So what about healthcare?
American healthcare is riddled with pernicious racism. In fact, although the Centers for Disease control only recently declared racism to be a public health hazard, systemic racism has been an epidemic as long as modern western medicine has existed. Some examples of it are common knowledge, but many are not.
I gather that most people reading this probably know that Black, native American, and Hispanic Americans have died at twice the rate of white Americans from COVID. I imagine most know that Black maternal mortality - even when accounting for levels of wealth, income, education, and healthcare affordability or insurance status (half of all births in America are covered by Medicaid) - is over three times higher than white maternal mortality.
But did you know that fully half of medical students in 2016 in a survey harbored one or more race-based ideas about Black health? Beliefs like Black people have fewer nerve endings than whites, that they have thicker skin than whites, (thus they feel less pain), and that Black people’s blood coagulates faster than that of whites (thus requiring less medical attention for wounds) are frighteningly common among medical students.
Let me say it again. Almost half of medical students, in America, in 2016, believed in one or more dangerous medical myths about Black people. Not old doctors on their way to retirement but physicians of tomorrow. Not in the year 1916. In 2016.
That’s just those who admit it. I think you’ll have a hell of a difficult time finding a survey of police cadets from the past 5 years that show the kind of racist beliefs our incoming class of physicians appear to demonstrate.
All that has real life consequences. In 2012, a meta analysis of studies over 20 years found that Black patients who have pain are 22% less likely to receive any pain medication than their white counterparts.
In what is becoming a theme for this article, let me say this again. In America. For every 100 white patients with pain that receive pain medication, only 78 Black patients will receive ANY pain medication at all, and that’s before getting into the broad disparity in treatment even among those who are lucky enough to get pain medication.
The 20 year timeline is important, because it covers periods well before the rise of the opioid crisis. But the opioid epidemic is, in and of itself, a glaring example of systemic racism at the intersection of health care and law enforcement. It wasn’t until white people started getting addicted to drugs and dying from overdoses that America recognized drug addiction as a disease, rather than a moral failing. When Black and brown people were dying from drug overdose, they faced jail. But when white people started dying from it, it was all of a sudden a public health emergency, and they needed treatment, not prison.
Yet I do not remember any leftists demanding the medical system be defunded and burned to the ground in protest of how it treated drug addiction for white people vs. Black people in front of our very eyes.
Lest you believe that our medical system’s deep racial bias begins and ends with Black adults, let me disabuse you of that notion now.
Black and Hispanic children have higher instances of chronic illness, including chronic pain and asthma, they often have higher disease activity. Yet, they are chronically prescribed less medication by pediatricians, according to a study from the University of Washington.
Importantly, those disparities hold regardless of insurance status. In fact, some of the worst disparities are noted in the Military Health System, a fully socialized medical care model. The researchers noted (emphasis mine),
Yes, systemic racism in policing is deadly, but can you say it sends over 200 innocent Black people to an early grave every single day?
That's a rhetorical question, because we already have the answer. 241 Black people were shot to death by police in the entire year of 2020. That number in 2019 was 235. This means that the medical system is responsible for as many premature deaths in a single day as all of policing is in a whole year.
So, with the logic of defunding, who really should be defunded here?
Does it matter who pays for healthcare or what kind of healthcare system a country has? Not really. As Dr. Williams said,
The problem with modern medicine is much the same as the problem with modern policing: it’s a much more of a systemic white racism problem than it is a rich-poor problem.
Here’s a hard truth: health disparities that kill people of color, and especially Black people, aren’t only the result of biases limited strictly to the medical system. Systemic racism is intertwined with our culture, politics, media, the way our public schools are funded, the way Black people are followed around in grocery store isles, and both in the way right wingers disenfranchise the Black vote AND in the way white, wealthy NIMBY progressives use zoning laws and "historical character preservation" initiatives to keep out mixed-income, mixed-racial, high-density housing from their neighborhoods.
What do all these things have to do with healthcare disparities?
Providers are not immune from the biases of the broad society in which they live, the media and social media content they consume, and the news they read.
Neither are police officers.
Importantly, those disparities hold regardless of insurance status. In fact, some of the worst disparities are noted in the Military Health System, a fully socialized medical care model. The researchers noted (emphasis mine),
Racial and ethnic disparities are found in asthma care, medication use for ADHD, children’s timely and appropriate receipt of medication, pain management, and quality of primary care. For asthma, the rate of emergency department visits is 3 times higher for minority children than for nonminority children and use of daily anti-inflammatory medication is lower. African American and Hispanic children are more likely to have a potentially avoidable asthma hospitalization. African American and Hispanic children with asthma in the Military Health System are less likely to see a specialist than White children with asthma, even though specialist care for asthma is more likely than primary care to follow recommended guidelines. Minority children have lower likelihood of receiving a diagnosis of ADHD and of receiving any medication for ADHD.Here’s the most important part: proportionally, modern medicine is more deadly to Black and brown people than bullets from police sidearms. Much more deadly. A segment from CBS's 60 Minutes, aired Sunday, April 18, lays out just how deadly modern medicine is for Black people. 220 Black Americans die prematurely everyday due to disparities in health care, according to Harvard researcher Dr. David Williams.
Yes, systemic racism in policing is deadly, but can you say it sends over 200 innocent Black people to an early grave every single day?
That's a rhetorical question, because we already have the answer. 241 Black people were shot to death by police in the entire year of 2020. That number in 2019 was 235. This means that the medical system is responsible for as many premature deaths in a single day as all of policing is in a whole year.
So, with the logic of defunding, who really should be defunded here?
Does it matter who pays for healthcare or what kind of healthcare system a country has? Not really. As Dr. Williams said,
We've done studies in South Africa. There're colleagues doing studies in Australia, studies in the U.K., studies across the world. And we find in all of these contexts, empirically, statistically that experiences of discrimination are directly impacting health.If you haven’t seen Sunday’s segment on health disparities on 60 minutes, the full 13-minute segment is worth a watch:
The problem with modern medicine is much the same as the problem with modern policing: it’s a much more of a systemic white racism problem than it is a rich-poor problem.
Here’s a hard truth: health disparities that kill people of color, and especially Black people, aren’t only the result of biases limited strictly to the medical system. Systemic racism is intertwined with our culture, politics, media, the way our public schools are funded, the way Black people are followed around in grocery store isles, and both in the way right wingers disenfranchise the Black vote AND in the way white, wealthy NIMBY progressives use zoning laws and "historical character preservation" initiatives to keep out mixed-income, mixed-racial, high-density housing from their neighborhoods.
What do all these things have to do with healthcare disparities?
Providers are not immune from the biases of the broad society in which they live, the media and social media content they consume, and the news they read.
Neither are police officers.
And if we believe that physicians can correct their behavior by paying attention to implicit bias training, then so can police officers. If we believe that medical care can change over time through changes in training, tools, and laws, change, then so can policing.
The difference is that so-called progressives and cosplay socialists aren’t going around demanding that the federal government, states, and municipalities defund healthcare because of the systemic bias of healthcare providers, but somehow, we are to believe that defunding policing because of the systemic bias of police officers is the correct solution.
Well, it is not. It’s an easy, cowardly way to duck a tough problem.
Being “against” police, or putting the ‘ACAB’ hashtag (short for “all cops are bastards”) can send a tingle up your leg and an euphoria to your brain like you’ve done something, stood up against a bad system, or at least said something smart and important. You haven’t. All that you say, when you say ‘defund the police’, is that you don’t want to deal with the problem of pervasive, cross-systems, culture-wide systemic racism because it makes your brain hurt.
Addressing systemic racism in policing, like systemic racism in healthcare, education, housing (a big part of which is zoning, not the moronic “cancel rent forever” mantra), will require all of us to take a hard look not just the things we oppose but the things we support. Not just the institutions that make us mad but the institutions we feel good about. Not just the actions and biases of other people but those of our own.
And addressing systemic racism requires the acknowledgment that racism is not a result of some feel good class reductionism theory. It requires recognizing that racism is more deeply rooted and more fundamental in our society than class divisions, and therefore, using class reductionism to try to analyze or solve problems of systemic racism is itself fundamentally racist.
If you can’t do that, at very least, sit the hell down and shut your ever-loving mouth.
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The difference is that so-called progressives and cosplay socialists aren’t going around demanding that the federal government, states, and municipalities defund healthcare because of the systemic bias of healthcare providers, but somehow, we are to believe that defunding policing because of the systemic bias of police officers is the correct solution.
Well, it is not. It’s an easy, cowardly way to duck a tough problem.
Being “against” police, or putting the ‘ACAB’ hashtag (short for “all cops are bastards”) can send a tingle up your leg and an euphoria to your brain like you’ve done something, stood up against a bad system, or at least said something smart and important. You haven’t. All that you say, when you say ‘defund the police’, is that you don’t want to deal with the problem of pervasive, cross-systems, culture-wide systemic racism because it makes your brain hurt.
Addressing systemic racism in policing, like systemic racism in healthcare, education, housing (a big part of which is zoning, not the moronic “cancel rent forever” mantra), will require all of us to take a hard look not just the things we oppose but the things we support. Not just the institutions that make us mad but the institutions we feel good about. Not just the actions and biases of other people but those of our own.
And addressing systemic racism requires the acknowledgment that racism is not a result of some feel good class reductionism theory. It requires recognizing that racism is more deeply rooted and more fundamental in our society than class divisions, and therefore, using class reductionism to try to analyze or solve problems of systemic racism is itself fundamentally racist.
If you can’t do that, at very least, sit the hell down and shut your ever-loving mouth.
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