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Plus ça change, plus c'est la même chose [The More Things Change, the More They Stay the Same].

Reading the study by Haider and colleagues1 in this issue of Medicare Care provoked profound frustration and despair. Frustration because of limited progress towards the Healthy People 2020 goal “to achieve health equity, eliminate disparities, and improve the health of all groups”.2 Despair because of the realization that descriptive scientific work has little ability to change pervasive racial/ethnic healthcare disparities. Fifty years ago, Dr. Martin Luther King was purported to have said “Of all the forms of inequality, injustice in health care is the most shocking and inhuman.”3 Agreed. Critiquing the disturbing work by Todd et al4 as a graduate student opened the Pandora’s box of social injustice in healthcare to which I had been ignorant. The unacceptable truth is that sweeping, widespread change to promote equity in health care in the United States has not occurred. Not with the election of President Obama. Not with the enactment of the Affordable Care Act.