Abstract

This chapter examines the ways race should and should not affect the delivery of health care benefits in a system that is just. To show how race affects the distribution of health care, it highlights disquieting similarities between the infamous Tuskegee study of fifty years ago and contemporary public health efforts directed at reducing HIV infection/AIDS in the African-American community that may detract from the effectiveness of these programs. It argues that a just society’s stability may require resource allocation for the purpose of demonstrating the extent of justice in the system. Furthermore, patients’ trust in their physicians is important to good health care and distrust is a disadvantage in obtaining effective health care. The chapter also proposes a series of remedies. In an illustrative postscript, it considers Michelle Obama’s initiative to reduce the incidence of obesity in U.S. children and contends that, given the history of anti-black racism in America, African Americans still have special reasons to distrust programs that would alter their eating habits and lifestyles.