opposite: by making doctors treat minorities just like everybody else.