The ongoing wave of institutional attention to diversity, equity, and inclusion (DEI) is long overdue and profoundly necessary, but it is radically insuffi cient, especially in health care, health-related research, and bioethics. Understanding why DEI in hiring and funding more people of color can leave signifi cant inequities untouched helps move this essential effort beyond virtue signaling. Consider: Some institutions may decide that a few new non-White hires can do all that is needed to improve workplace conditions, serve on all committees, and be spokespeople for their employer—a familiar “Black tax” often imposed on employees of color. And if research funding is made available to a few more investigators of color without requiring more broadly inclusive efforts from all, those new investigators could also be taxed to level the playing fi eld while still competing on a tilt. This would let