There is currently an ongoing debate in the USA about whether the US government should expand health coverage to include some groups that have limited access to health care. In the UK, we have had universal health coverage since 1948, when the NHS was introduced. The US health system has some stark disparities between ethnic groups. A recent article from Imperial College published in the Journal of Public Health examined change in the quality of care for people with diabetes over a 10 year period from 1997-2006. We found that although Although ethnic disparities persist in diabetes management, these are starting to be addressed, particularly in the South Asian group. It appears therefore that all ethnic groups have benefited from recent quality improvement initiatives in the UK.