This chapter considers disparities in the quality of healthcare Black patients and White patients receive. One major cause of these disparities is that healthcare in the United States is basically a privately financed system. This makes access to necessary healthcare more difficult for Black Americans, because they are, on average, economically disadvantaged. Another factor is that American healthcare is still largely separate and unequal. Black patients are often treated at lower-quality medical facilities. Even within the same facilities, they frequently receive poorer care. Systemic racism within medicine also creates practice that contributes to racial healthcare disparities. One example of this is the widespread use of flawed diagnostic algorithms that reflect racist myths about the bodies of Black people; another is algorithms that systematically underestimate the health needs of Black patients. In addition, unique educational and financial challenges to entering medical professions faced by Black people and hostile institutional and professional climates that discourage Black trainees and practitioners have created serious shortages of Black healthcare professionals. This has numerous negative consequences for Black patients. Thus, racial healthcare inequities reflect both the nature of contemporary political, economic, and social structures in the United States and practices within medicine that seriously disadvantage Black patients.