By Jack Butler
Sunday, October 06, 2024
A new study challenges one of the more popular reasons
cited for introducing left-wing ideology into medicine, and it outlines an
agenda for making health care apolitical.
‘A sick society must think much about politics, as a
sick man must think much about his digestion,” C. S. Lewis wrote. “To ignore
the subject may be fatal cowardice for the one as for the other.” In the
national delirium of a presidential election, the maladies of politics impose
themselves on our minds to an even greater degree.
Unfortunately, the current state of the medical field is
not much of an analgesic. In recent years, left-wing ideology has thoroughly
penetrated medicine. But new research undercuts one of the more popular
academic buttresses of this blatant politicization. It’s more than enough to
make one wonder if a movement that bills itself as pro-health might actually be
iatrogenic.
Health care has not been immune from the whole-of-society
effort by the Left to take control of institutions and subordinate them to its
aims. Medical schools, journals, professional societies, continuing-education
courses, and other institutions of the medical field now tilt left, as I documented last year.
Examples abound. The official publication of the American
College of Emergency Physicians recently published a case for DEI in medicine. Harvard’s School of
Public Health is offering a “Settler Colonialism” course. The Cleveland
Clinic is currently being investigated for possible discrimination against white
patients. The important roles academia and the government play in the medical
field make this reality sadly unsurprising.
It still may have been a surprise to some when a related
research paper became fodder for the Supreme Court. In her dissent from the
Supreme Court’s majority opinion that overturned affirmative action last year,
Justice Ketanji Brown Jackson wrote that the practice “saves lives”
(indirectly), citing a 2020 study
to claim that high-risk black newborns are twice as likely to live if they have
a black physician. What the study actually found was that half as many black
newborns died while being treated by a black physician as when treated by a
white physician, while the survival rate was above 99 percent in either
case.
There have been enough questions about this paper to
justify reservations about its reliability. But a new
study by Manhattan Institute fellow (and National Review alumnus)
Robert VerBruggen and Harvard University economist George Borjas should inspire
more. VerBruggen and Borjas argue that the previous study hadn’t sufficiently
accounted for low birth weight. The original paper’s focus on the most common
comorbidities for newborns had left out birth weights below a threshold (1,500
grams) that is strongly associated with infant mortality and below which black
babies more frequently fall. Properly accounting for this, “the influential
estimates of the impact of racial concordance on Black newborn mortality are
substantially weakened and often become both numerically close to zero and
statistically insignificant,” the researchers found. Any remaining correlation
can plausibly be chalked up to the fact that low-birth-weight babies are sent
to specialists, who are more likely to be white doctors, and who are then
associated with higher mortality rates. “Black newborns attended by White
doctors are more likely to have a vulnerability closely linked to mortality,”
as VerBruggen and Borjas put it.
Their findings do more than justify skepticism about the
original research. They should also call into question the uses to which that
research has been put. The original paper casts itself as part of a consensus
that “hospitals and other care organizations” should fight the “stereotyping
and implicit bias” that “contribute to racial and ethnic disparities in health”
by investing “in efforts to reduce such biases and explore their connection to
institutional racism.” Prioritizing a diversified medical field would also
serve this goal, hence Justice Jackson’s interest in the study.
But if an unaccounted variable, not doctors’ race, is
chiefly responsible for the slightly increased rate of infant mortality among
black newborns, these imperatives seem less relevant. “In this case, we took
another look at the data, and we found, I think, a really clear explanation”
for the differences in infant mortality, VerBruggen told me. “And it’s not
something that necessarily has a whole lot of import to the affirmative-action
debate because it’s a matter of health differences as opposed to the race of a
doctor.”
This is not to dismiss the problem of low birth weights
for black newborns, a disparity that VerBruggen and Borjas acknowledge. Indeed,
VerBruggen considers it an “entirely legitimate line of research.” It is,
however, to suggest that addressing these issues through political
transformations in the medical field might not be productive. Health-care
spending in the U.S. may be growing, but resources remain finite; a dollar
spent on more DEI training is one that doesn’t go to a new incubator.
In this light, affirmative action and similar, related
programs now offered by schools that are trying to skirt or openly defy the
Court’s recent decision look, at best, like virtue-signaling. At worst, if the
goal is to provide the best possible care to patients, the de-prioritization of
merit that such programs represent is actively harmful.
The proper response to the Left’s politicization of
medicine is to drive politics as far out of medicine as possible. That will
involve political action. And it will almost certainly set Republicans (who at
this time are the only ones taking this problem seriously) against the Left. But what
may seem like a typical partisan conflict captures something bigger, and
possibly more powerful: a politics of depoliticization.
The Right often faces a disadvantage: A coalition to
reduce the importance and lower the stakes of political life can appear
outmatched by highly motivated individuals and coalitions that want to expand
the scope of politics. But if the practical risks and drawbacks of a left-wing
ideology that is infecting medicine aren’t sufficient motivation, the
heightened rancor that comes with it could rally many to the cause of keeping
politics out of the hospital.
The diagnosis is clear: As Lewis put it, a political
monomania that “was undertaken for the sake of health has become itself a new
and deadly disease.” In this case, we are the patients — and the cure.
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