Society's choice: the tradeoff between efficacy and equity and the lives at stake

Abstract

Society understands that racial and ethnic minorities experience inferior medical care and health status, but may not appreciate the seriousness of the problem. Each year the nation spends billions of dollars to perfect the "technology" of health care (e.g., development of new drugs) and modernize delivery systems, thereby saving thousands of lives. Correcting disparities in care, however, would avert five times as many deaths. If policymakers adhered to the goal of optimizing population health, greater priority would go to resolving disparities than to refining technology, but reverse priorities prevail. Adverse socioeconomic conditions-chief among the many causes of disparities-could be eased through bold socioeconomic reforms. Society has the resources to enable the disadvantaged to attain better health but pursues other priorities.