The questions raised are: why modifying existing federal law (i.e., Title VI) is insufficient or why not adopt a Health Care Anti-Discrimination Law on the federal level? My discussion above should answer the first question. Title VI is hopelessly flawed and minor tinkering will not be sufficient to make it an effective tool. As to the question of why not a new federal law, frankly the answer is political feasibility. From a political perspective, the antagonism to civil rights makes it highly unlikely such an approach will work. Furthermore, the states are major players in the civil rights arena and have an infrastructure on which a new civil rights law could be based.

The discussion of discrimination in health care has been limited. That discussion has centered almost entirely around Title VI of the Civil Rights Act and on assuring access to facilities and providers. In an effective public health policy, appropriate state and federal laws must be available to eliminate discriminatory practices in health care. Thus, the crux of the problem for the legal system: given managed care, the historical inequity in health care, and unthinking discrimination, what is the best way for the legal system to remedy racial discrimination in the health care system?