Race preferences in health care are here

(AP Photo/Eraldo Peres)

A new report–essentially a whistleblower report–has revealed that racial “equity” determines who gets what surgery and when in New Zealand. People with the right genes go to the head of the line.

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The practice began in 2020 but wasn’t revealed until a news radio station revealed the fact in what has now become a bombshell story in the country.

The health care system in New Zealand is primarily public, although reforms have been made over the years to allow people to buy private insurance because rationing has made wait times unacceptably long.

Go figure. Who would have thought that a government-run healthcare system would leave people dissatisfied? Governments are known for their efficiency, after all.

Because of those long wait times, those people who depend upon the government-run hospital system are put on a list and a ranking system is used to determine who gets what care and how quickly. Lots of factors are involved, of course, but it turns out that one of those factors is racial equity.

WELLINGTON, New Zealand — New Zealanders this week were debating a thorny health care issue — whether ethnicity should be a factor in determining when patients get surgery.

It turns out that in some parts of Auckland, the country’s largest city at 1.4 million people, clinicians have been using an algorithm to adjust where patients sit on elective surgery waitlists. Clinical need remains the top factor, but the algorithm also takes into account how long patients have been on the waitlist, where they live, their financial circumstances, and their ethnicity.

Indigenous Māori and Pacific Island patients are given a higher priority on the list, pushing down white New Zealanders and other ethnicities. The idea is to balance out longstanding inequities in the publicly funded health system.

“At the moment, there is clear evidence Māori, Pacific, rural and low-income communities have been discriminated against by the health system,” Prime Minister Chris Hipkins told reporters.

The algorithm has been used in Auckland since February and similar policies have been in place there since 2020. But most people weren’t aware of the algorithm until Monday, when radio station Newstalk ZB reported on it, saying some surgeons were ethically opposed to using ethnicity as a factor.

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It seems quite plausible to me that there have been racial disparities in health care in New Zealand–there have been pretty much everywhere–and that at least some of those disparities have been the result of racial bias. I suspect that as large a factor is the population distribution geographically since the racial diversity of the population is hardly equally distributed by location.

But at least some of it was, indeed, motivated by conscious or unconscious racial bias. To the extent that this has been the case, the biases should be rooted out and eliminated.

But the way to eliminate racial bias is not to implement…racial bias. Which is exactly what is happening here. Since New Zealand’s health care system has been government-run since 1938, I think it is safe to say that if such racial bias existed then it was government employees who are responsible.

Yet it is not the government that is accepting responsibility for and compensating victims of discrimination. Instead, the government is now choosing to discriminate against yet another class of people who have done absolutely nothing wrong except need health care today.

It’s almost as if the government thinks of itself as the distributor of spoils, and not as public servants serving citizens.

Hmmm. Maybe not almost. That is absolutely what the people in power think. They get to make arbitrary choices and then require others to pick up the tab.

New Zealand isn’t the only place where this is happening. Here in the United States, the COVID vaccine was distributed around the country based upon a number of variables, one of which was “equity.” There were people at higher risk of catching and dying from COVID who had to wait in line before others deemed in need of “equity” in health care got their shots.

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This is becoming an increasingly common practice, and given the fact that in New Zealand they were able to hide this practice for over 2 years, it is quite likely that there are lots of other places where this happens and nobody has heard of it.

It shouldn’t take a whistleblower to reveal uncomfortable facts about how our public services are distributed. If the government is creating priority lists, citizens should have the right to know exactly how those priorities are developed and ranked.

The racism involved is not the only, or even the most significant problem here. It is the fact that government elites are empowered to distribute goods and services in a manner kept secret from the public.

The lack of accountability is even more corrosive to society than the practices themselves, however serious they are. It absolutely destroys social trust and undermines the very foundation of democracies.

Handing over what amounts to plenary power to pick and choose who gets what politicizes every single decision made in society. This is what tyrannies do, and how tyrants stay in power. Putin is able to rule Russia with an iron fist because he controls the pursestrings for everybody. The oligarchs aren’t in competition with him for power, nor are any other politicians. Everybody is dependent upon his authority for their position.

That is how tyranny persists. Tie everybody’s interests to the people in power.

That isn’t equity. It’s arbitrary.

 

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