Race-Based Medical Selection Criteria in Identitarian Medicine

Discussion

Aaron Sibarium:

"In late 2021—it seems like so long ago—there was the Omicron variant of the coronavirus, which at that point was by far and away the most transmissible variant that had evolved. And it was also uniquely resistant to vaccine-induced immunity. A lot of people in the winter of 2021/2022 were suddenly sick with COVID. And so states needed a way to allocate these new drugs called monoclonal antibodies. And there was also something called Paxlovid, which is an antiviral produced by Pfizer. These were very new drugs that, if you develop COVID, helped to alleviate the symptoms. If you're high risk, if you have diabetes or you're overweight or you have some lung issue, that's who you would expect would be prioritized for these drugs, which were very new. There weren't that many doses of them.

But what these states did was they came up with these numerical scoring systems that gave points to people who had diabetes or obesity or things like that, but they also gave points based on race. It literally was that anyone who was not white pretty much automatically got something like two extra points, which was the same weight as what was given to conditions like hypertension or diabetes.

The rationale of course was this kind of utilitarianism where people said, well, on average people of color suffer more adverse outcomes from COVID. So if we prioritize people of color, we're more likely to do more good with the limited resources that we have. The problem with that reasoning is that first of all, the bar for any kind of racially discriminatory policy in the United States is really, really high. It has to satisfy something called strict scrutiny, which in practice, none of these systems came close to satisfying. It's a very high evidentiary burden. You have to show that there is literally no other way basically to achieve the goal other than racial discrimination, which they did not have strong enough statistical evidence to show. But the other thing is that even if it's the case that, on average, people of color do suffer adverse outcomes from COVID at higher rates than white people, the question is why? And some of the reason is that people of color are just more likely to have the other conditions that went into the scoring criteria, like obesity and diabetes, in which case if you just include those conditions, you in theory will still end up disproportionately helping people of color.

The other reason I suspect you saw racial disparities is, and I don't have proof of this, but based on my own anecdotal experience seeing people of different class backgrounds navigate the medical system, including within my own family, I think that, especially if you come from maybe a more working-class background and are just not as used to the norms of medicine and doctors offices, you often don't seek treatment as aggressively. My suspicion is that the reason you were seeing some of these disparities by race is really that maybe African-Americans and Hispanics tended to be more working class. So it was not a solution, I think, that was even very well-tailored to the real problem. But in any case, the state ended up having this just blatantly discriminatory policy. And they backed off of it in most cases after I reported on it and after they received a number of legal threats, which I think just goes to show that they knew it couldn't really be defended and wouldn't hold up in court.

But that was a lot of people who were potentially stymied from getting monoclonal antibodies or Paxlovid as quickly as they might have just based on their race. And in fact, I think one of the ironies is that when I did a follow-up story about Utah's system, one of the arguments that the governor's office actually gave me was, well, we changed the system eventually because we found that it wasn't even working to get the drugs to the people we wanted to get them to. It's like, okay, so you're basically admitting that you artificially made it harder for white people to get the drugs, and it didn't even help black or Hispanic people get the drugs. Like all you did was make life harder for one group of people without helping anyone else. Totally irrational from any kind of policy standpoint."

(https://yaschamounk.substack.com/p/aaron-sibarium-on-identity-politics?)