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"Startling research from the biggest study ever of U.S. health care quality suggests that Americans - rich, poor, black, white - get roughly equal treatment, but it's woefully mediocre for all. "This study shows that health care has equal-opportunity defects," said Dr. Donald Berwick, who runs the nonprofit Institute for Healthcare Improvement in Cambridge, Mass.

The survey of nearly 7,000 patients, reported Thursday in the New England Journal of Medicine, considered only urban-area dwellers who sought treatment, but it still challenged some stereotypes: These blacks and Hispanics actually got slightly better medical treatment than whites.

While the researchers acknowledged separate evidence that minorities fare worse in some areas of expensive care and suffer more from some conditions than whites, their study found that once in treatment, minorities' overall care appears similar to that of whites. "It doesn't matter who you are. It doesn't matter whether you're rich or poor, white or black, insured or uninsured," said chief author Dr. Steven Asch, at the Rand Health research institute, in Santa Monica, Calif. "We all get equally mediocre care."