Posted on February 2, 2022

Race-Based Rationing Is Real — and Dangerous

Shadi Hamid, The Atlantic, January 30, 2022


{snip} During the coronavirus pandemic, the instinct to bring crude generalizations about race to the center of every discussion is seeping into public policies about quite consequential matters. What happens, for instance, when in the name of racial equity, membership in a particular ethnic group can make the difference between getting and not getting potentially lifesaving medical care? {snip}

In a series of articles this month, The Washington Free Beacon’s Aaron Sibarium reported that hospitals in Minnesota, Utah, New York, Illinois, Missouri, and Wisconsin have been using race as a factor in which COVID-19 patients receive scarce monoclonal-antibody treatments first. Last year, SSM Health, a network of 23 hospitals, began using a points system to ration access to Regeneron. The drug would be given to patients only if they netted 20 points or higher. Being “non-White or Hispanic” counted for seven points, while obesity got you only one point—even though, according to the CDC, “obesity may triple the risk of hospitalization due to a COVID-19 infection.” Based on this scoring system, a 40-year-old Hispanic male in perfect health would receive priority over an obese, diabetic 40-year-old white woman with asthma and hypertension.

Meanwhile, Minnesota’s Department of Health used a scoring calculator that counted “BIPOC status” as equivalent to being 65 years and older in its risk assessment. (BIPOC is shorthand for Black, Indigenous, and people of color.) New York did away with a points system entirely; people of color are automatically deemed to be at elevated risk of harm from COVID—and therefore are given higher priority for therapeutics—irrespective of their underlying health conditions. Sibarium’s reporting in the Free Beacon spread to various right-wing media outlets, prompting significant pushback. Under threat of legal action, SSM Health announced on January 14 that it “no longer” uses race criteria. On January 11, Minnesota’s public-health authorities edited out the BIPOC reference, leaving no trace of the previous wording. New York State, however, has not yet altered its guidelines.

The racial disparities in COVID outcomes are a matter of record, but to suggest that race causes these negative outcomes is a classic case of mistaking correlation for causation. This is how facts, despite being true, are misused and weaponized. Rather than race itself, variables that are correlated with race—such as socioeconomic status, health-care access, geography, and higher rates of obesity or diabetes—are what affect a patient’s health. Those who presumably know better, such as the Food and Drug Administration, have contributed to the confusion by highlighting that race—on its own—may place individuals at greater COVID-related risk.

To emphasize race or ethnicity as a determining factor for risk assessment also raises the question of which race. Presumably, not all people of color are the same. Should all nonwhite people—Hispanic, Black, Arab, South Asian, East Asian, Indigenous—be lumped in together as part of some undifferentiated whole? To put a finer point on it, I am nonwhite. Should I be given priority for COVID treatments over a white person who is obese, asthmatic, and diabetic? That I happen to be nonwhite—an accident of birth—defines me in opposition to whiteness, but it says practically nothing about whether I’m at higher risk of hospitalization due to COVID.


{snip} Few are willing to defend policies such as these on the merits, because what exactly would they say? Tellingly, these controversies have received limited coverage from mainstream outlets. Recently, the Associated Press published an article portraying claims of race triage as right-wing propaganda. “Medical experts say the opposition is misleading,” the story declared. {snip}

Asserting that reality is not real simply because it is a Republican talking point is gaslighting. Ideas, even good ones, become destructive when they demand that people prioritize advocacy over truth. {snip}


In theory, woke ideology shouldn’t matter that much, but it will matter in practice, including in ways unanticipated just a few years ago. What public-health officials and hospital administrators have done with race criteria, likely with the best intentions, is only the most striking example of how seemingly symbolic positions become all too tangible. As I write this, standardized testing and entrance exams are being rolled back because of the intriguing notion that doing well on tests is a form of white privilege. Crime rates are rising across the country, yet prominent Democrats either dismiss the problem as “hysteria” or avoid talking about it altogether. Addressing crime and protecting those at risk require police, which in turn require funding and resources that progressive elites—but not actual Democratic voters—propose to divert away from law enforcement.