<P> There is considerable research into inequalities in health care . In some cases these inequalities are caused by income disparities that result in lack of health insurance and other barriers to receiving services . According to the 2009 National Healthcare Disparities Report, uninsured Americans are less likely to receive preventive services in health care . For example, minorities are not regularly screened for colon cancer and the death rate for colon cancer has increased among African Americans and Hispanic people . In other cases, inequalities in health care reflect a systemic bias in the way medical procedures and treatments are prescribed for different ethnic groups . Raj Bhopal writes that the history of racism in science and medicine shows that people and institutions behave according to the ethos of their times . Nancy Krieger wrote that racism underlies unexplained inequities in health care, including treatment for heart disease, renal failure, bladder cancer, and pneumonia . Raj Bhopal writes that these inequalities have been documented in numerous studies . The consistent and repeated findings were that black Americans received less health care than white Americans--particularly when the care involved expensive new technology . One recent study has found that when minority and white patients use the same hospital, they are given the same standard of care . </P> <P> The Food and Drug Administration (FDA) is the primary institution tasked with the safety and effectiveness of human and veterinary drugs . It also is responsible for making sure drug information is accurately and informatively presented to the public . The FDA reviews and approves products and establishes drug labeling, drug standards, and medical device manufacturing standards . It sets performance standards for radiation and ultrasonic equipment . </P> <P> One of the more contentious issues related to drug safety is immunity from prosecution . In 2004, the FDA reversed a federal policy, arguing that FDA premarket approval overrides most claims for damages under state law for medical devices . In 2008 this was confirmed by the Supreme Court in Riegel v. Medtronic . </P> <P> On June 30, 2006, an FDA ruling went into effect extending protection from lawsuits to pharmaceutical manufacturers, even if it was found that they submitted fraudulent clinical trial data to the FDA in their quest for approval . This left consumers who experience serious health consequences from drug use with little recourse . In 2007, the House of Representatives expressed opposition to the FDA ruling, but the Senate took no action . On March 4, 2009, an important U.S. Supreme Court decision was handed down . In Wyeth v. Levine, the court asserted that state - level rights of action could not be pre-empted by federal immunity and could provide "appropriate relief for injured consumers ." In June 2009, under the Public Readiness and Emergency Preparedness Act, Secretary of Health and Human Services Kathleen Sebelius signed an order extending protection to vaccine makers and federal officials from prosecution during a declared health emergency related to the administration of the swine flu vaccine . </P>

Does the us have a national healthcare system