“…This research design supports the conclusion that SES factors other than pure financial cost (ie, parental educational level, employment, race and ethnicity, and family structure) play a greater role in levels of insulin pump uptake than cost alone. The authors aptly characterize this finding in the discussion, stating that "disparities may not be strictly owing to monetary concerns" 1 The US literature is lacking in its capacity to separate the association between the cost of devices and family income from other SES variables; although authors have attempted to conduct similar analyses using stratification by insurance type or poverty level, the health care system financing in the US precludes conclusive analyses such as those conducted by Ladd et al 1 However, even with this improved capacity to partially eliminate confounding, the authors were unable to control for what remains a challenging variable to capture and quantify in health care disparities research: implicit bias. Multiple findings within the study suggest the persistence of bias despite financial support (eg, the association between race and ethnicity and insulin pump uptake in Québec); yet, as the authors acknowledge, without explicit data about family preference and/or health care professional biases, they cannot measure its outcome.…”