This view, however, squarely contradicts what the vast majority of research studies have found for decades – that some patients, most notably African Americans, Latinos, those who don't speak English well, and in some cases, women – receive a lower quality of health care than their counterparts, even when they have similar health insurance and are treated for the same health conditions in the same hospitals. This applies across the gamut of health care, ranging from basic services such as screening and immunization, to primary care, to more expensive, high-tech, specialty procedures.
These are the conclusions of literally hundreds of studies published in peer-reviewed journals over the last two decades. And while a few studies, such as the Asch study, find that disparities are diminishing or that all groups receive equal (albeit poor) treatment, their findings must be considered relative to the massive volume of evidence to the contrary. Even the U.S. Department of Health and Human Services' National Healthcare Disparities Report, released in January and which represents the most comprehensive survey of its kind, finds that, despite some areas of improvement, racial and ethnic healthcare disparities persist, and are worsening in some areas. For example, the NHDR found that Latino patients with diabetes are receiving poorer quality care today than they were even a few years ago.
Smedely doesn't discuss where the research disparity comes from, but clearly there's something to think about here. Asch's study may very well be abberration, but the bottom line is that quality of care is poor, and everything else tells us it's even worse for the actual poor. Also, remember again that Asch's study only looked at what happens after patients get to the hopsital -- it says nothing about those who can't afford care.