The Volokh Conspiracy
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N.Y. Rationing COVID Drugs Based on Race
Sick non-Hispanic whites can only get oral antivirals if they have a medical condition or unspecified "other factors that increase their risk for severe illness"; sick "[n]on-white[s]" and "Hispanic[s]" don't face such a requirement.
That's from the N.Y. State Department of Health, Dec. 27, 2021. The full list:
As Glenn Greenwald points out:
That means that a healthy twenty-year-old Asian football player or a 17-year-old African-American marathon runner from a wealthy family will be automatically deemed at heightened risk to develop serious COVID illness—making them instantly eligible for monoclonal treatments upon testing positive and showing symptoms—while a White person of exactly the same age and health condition from an impoverished background would not be automatically eligible.
This policy was first flagged by New York journalist Karol Markowicz, whose Twitter summary described it as "white people need not apply." That summary is not accurate. White people who are sick from COVID can still be eligible for antibody treatment, but only if they first demonstrate that they have "a medical condition that increase[s] their risk for severe illness." But non-white people have the significant advantage of being automatically eligible without having to demonstrate that, since their non-white race is deemed to inherently constitute an increased risk of severe illness or death from COVID-19. In other words, when determining eligibility for life-saving treatments, New York state is explicitly prioritizing some races over others.
For more of Greenwald's detailed analysis, see here. Thanks to Hans Bader (Liberty Unyielding) for the pointer; as he points out, such use of race as a proxy for supposed greater risk—instead of focusing on the more directly relevant factors ("race-neutral alternatives," in doctrinal terms), such as underlying medical conditions, vaccination status, lack of access to good alternative care, or the like—would violate the Equal Protection Clause in this situation.
UPDATE: My UCLA colleague Prof. John Villasenor points out this provision of the New York Constitution:
§11. No person shall be denied the equal protection of the laws of this state or any subdivision thereof. No person shall, because of race, color, creed or religion, be subjected to any discrimination in his or her civil rights by any other person or by any firm, corporation, or institution, or by the state or any agency or subdivision of the state.
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Democrats are racist.
I am shocked, shocked.
Institutionally racist.
Systemically racist.
You were never supposed to notice that the "racist" institutions tend to have been run by the left for a long time.
Certainly the institutionalization of racism has been an aspect of the Democrats across the centuries, yes.
Yawn.
Who could have guessed that a male, White, right-wing blog would attract a string of obsolete misfits expressing their rage and alienation in today's America with claims that the "real racists" are Democrats and other educated, reasoning, accomplished residents of successful, modern, diverse communities?
Who could have guessed that Kirkland would post in favor of overt racial discrimination against a group that he hates? Pretty much everyone would.
Like I said the other day: denying legal / constitutional protections to disfavored persons or classes of persons. The Left knows no other way.
My comments have not addressed the medical treatment issue; my comments relate to the swarm of bigots this White, male, right-wing blog attracts, and to the remarkable lack of self-awareness reflected by the proprietor's choice of subjects.
Carry on, clingers. We'll let you know how far and how long.
With a lot of racists you have to listen to the code words and read between the lines, but when the good Rev. Kirkland gripes about White people doing White things and giving White opinions on White blogs to protect White culture, his comments are refreshingly clear.
"With a lot of racists you have to listen to the code words and read between the lines"
Yeah, I don't think that's actually true. There are a lot of code words and reading between the lines involved in accusing people of racism, but that's not the same thing as real racists using code words.
I've met one or two real racists, and sheesh, code words were nowhere in evidence, they just came out and said it.
You mean to say, "Conservatives Pounce!!"
White? Prof. Volokh is of Jewish descent. If you consider Arabs to be brown, shouldn't your racialist classification consider Jews, genetic cousins of Arabs, to at least be beige?
Constitutionally racist
Fuck this..I'm leaving NY State. This marxist sunk cost logic is ridiculous. We have moved from govt not discriminating or forcing people to discriminate to govt discriminating for retribution, anger, bigotry, and tribalism.
This can't be constitutional in any way???
I especially like the part where "the patient cannot be hospitalized due to sever or critical COVID-19"
WTF?
I think they mean that one of the criteria for administering the drugs is that the patient must not already have severe or critical COVID (presumably because the drugs tend to prevent severe COVID, but not to cure it).
In Maryland, you do not qualify for treatment if you have been admitted to a hospital and placed on oxygen. They assume that you are too far along in order for the treatment to be effective.
Interesting, they told us my wife did not qualify for monoclonal antibodies because she was not sick enough to be admitted to the hospital, even though she has comorbidities.
Nothing like government consistency.
Progressive obsession with racism
I have no doubt that the New York Health department is perfectly well aware that this policy is illegal (not to mention deeply immoral) ... but this is all part of a growing trend toward anarchy: try whatever you can and see if it sticks.
The courts' overly deferential attitude to the executive has led to a wild west attitude among the political class. Nature abhors a vacuum.
Illegal, sure. But not immoral -- the law which makes it illegal is what is immoral. Get woke!
Exactly, this is allowed because the courts have continued to fail to to their job during this pandemic.
I'm a bit disappointed that a court has not already shot this down. No way they have no complaints already filed and this could not be more blatantly illegal without using racial slurs to make it more obvious.
It's probably hard to find someone with standing; you'd need someone who tested positive, is white with no risk factors, could start the treatment within 5 days of symptom onset (including the time it takes the court to rule), and wants the treatment. I guess a court could issue an emergency order, but the case would be void for mootness before a final precedential ruling could be issued, wouldn't it?
Then you also have the Courts not wanting to make a ruling that they can be held accountable for.
I got a big laugh about a lower Court ruling that banning 18 to 20 year olds from being able to purchase handguns violates their Second Amendment Rights. Then another Court rules against the first Court. It goes to the USSC, who refuses to hear the case, not on it's merits, but, because the people who brought the case turned 21 while waiting for it to go through the process.
This is the same question that comes up with affirmative action. When you see substantial racial or ethnic disparities in a particular outcome, what do you do about it? Acting without regard to those categories at all would seem to be ignoring the issue.
Well, one thing you shouldn't do is kill some white people to achieve social equity.
The thing is, the fact that this could be a life or death issue highlights the failure of running this by legal counsel. It's very possible that (1) there's no qualified immunity here, because the law is clearly established and (2) someone could end up on the hook for a wrongful death action or an action from someone with six figure hospital bills if this policy is really enforced.
No matter how one feels about affirmative action and race based preferences, it's a real failure to not vet a policy like this. There's enormous legal exposure here.
Unfortunately, some states (NC being one) have passed blanket immunity for persons providing medical care while COVID emergency orders are in place. There is literally no medical malpractice in NC right now, for practically anything.
What makes you think this wasn't vetted?
"The thing is, the fact that this could be a life or death issue highlights the failure of running this by legal counsel. It's very possible that (1) there's no qualified immunity here, because the law is clearly established and (2) someone could end up on the hook for a wrongful death action or an action from someone with six figure hospital bills if this policy is really enforced."
Presumably the legal counsel told them that they would be indemnified under New York Law:
Well, one thing you shouldn't do is kill some white people to achieve social equity.
How would that work? Why wouldn't White people get oral antivirals based on their particularized medical needs? In cases where White people do not have particularized medical needs, why is it a medical problem if they do not get medicine which presumably will not help them?
Seems like commenters here are misreading this, maybe on purpose. The hazard here does not seem reasonably to include, "White people will be sacrificed."
Black people generally get worse and less frequent medical care than white people generally. That is not in question, I think. It matters here. The ability of anyone, White or Black, to establish that they, "Have a medical condition or other factors that increase their risk for severe illness," will depend in a non-trivial way on the quality and continuity of their medical record, and on their ability to access that record to establish that they meet requirements. In those regards, Whites generally will be systematically advantaged compared to Blacks generally. It does not seem unreasonable to take that into account in the regulations.
“Black people generally worse and less frequent medical care than white people”.
Granting that this is true, the question is why.
Are the majority of America’s doctors racist? Probably not.
Is their lower level of healthcare dictated by government policy like this? Nope.
Maybe the answer is something other than racism. How does quality of healthcare for blacks compare to that of other groups adjusted for income/wealth?
and is it not racist to judge individuals solely based on their skin color? "You are black, therefore you have had crappy health care"; "you are Asian, therefore you have had wonderful health care". You don't know anything about either of these people but the color of their skin, yet you make blanket assumptions about their lives? Why not look instead at the individuals, and what their particular traits might be? I know this type of thinking is not in favor with progressives, but NOT judging people based on race used to be a universally accepted goal.
pt, in my personal conduct individual assessment of the person in front of me has always been my practice. It seems both wise and fair to organize personal interactions around that principle.
Policy decisions are not personal interactions. Policy cannot as a practical matter be tailored to individuals. To assure fairness, polices have to apply alike to everyone. Demands for personal policy tailoring ignore practicality. They generally come from people who oppose the policies, who are trying in some way to make opposition appear virtuous.
"To assure fairness, polices have to apply alike to everyone." Did the fact that you just wrote this even register on your opinion on the matter?
tkamenick, alas for your attempted cleverness, "alike," in this instance refers to comparative assessments among individuals. Policies may differ with regard to classes. Otherwise, no government distinctions could be mobilized on account of race, sex, age, income levels, occupational status, religion, etc.
Of course I also referred to persons who oppose policies like anti-racism. Do you count yourself among those?
" When you see substantial racial or ethnic disparities in a particular outcome, what do you do about it? "
The Volokh Conspirators ignore it, if the context is the astoundingly White, inexplicably male nature of a blog that operates in modern legal academia.
Well, maybe not inexplicably . . .
Not discriminate.
They (liberals / progressives) want government to prevent private (non-governmental) entities from discriminating while having the government itself engage in discrimination.
The way to stop discrimination on the basis of race is to stop discriminating on the basis of race.
Which you can easily do if you have plenary power to dictate national policy, plus a time machine.
You don't understand what "stop" means?
TwelveInch, if "stop," meant anything like it would have to mean to eliminate discrimination based on race, right wingers would oppose it.
Just, "stop," excluding Black applicants from Ivy League schools because they didn't get the educational opportunities to meet admissions requirements? Just, "stop," disproportionately executing Black people, because some state justice systems were long ago structured to attack Blacks disproportionately, and still do?
Sorry, racists. You don't get to build into society a malign institutional racial bias, and with that structure in place and still active, discover that justice requires freezing everything in place.
People who want racism out of society will continue to demand racially tailored remedies to racially tailored problem institutions and racially tailored customs. Justice demands it.
Want to know when that process ought to end? It ought to end when neither you nor I can go into an urban hospital's delivery ward, and accurately divide infants in the nursery into a richer class and a poorer class, just by looking at them.
That day will come a lot quicker if right wingers stop opposing the racially-tailored remedies needed to achieve it. Keep opposing, and expect to live for a long, long time amidst racially-observant advocacy to set things otherwise.
Of course you could hope to find some way to suppress that advocacy by force. Or just to outlaw it as a matter of, "principle." I suppose that would mean you would have to endure anti-racism even longer. Alas, you can't just, "stop," anti-racism. First, you have to just, "stop," racism. It has to be done in that order. The babies in the nursery will tell you when it happens.
Stephen, you're trying to make a point, but fumbling it.
You believe we should stop "excluding Black applicants from Ivy League schools because they didn't get the educational opportunities to meet admissions requirements". If you said, Let's do the hard work of improving education for Black students, you'd be right. But if your proposal is to admit inadequately prepared students to selective colleges, you are setting them up for failure, either in college or thereafter.
You say we should stop "disproportionately executing Black people, because some state justice systems were long ago structured to attack Blacks disproportionately, and still do". Of course we shouldn't execute the innocent or the not-all-that-guilty, of whatever race. If the "long ago" structure that disproportiontely attacks Blacks is still present in a particular jurisdiction, we should do the hard work of identifying that structure and eliminating it. If you set out to do that work, you would find that you had willing indeed enthusiastic allies on the Right. But yelling "Racism, Racism, Racism" is lazy and won't cut the mustard.
Nope, Eric. If I tried what you suggest, or if I tried what you say are my inappropriate methods (and I do not argue that your suggestions would not improve them), it would be all the same. If there were any suggestion that race played any part in the reasoning, rights wingers would do what we see them doing here—argue against anti-racism because they don't like anti-racism.
What you call "anti-racism" is just neo-racism dressed up in new words - which is why you call for explicit discrimination based on race, just like all the other racists in history. Of course decent people will argue against that.
And have you noticed how severely contemptuous you are by removing all agency from blacks?
Q.E.D.
Um, Ivy League schools give massive advantages to black applicants based on these sorts of racial generalizations; they're not being excluded. It's Asian applicants, not blacks, being excluded.
The Ivy Leagues are just leveling the playing field that Asians are skewing by working too hard.
If Asians are so smart why does it take them 50-75 hours of studying a week to excel enough to get into an Ivy League school.
My father-in-law’s was a great case in point, he was a Fulbright scholar and calculus professor, but he wasn’t demonstrably more brilliant than me. So great, he gets a full ride scholarship and gets to meet Eisenhower because he’ll put in 100 hours a week if he needs too. Why should I be penalized for being lazy? I could have done all that if I tried.
And in the meantime we have to constantly impose new "malign institutional racial biases"? How the hell does that ever fix the problem?
David,
The way to stop discrimination on the basis of race is to stop discriminating on the basis of race.
CJ Roberts makes this seem obvious and correct, but it ignores the nature of the problem. If racial disparities were only a matter of current policies, then correcting the policies would fix it. But it should be obvious that this isn't true. For ever Black person that grew up poor that made it into an Ivy league school and became a top neurosurgeon or Supreme Court Justice, how many others didn't overcome the hurdles of poverty and discrimination despite having the same innate potential? How many of their kids will be denied equal opportunities now, because of the fewer resources they have compared to the average white child?
If family wealth and neighborhood resources matter for the likely outcomes of a child's economic future (and by extension, health outcomes), which it obviously does, then simply stopping discrimination now will not correct for that. That seems incontrovertible to me.
Engaging in discrimination makes the problem worse.
And what will address the problem, then? When I see people that only ever shoot down proposals to try and fix a problem, I begin to wonder if they don't want to try and fix it because they like things they way that they are.
If society wants to put its thumb on the scales based on wealth, the efficient way to do that is to put its thumb on the scales based on wealth, not finding something correlated to wealth and using that as a proxy.
For example, if you want to help poor people with their heating bill, base it on income, not race. Otherwise we end up subsidizing Oprah's utility bill.
When I see people that only ever shoot down proposals to try and fix a problem
The proposals in question are not geared toward fixing anything other than the self-imposed guilt of the proposers and/or their need to score virtue signaling points.
If the goal was to give a leg-up to people who come from economically disadvantaged backgrounds you wouldn't use race as the qualifier. You'd use...you know...their economic background.
"If racial disparities were only a matter of current policies, then correcting the policies would fix it."
But "racial disparities", by themselves, are not a thing that needs fixing.
For instance, there's a huge racial disparity in murder rates. There are more murders committed by blacks than whites, despite the fact that there are about 4.8 times as many whites as blacks. The black murder rate is about 5 times higher than the white murder rate.
In theory, we could completely erase this disparity by whites simply going on a murder spree. An extra 12,000 murders a year by whites would accomplish it, by equalizing up white murders.
Would this be considered a good thing? Would the horror of it even be slightly reduced by the disparity vanishing?
Alternatively, if blacks and whites both committed half as many murders each, the racial disparity would not shift in the slightest. Would we not consider blacks to be hugely better off if this happened?
You look for the cause rather than simply assume it? Especially since there are ample studies showing that in nearly every case racism is not the prevailing factor of otherwise disparate outcomes by race.
Perhaps study economics rather than grievance studies?
Not be racist yourself?
Those are just a few ideas.
sparkstable, amazingly, what you call, "grievance studies," may be better predictors of future outcomes than economic studies —it's a very low bar, economics predictions. For instance, we want to know what net worth a child today can expect to enjoy 6 decades hence. You could do an "economic," study, based on the parents' present economic condition. Or you could do a, "grievance," study, based on their race.
Of course we cannot know the future, and much could change. But if we based our prediction on history, and looked back 6 decades to discover information we could prove for the same analysis, which premise regarding the parents' status would you put your money on—an economic analysis or a racial analysis?
An economic one would be vastly superior in your hypothetical. Race wouldn't be able to predict any differences within a race, economics would.
I thought a race-blind initial premise, followed by a race-aware data analysis was the obvious methodological choice. Apologize for that omission, benji. Do you suppose that during the last six decades Whites in America have done better economically, or Blacks?
" Do you suppose that during the last six decades Whites in America have done better economically, or Blacks?"
Black African immigrants to the United States have higher average incomes than native born white Americans.
Brett nails it. The constant assumption of racism being the root and primary cause of all ills befalling one particular "race" group is what keeps racism alive and powerful.
Brett is pretty bright. But, "Brett nails it," rarely applies. This time, as usual, he is changing the subject. You don't, "nail it," by changing the subject.
In either case, Ronnie isn't Brett.
Stephen, absent present discrimination, (Which, if anything, is in favor of blacks.) past discrimination must work through the very factors that you'd look at in your initial race blind analysis. Then proceeding to look at race would be double counting.
" When you see substantial racial or ethnic disparities in a particular outcome, what do you do about it?"
Chalk it up to IQ and move on.
Chalk it up to IQ and move on.
Oh, so you think we should assume that the racists that believed that those groups were inherently inferior were correct to be racist?
You realize that you could treat everybody blindly according to their individual merits, and if individual merits happened to correlate with race, even though every individual were treated with perfect justice, disparities would be present?
There are all sorts of traits that are loosely correlated with race. Height. Fast twitch/slow twitch muscle ratios. So that you'll find that most high performing basketball players are black, for instance. Is this because the sport discriminates against whites?
That IQ doesn't correlate with race isn't science, it's ideology. Reality doesn't care about ideology, or morality, it just goes on being what it is even if it offends people.
Refusing to look at reality doesn't mean reality goes away. It just means that you stupidly attribute what you are willing to see to the wrong cause.
That IQ doesn't correlate with race isn't science, it's ideology. Reality doesn't care about ideology, or morality, it just goes on being what it is even if it offends people.
Three former Boston-area residents with intelligence about as far above the norm as anyone, ever: Larry Bird; Pedro Martinez; Tom Brady. Does that generalization fail to match your own estimates, Brett? Blame it on ideology.
It is not for you, or anyone, to posit a scale of absolute merit which favors some folks, but disadvantages others, according to your tastes about what kinds of people ought to be advantaged. That includes, by the way, your tastes about what personal characteristics you think are socially advantageous, or what traits are economically productive.
Are you a believer in meritocracy, Brett? Can you understand that the notion of meritocracy is destined either to fail quickly, or, if you can keep it going, to devolve into an all-out, no-holds-barred contest to settle the question who gets to define merit?
Anyone trapped in someone else's ideal meritocracy is a fool if he does not undertake the most efficacious violence to overturn it. Leave the idea of meritocracy lying around among folks who are alert to their own chances in life, and you will presently see how often the process delivers extremist results—fascist tyrannies or communist tyrannies, take your pick—but in either case advancing the most meritorious strivers according to customary standards of merit.
Want proof? See how long it takes for someone to show up and explain, "Oh no, the very best anyone can do for himself is submit to the more meritorious class, who will do better for him than he can do for himself."
" Does that generalization fail to match your own estimates, Brett?"
Well, that's just typical stupidity about population genetics. We're talking about the centers of broad distributions not being identical; That tells you absolutely nothing about any given individual, just what you'd tend to find in the statistics of large populations.
Such statistical information is totally useless in any individual case.
But it does undermine the case for statistical disparities being proof of discrimination, which is why it's so important to some people that the notion be inadmissible.
Brett, how do you propose to make useful the racial statistical information you prefer in policy cases?
Outside of a few medical issues, such as Tay-Sachs being much more common in ethnic Jews, or sickle cell anemia in blacks, racial information is basically just an otherwise useless temptation to behave in a racist manner. What I propose is that we ignore it entirely in almost all contexts, much as we do eye color or whether you're a red head, and just treat people according to their individual merits.
The only reason I responded to Jason is that there IS some slight evidence that IQ is correlated to race, and even though it tells you absolutely nothing about any person you might happen to meet, it ruins any case for treating statistical racial disparities in outcomes as proof of racial discrimination. In many contexts, the only way you wouldn't see racial disparities in your statistics is if you were implementing a racial quota.
Prior to gene sequencing being practical, race may have been the best you could do as a proxy correlated with the underlying genetics.
I'm not sure how far along sequencing has come, but that is the direction we want to go, for two reasons:
1)I read recently the claim that there is more genetic diversity south of the Sahara than in the rest of the world combined. This is because humans evolved for a long time in Africa, and the rest of the world was populated relatively recently by relatively small groups. That would mean that stopping your inquiry at 'Black' necessarily lumps way to much diversity together; you want to me dealing with the actual underlying genes that are affecting kidney function or whatever.
2)At the same time, people are stirring the genetic pot by intermarriage. Is a Norwegian-African-American black or white for medical purposes? What if they are 7/8 white and 1/8 black, but do happen to have the medically significant gene Z? Or are 7/8 black and 1/8 white, but don't have gene Z?
In short, outside of perhaps skin cancer, where skin color may actually directly affect risks, we should be trying to treat people according to their individual genetics. It may be that for some particular disease we don't understand the underlying genetics well, and race may be the best proxy we currently have. But for the reasons above, we should view that as an unfortunate area of ignorance that should be resolved.
Even in the case of skin cancer, the skin color is a result of their individual genetics, and their sun exposure, of course.
To be clear, even in the case of something like Tay-Sachs, the only thing racial/ethnic information would tell you is whether or not you should bother with a screening test.
Like I said the other day: Liberals / progressives have this misguided idea that the government must spring into action and rectify every wrong. I disagree. So, to answer your question -- absolutely nothing (unless you can show deliberate discrimination by government officials).
So, to answer your question -- absolutely nothing (unless you can show deliberate discrimination by government officials).
We shouldn't do anything about deliberate discrimination by private actors? I don't think that is what you mean. At least, I hope not.
Government doesn't have to "spring into action and rectify every wrong", but it should act when it is in the best position to rectify wrongs. Especially wrongs that were committed by past government action, along with wrongs committed by private individuals with a government wink and nod.
There simply is no question that the racial disparities we see today, especially between whites and Blacks, are due to past government policies. And it is also true that not all of those discriminatory policies have gone away. Simply saying that we should stop discriminating based on race now, will not create a level playing field. The effects of the past discrimination will continue to affect many measurable outcomes for generations to come. There is not even a guarantee that those effects would ever go away without deliberate efforts to correct for them.
How has the 14th Amendment failed to eliminate these policies?
"We shouldn't do anything about deliberate discrimination by private actors?"
"We" includes private actors, who are perfectly entitled to do at least some things about deliberate discrimination. For instance, if I found out a restaurant in my area were racially discriminating, I'd never eat there. I'm entitled to do that, just as somebody else would be entitled to eat there every day for the same reason.
But should the government do anything? No, I don't think so.
Racial discrimination is an issue. When we see it, we should address it by (1) stopping the discrimination, (2) adopting policies that preclude future discrimination, and (2) providing redress to those harmed by the past discrimination. But "substantial racial or ethnic disparities in a particular outcome" is not an issue that anyone needs to do anything about.
I turn on my TV every Sunday and see blacks, who make up approximately 13% of the population, making up about 70% of the starting lineup on NFL teams. There is no issue there to address , because that racial disparity does not result from racial discrimination.
If Al Sharpton got a job as general manager of a team and cut all the white players just for being white, the remedy would be to remove Sharpton, to adopt a clear team policy banning racial discrimination, and to offer the players cut due to their race their jobs back.
Eugene, Not sure that they re using race as a proxy for health issue since they consider historic social inequities as a factor. That is simply too vague to constitute a medical factor. Indeed, it is patently unquantiiable. This is racism, thinly disguised.
" This is racism, thinly disguised. "
And a White, male, right-wing blog is just the vehicle to illuminate it!
Carry on, clingers. So far as your betters permit . . .
Of adults arrested for murder, 51.3 percent were Black or African American, 45.7 percent were White, and 3.0 percent were of other races.
that's (former) Director James Comey's FBI #s for 2020
funny, in the movies seems like there's more Asian Murderers
Stop watching Shaw Brothers movies.
don't know what that is? (should I?) I'm a "Kill Bill" dude
They made classic HK kung fu films. Lots of great stuff, lots of not-so-good stuff.
Run Run Shaws’ movies were part of the inspiration for Kill Bill Part II.
Odd, in the cinema I watch, all the murderers seem to be upper class British men and women, and the mystery is solved over tea and crumpets by posh detectives.
Looks like we need to take some affirmative action and start arresting a lot more honkies and Asians, and keep doing it until we reach "arrest equity." After that, we can work on getting white and Asian convictions up.
Now do murder victims
Well, of course, thanks to population distributions, black murderers mostly kill blacks, and white murderers mostly kill whites. It would take some major statistical analysis to determine if there was any reason to believe there was actual discrimination going on, and I doubt the numbers would be reliable given how many badly controlled confounding variables would be present.
Looking at COVID-19 statistics worldwide, one finds no evidence that would provide a medical basis for such a policy that automatically provides a benefit to an Argentine immigrant but denies the same to a Brazilian immigrant
Wow. White people end up with the short end of the stick because some regulation drafters didn't think it through as well as Glenn Greenwald did. Yay! Victimhood for whites at last!
Now do the next 20,000 or so regulations and let's see how many times it works out to be the other way around. All for innocent reasons from the "we're-not-racist-but--thats-what-the-statistics-show" crowd. But now, because white people might see an obstacle it is a huge problem and "Democrats are the Racists" is proved once again.
Personally I would rather see resource allocation based on whether they were anti-vax/anti-max. Of course that's not going to happen. Last night my wife's son was rejected admission in the ER twice because the beds were all filled with Covid patients.
Why are hospital resources still being allocated to unvaccinated, antisocial, delusional, bigoted jerks?
The unvaccinated and infected should be respectfully encouraged to pray on it a spell, if they wish, but better Americans should not reward belligerent ignorance, bad judgment, and antisocial conduct with a scarce hospital bed.
Umm, you mean Black Peoples?
because we don't deny hospital resources to unvaccinated, antisocial, delusional, Bigoted Jerks,
like yourself,
I didn't mention race, Frank Drackman. I am impressed that you did not use a vile racial slur. And, I would wager, the proprietor is disappointed.
"better Americans should not reward belligerent ignorance, bad judgment, and antisocial conduct with a scarce hospital bed."
We will remember that when a lifetime of your own vices cuts you down. Lung cancer from smoking? No help for you. Obesity related complications? Too bad. Drug OD? Better luck elsewhere.
Fortunately, clingers will become increasingly irrelevant in modern America, thanks to the glorious liberal-libertarian victory in the culture war. Your right-wing opinions are a receding concern among your betters, Kleppe.
the (very Wrong) Rev. Arthur L. Kirland? it'll be Terminal Tertiary Lues (he'll have to google that shit) just like the Tuskegee Airmen had (Man!)
The policy is explicitly racist. That is the problem here.
A simple "if you have co-morbidities you get it first" would benefit black people more than white! Its also totally reasonable thing to do!
It attempts to counteract disparities, which do exist, but fails to ask WHY those disparities exist. Black people get sicker at higher rates because they are more likely to have co morbidity because (insert whatever cockamane theory you want). So a policy targeting co morbidity works. It achieves outcomes without being racist.
AC,
True that would at least have sounded reasonable even if for most of the common co-factors cited, any correlation with serious outcomes of COVID-19 are very weak.
But why a flat-earther, unvaxxed Kyrie Irving should have automatic preference over anyone is beyond me
because he's got more Melanin, what are you? a Trump-ist?
No, but if I were one of his teammates I'd be sore pissed at him because he is costing them lots of cash.
Much better in your mind that he be enslaved to them and their wishes. Got it
Being vaccinated is no more being "enslaved" to them than showing up to practice at the same time as the rest of them is.
Enslaved. Heh. You just lost the room.
Aladdin, you missed something there. Co-morbidities are diagnosed medical conditions. A medical record showing them will correlate with the lifetime continuity of medical care, the quality of lifetime medical care, and the availability of the record to the applicant—at least. And those various factors will each bias the co-morbidities medical record against Blacks.
Why are you inventing a fake issue? This policy is not based on the idea (that has no empirical support, anyway), that black people have undiagnosed conditions.
It is a real issue of course. When you call it fake, you are just expressing a preference that it not be brought into this discussion.
I will leave it to you to justify that preference.
Nieporent, however tacitly, that issue is a major, unavoidable part of the harder-to-analyze generalization that Blacks suffer lower medical expectations, less care, worse outcomes, or whatever. To me, it looks like the most sensible part of a general explanation to justify the policy being discussed here. Not that I think the policy needs much justification, so long as there is no showing that any White people are actually being unreasonably denied medical care that could be reasonably expected to help them.
" Blacks suffer lower medical expectations, less care, worse outcomes, or whatever. "
Let's take this approach. Could you, hypothetically, charge African Americans higher premiums for health insurance, because the "suffer worse outcomes". No other condition needed, just the color of their skin?
Or would that be racist?
Armchair, that would be taking punishment of Blacks pretty far, don't you think? You are suggesting that because they consume less medical care they should pay more for it? To the extent that they pay the same for health insurance as others, Blacks already do pay more per medical visit, more per procedure, etc. You suggest that already-existing inequity should be increased?
Whoa, you have evidence that blacks with the same health plans as other races still pay more per medical visit and more per procedure?!
Please, provide some citations for what you just said. That, or re-adjust your claim to reflect something vaguely like reality.
Take it up with Armchair. It's his looney premise.
That's you, Lathrop. That's you claiming that blacks already pay more while have the same health insurance.
It's not true, of course. That's why you cannot provide evidence of it, and are trying to deflect. It's your loonie premise.
Take it up with Armchair. It's his looney premise.
It was YOUR looney premise, you lying sack of shit.
Explicitly racist; explicitly anti-racist; racially aware: see if you can distinguish them, Aladdin.
Anti-racism is just racism or excuses for why racism is a good thing, so not sure how you'd distinguish racism from racism.
Aladdin, that policy risks excluding, for instance, Covid-infected Blacks with sketchy, incomplete, or low-quality medical records, who nevertheless have co-morbidities they may even be unaware of. Auto-immune conditions would be standout candidates for that.
Your story about your wife's son sounds made up.
benji, speculative invective is one of the lower forms of pseudonym-protected internet clownishness—which puts it pretty low. Try to stay away from it.
You advising anyone on the avoidance of clownishness is like Elizabeth Holmes lecturing on business ethics.
"Now do the next 20,000 or so regulations and let's see how many times it works out to be the other way around"
That white people are expressly given beneficial treatment? I'm going to put the over-under at 0.
Where's the DOJ on this?
Oh, yea, never mind.
This is among those things that will precipitate a revolution.
Disaffected, dispirited, defeated, all-talk right-wingers are among my favorite culture war casualties.
define all the words you just used, Prick.
Get an education, Frank. Start with standard English, focusing on definitions and capitalization. Backwater religious schooling doesn't count.
Somebody didn't proofreed his post again?
Artie, has trouble reading. He has a known, easily identifiable disability
don't know any of them, I'll help you out. "Prick" Prick is a vulgar word for penis as well as a pejorative term used to refer to a despicable or contemptible individual.
make sense now, Prick?
I would advise you to be careful, Frank, because Prof. Volokh has censored people for less than that more than once, but we both know this blog's censorship practices are partisan, and that you are exceedingly unlikely to experience the censorship that liberal-libertarian commenters have repeatedly experienced here.
Perhaps Prof. Volokh could place 'less partisan hypocrisy' and 'less viewpoint-driven censorship' among his resolutions today. I see no reason to believe this blog is incapable of improvement.
Et Tu, Prick?
Just me. I am the only person around here who gets censored, it appears.
Which is within the proprietor's rights. Hypocritical, partisan censorship is not unlawful.
A strikingly White, remarkably male blog seems quite focused on decisions based on race and gender.
It's because of the Tuskegee Airmen! (Man!)
Does this blog generate right-wing bigots, or merely attract them?
That's a subject I do not expect Prof. Volokh to touch . . . he seems to prefer to let it linger, permeating the Volokh Conspiracy.
If the Volokh Conspiracy is going to publish a vile racial slur one more time this year, the Conspirators need to hurry. My current count for 2021 is 15 (different posts featuring the slur; the number of uses of that slur is a multiple of that figure), although I acknowledge I might have missed a couple.
Apparently you fell behind on your quota of drivel for 2021, and are trying to make up for it before the new year. You seem to be so panicked that you’re forgetting to include “clinger” in your screeds.
Sad, 10+ years later and the same tired schtick. Read a book, go for a hike, volunteer your time....serially complaining about a web blog seems kind of pathetic....there has to be better ways to get attention....
If you didn't like pathetic complaining, you wouldn't have spent more than 10 minutes at this blog, clinger. You must love disaffected ankle-biting and hypocritical whining -- at least, when right-wingers are complaining about all of this damned progress and whimpering because strong law schools won't hire more wingnuts.
Why do you drive up their views? Is there really no other blog that offers the racial and viewpoint diversity that you seek? If you don't like the content or people here, why stay?
It's a marketplace of ideas. Leavening this blog's downscale, bigoted, right-wing polemics with a bit of reality-based thought from the liberal-libertarian mainstream seems worthwhile and reasonable.
He's. A. Troll.
Sounds like the Critical Race Theory isn't just in the law schools anymore.
Precisely.
"Critical Race Theory", whatever it originally meant, has now officially expanded to the point of meaninglessness. Just more political bullshit.
The concept of “racial justice” through selective medicine is just another manifestation of a fundamentally racist view of the world. Its racially-conditioned resource availability and it stinks.
Remember, when ObamaCare was first introduced, some Republicans objected to it on the ground that it would entail death panels? Well, imagine a "woke," racially-conditioned death panel. We're getting closer to Nazi Germany day by day...
Another potential example of that is the “unvaccinated people who get sick should be refused treatment” thing that’s running around out there. You don’t want hateful political zealots in charge of healthcare.
So does "Senator" Elizabeth "Poke-a-Hontas"(HT "45") Warren get 1/1,024th Paxlovid?
Just remember that when you have President Trump, Republican majorities in both federal houses, and even blue states start flipping how much fun that "racial reckoning" was for you with all that rioting and anti-fa violence. And don't expect your new rulers to be very kind to you after how you have treated them...
"January 6th"??? wait until January 20th, 2025! (Man!)
Seeing January 6th is pure fiction where nothing of note ever happened, of course the next date for action would be January 20th, 2025 at noon. Personally I hope we get DeSatan or someone who is a little bit more politically savvy this time around....
Forecasts of Republican political dominance -- in an America that has been stomping right-wing preferences for at least 50 years, and whose culture war has been settled in favor of the better Americans who constitute the liberal-libertarian mainstream -- are always a treat.
Who is going to reverse the tide of American progress for clingers? It would take a miracle, and only gullible children believe in miracles.
Are you really (former) President, I mean SOS(literally) Senator Hilary Rodman (HT(The very Wrong) (Rev) Jesse L. Jackson) Clinton??
I mean, it was all over except for the Crying (You, Senator Rodman, and everyone else on the Marxist Stream side) Somehow the Pussy Grabber In Chief won.... But hey, no POTUS has ever been reelected after being voted out.....
" Somehow the P___y Grabber In Chief won "
Prof. Volokh censored me for using that term, so I can not use it here.
But Frank Drackman can.
Why?
Probably because you are a bigoted jerk, that is all.
Prof. Volokh has attempted to explain his censorship a time or two. It didn't go well for him, so he seems to have stopped.
But it is not that difficult to understanding his censorship practices. Maybe it's better that he censors in silence.
If Prof. Volokh were to apologize and admit error, I would have much less occasion and cause to mention this blog's hypocritical, partisan, shabby, viewpoint-driven censorship. Maybe a new beginning for the new year?
Otherwise known as, he posted specific examples of the vile spew at issue, and you attempted no cogent response because none was possible.
Instead, you sit around and endlessly whine at the clouds like the pussy you are.
Say her name.
Something of extreme importance happened that day; it just had nothing to do with the mostly peaceful protesters.
A bunch of worthless people punched their tickets for a jail cell that day.
Not Ashli Babbitt, though.
Probably won't be so funny when it is your turn to sit in some hot jail cell in Florida, or at least you won't think it is that funny then....
I am the one who locks that cell door, clinger.
Pray your betters continue to be relatively gracious in triumph.
You're a Screw? makes sense.
Soon to be screwed....
I'm very skeptical of such a policy but Greenwald is way too quick in assuming he can dismiss it as unjustified on purely a priori considerations.
One could certainly imagine a possible state of affairs in which minorities admitted for COVID tended to have their chronic health impairments diagnosed at such lower rates than white people admitted for COVID that this policy maximized the number of lives saved. I'm quite dubious anything like that situation actually obtains but lets at least acknowledge the possibility and do some digging to verify it one way or another.
so does (Senator) (D) Elizabeth Poke-A-Hontas Warren(HT, "45") get 1/1024th of the life saving medication due to her 1/1024th In-jun heritage?
In other words the information we need isn't the rate of COVID deaths amoung minorities compared to white populations but the difference between the deaths that would be predicted among minorities after controlling for other risk factors and the actual deaths. If there was a sufficiently high excess number of deaths that would justify such a policy (and might even pass strict scrutiny) but it seems unlikely that anyone has done this.
Even, if you dig there is no justification for the "automatic" provision. Kyrie gets no preference. He can afford the best health care. He is just a fool.
Don Nico, I don't even know who Kyrie is, and don't care enough to find out. But can you show that all his life he enjoyed the best health care? That distinction matters. Co-morbidities are not all discoverable right now, in the absence of a comprehensive medical record. Various auto-immune problems, for instance, have inflicted suffering for many years before getting accurate diagnoses. Some diagnoses depend on imaging records of physical transformations which can take decades to disclose themselves.
Ignorance is bliss for some people, I guess.
I think that making the case that American racism has inflicted a disadvantaged life on Mr. Kyrie, or that he is receiving substandard health care today will be a pretty hard case to make. If anyone can make that case, though, it would be you.
Absaroka, did I take some kind of bait without knowing it? Why is anything I said critically dependent on the kind of life Kyrie has had? Policy cannot be made on a tailored-individually-to-each basis. Courts go overboard when they say, "Gotcha, we found an exception where the premises to justify that policy do not apply, which means we get to strike down the policy." That is judicial overreach on stilts.
I mean, that's completely wrong. It's so stupidly wrong that you must have been drunk in anticipation of New Year's Eve when you posted it. Of course it can be, in general, and it must be, in the case of medical treatment. One does not treat a patient by a generalized policy; one treats a patient based on that patient's individual needs.
Nieporent, do you suppose facilities treating patients according to their individual needs are not simultaneously responding to more-general policies? Or do you suppose that those two entirely different kinds of activities—patient treatment, and health-related policy making—must be, or even can be, governed alike? If so, any such supposition will not survive the increased exposure to America's health care system you are likely to experience as you get older.
Kyrie Irving is a multi-millionaire basketball player who has played for many of the most popular basketball franchises in the world including Duke.
If you don't know SL, then you're clueless in the sports world.
He earns more a month than you have likely earned in a lifetime. He is a flat-earther, anti-vaxer and black basketball superstar. He is not allowed to play for the Nets because of NY's covid mandates. But hey, if you can read, find out for yourself
You're trying to make excuses why he should have automatic priority is a pathetic example of bad judgement.
Finally all your blahblah has no bearing on why race or Hispanic ethnicity (whatever that is) should put anyone at the automatic front of the line.
Don Nico, I am clueless about today's basketball. Other sports I know only a bit better. About this time last year, I was wise enough to advise Loki not to bet against Tom Brady's chances in the Super Bowl.
With regard to basketball, somewhere along the line I noticed that I could no longer predict when a foul would be called, except by a presumption that lesser players would be policed more sternly than the stars. That was when I gave up watching basketball, quite a few years ago.
So you hate in basketball what you promote in society, the officials picking the winners and losers, not playing the game fairly. Since you see yourself in the position of commisar, er official, you don't realize that you're turning your exotic ethnic pets into favored stars.
Ronnie, your advocacy is to ditch the rulebook and apply free market principles to refereeing basketball games? Actually, there was some of that going on about the time I quit watching.
SL,
If you think referreeing in any other professional sport is any different than in basketball, you are just self-delusional
Or... follow me here... we don't codify racism.
You are right... there may be racism against blacks and Hispanics in the medical field. We can address that by reducing THAT racism. It is not a solution to just do more, other-direction racism on the back end. While those individuals who were harmed on the front end deserve justice, justice also demands that we not further victimize more innocent people.
This is just "eye for an eye" based on race... pure and simple. Maybe just stop poking people's eyes out?
spakstable, you seem unhappy that anti-racism policies have not been chosen and administered to your tastes. Perhaps you have a point. There has been a lot of carelessness, and a lot of injustice along the way. Why don't you try advocating reform of anti-racism policies, instead of advocating their abolition?
Some policies are simply racist and need to go rather than being "reformed."
So is it your view, benji, that anti-racism needs to go?
Hiw us racial discrimination anti-racist?
First define "anti-racist." If you mean Kendi's definition... I am adamantly anti-anti-racist.
If you mean "against policies that treat different races differently"... then that is exactly why I have a problem with the proposed policy.
You don't stop murder by killing more people. You don't stop illiteracy by refusing to learn to read. You don't cure your hunger by refusing to eat. You don't reduce racism by being racist.
In this thread, Lathrop makes the Orwellian assertion that discrimination based on race is "anti-racism".
Well, that IS what the term means, in practice, just as "wrongthink" doesn't literally mean that what you're thinking is wrong.
Well, that IS what the term means, in practice
Yes, but that's not what those touting "anti-racism" (like Lathrop) pretend that it means.
just as "wrongthink" doesn't literally mean that what you're thinking is wrong
But "wrongthink" does literally mean that what you're thinking is wrong, as in it is contrary to prevailing orthodoxy (as held by the defining group).
"as he points out, such use of race as a proxy for supposed greater risk—instead of focusing on the more directly relevant factors ("race-neutral alternatives," in doctrinal terms), such as underlying medical conditions, vaccination status, lack of access to good alternative care, or the like—would violate the Equal Protection Clause in this situation."
Vaccination status and underlying medical condition appear to be the primary factors used for determining which Tier individuals are placed in. According to the NY Department of Health framework, age and number of risk factors are then used to prioritize individuals within the tiers. The list of risk factors also includes numerous medical conditions, with the race/ethnicity considered as a risk factor.
The analysis in this post (and Greenwalds) does not convey a full understanding of the framework and how race and ethnicity are factored in. Given Greenwald's frequent references to the claims of liberals, it is clear that he is making a political argument, as opposed to a legal one.
I'd also be interested in hearing the argument that access to the Covid antiviral drug is a "civil right," since that is not immediately clear.
But, based on the comments on this post, it looks like Greenwald (and Eugene) have successfully primed their audience to oppose the policy. So the posts did what they were supposed to.
You're being silly. Not being discriminated against on the basis of race is the civil right. It doesn't matter whether it's access to Paxlovid or Mets tickets.
"No state shall make or enforce any law which shall abridge the privileges or immunities of citizens of the United States; nor shall any state deprive any person of life, liberty, or property, without due process of law; nor deny to any person within its jurisdiction the equal protection of the laws."
seems like I read that some where....
You're ignoring the fact that race and ethnicity are considered risk factors in themselves instead of the easily diagnosed/identified risk factors of obesity, age, and substance use/abuse. The fact that those are correlated with certain minorities (not even all) doesn't mean that ethnicity/race is a risk factor for every relevant individual. It's a fallacy of division.
But in fact race and ethnicity are NOT medical risk factors. Stop making believe that they are.
Making the priority "automatic' is not factoring in. It is pre-discrimination, before any balancing tests are made. That is at its heart racism, even though "hispanics" are white.
C'mon (Man)!, it's simple(Man), Senator Poke-a-Hontas-Warren gets 1,024th of the Covid Drug, Barak Hussein get's 1/2!, and Michelle get's the whole pill!!(Man!)
Absolutely right, Nico.
Don Nico, they may not be medical risk factors. They absolutely are medical record risk factors. And reliance on medical records is part of what this policy is about.
No, SL, they are not. Risk factors are judged individually. Period. Oh- yes there are a few counter-examples, such as Tay-Sachs (why aren't Jews also automatically entitled, sickle cell-anemia.
If some groups are too stupid to do what is best for them, is that what you are calling a risk factor?
Wise up.
Don Nico, did you miss that I was not talking about medical risk factors? Maybe if I had put in a hyphen where it could have helped, you would have seen I was talking about differences in the ability to qualify, based on medical[hyphen]record differences.
Do you deny the accuracy of a generalization that Blacks, for instance, will as a class have shorter, sketchier, less complete, and lower-quality medical records than Whites? Blacks will often also have a harder time accessing the medical records they do have. Or do you concede those points, but attribute them to, "too stupid." I hope that is not what you meant, but you said it in a confusing way which leaves that as a possibility.
If access to these specific drugs depends on a medical history which one class can produce with greater ease than another, why is it racial discrimination to formulate a policy which offsets that disadvantage?
Why does any of this matter, unless there is some showing—now apparently lacking—that Whites with needs for this class of drugs cannot get them because Blacks who do not need them are getting them instead?
Why—except for atrocious headline writing—are you joining in with the "White victimization," line being pushed by so many right-wing commenters here?
Yes. For one thing, blacks "as a class" don't have medical records. Blacks as individuals do.
I know you're determined to be argumentative, but the entire point of this policy is who should be prioritized for treatment because there are shortages.
Nieporent, I read it differently. I read it as a policy to mitigate or prevent avoidable shortages, given limited supply, and unlimited potential demand, based on precautionary advance buying by medical facilities, hoarding, etc. I do not think either one of us, or NY either, likely has information to decide which view is more likely to be correct in even a month or two.
The time to get worked up over this policy will come if a developing factual situation can be shown to threaten real damage, and nobody is doing anything to fix it. Absent that, it looks like an efficient and medically reasonable policy. Lord knows, the Covid pandemic has delivered plenty of opportunity for re-adjusted policies to match changing factual situations. No reason why this has to be any different.
I read it as a policy to mitigate or prevent avoidable shortages, given limited supply, and unlimited potential demand, based on precautionary advance buying by medical facilities, hoarding, etc.
Then you're even more of an idiot that anyone previously thought.
I read your bullshit "medical record risk factors" That is nonsense. Risk should be judged on an individual medical record basis and only on physiological or mental health factors. All the rest is the same as your blatant favoritism in sports.
"shorter, sketchier, less complete, and lower-quality medical records"
actually I do not know AND I do not care. I judge a medical risk based on what is IN the record, NOT on what SL imagines is NOT in the record.
Why do I take this position? Because the alternative is the worst kind of unethical medical practice. As for the right wring commenters. I also don't care what they write or say.
I have spent two years professionally on SARS-CoV-2 research and I don't buy the social justice line when it comes to dealing with this disease. I prefer the historic stance of that doctors are supposed to follow. Treat the patient, not what some do-gooder thinks that the patient out to conform to.
No, it isn't. You made that up.
Weird that this is phrased slightly differently than the advisory published on nyc.gov. I'm surprised you went with a source on an unsecured, private website over the official one. The copy New York has says:
"Consider race and ethnicity when assessing an individual’s risk. Impacts of longstanding systemic health and social inequities put Black, Indigenous, and People of Color at increased risk of severe COVID-19 outcomes and death."
Which is slightly, but I think significantly, different. Big difference between "consider this to be a risk" and "consider this when assessing risk." I'm provisionally calling this one fake news.
Don't use reality to stop their roll. They are all on such enjoyable rants about liberal racists and critical race theory.
Like I said (Man!), Poke-A-Hontas get's 1/1024, Barry Hussein get's 1/2, and Juicy Smollett get's Zero, but his Nigerian collaborators get the whole thing!
l2r homie
'Big difference between "consider this to be a risk" and "consider this when assessing risk." '
"Non-white race or Hispanic/Latino ethnicity should be considered a risk factor"
From coronavirus.health.ny.gov.
Yes, but that document is about prioritization, not eligibility, and treats ethnicity as equal to other major risk factors. That's a very much debatable, but much more reasonable, proposition.
As does the PDF document linked in the OP.
In any event, let me ask directly: are you suggesting that the PDF linked in the OP is a forgery?
"treats ethnicity as equal to other major risk factors"
despite the fact that there is NO scientific evidence to that statement.
Any quotes of raw US statistics are not scientific evidence as they have not been adjusted for other more dominant medical factors. That has to be done before any claim of disparate impact.
If one ethnicity has greater risk of fatality because it has a far smaller percentage of vaccinated members, where are the folks crying that anti-vaxers should not get treated on the government's dime.
Yeah, but this document from the New York Department of Health, titled "Prioritization of Anti-SARS-CoV-2 Monoclonal Antibodies and Oral Antivirals for the Treatment of COVID-19 During Times of Resource Limitations", says: "Non-white race or Hispanic/Latino ethnicity should be considered a risk factor, as longstanding systemic health and social inequities have contributed to an increased risk of severe illness and death from COVID-19"
It says it "should be considered a risk factor", not to merely "consider this when assessing risk".
https://coronavirus.health.ny.gov/system/files/documents/2021/12/prioritization_of_mabs_during_resource_shortages_20211223_1000_0.pdf
Eh, someone already linked this. No edit button, no delete button... whatever.
It is slightly different, but just as incorrect with respect to making race a risk factor.
Just like Brazilians, Argentinians should have to make an individual case.
Risk is assessed when looking at a medical case file. One should be able to make a fair decision without ever-seeing what a person looks like.
But let's pull on the disparate impact thread, based on fatality statistics, men have more see a clear disparate impact from COVID-19 than women, do men get special privilege. and if not, why not?
Whenever I see these attempts by government to draw lines based on race or ethnicity, I wonder how that actually gets enforced in practice. Do you just take the word of the person that he's really Hispanic, or can the government official say something like "well you don't look all that Hispanic to me." And if it's not just self-identification, then how does one prove that one is Hispanic or a member of any other ethnic group?
The policy being discussed is from New York state. You are referring to the similar policy from New York City. As Absaroka has pointed out the New York policy is accurately quoted.
"The copy New York has" is incorrect. The phrase you quote is in a memo from New York City, not New York. There is a significant difference between the two.
Meant for Drewski, of course.
From the Department of Insignificant but Still Embarrassing Quibbles:
RE: "That means that a healthy twenty-year-old Asian football player or a 17-year-old African-American marathon runner from a wealthy family will be automatically deemed at heightened risk to develop serious COVID illness—making them instantly eligible for monoclonal treatments upon testing positive and showing symptoms"
No it doesn't. The directive refers to ORAL treatments. Monoclonal antibodies are not oral treatment. Monoclonal antibodies are usually infused directly into a vein; a few monoclonal antibodies retain some of their potency if you inject them into a muscle or under the skin, but if you eat monoclonal antibodies, your digestive system will digest them like any other protein, and they won't do anything at all for you.
The document "Prioritization of Anti-SARS-CoV-2 Monoclonal Antibodies and Oral Antivirals for the Treatment of COVID-19 During Times of Resource Limitations" has that racial provision, so it seems to apply to both.
if this is indeed racism, then whites are free to get vaccinated which will further reduce dependency on a racist medical system.
I know you think you are witty and cunning, but this is like telling black people the best way to avoid jail is to not commit crimes. I have a feeling that you might have an issue if that were given out as common sense advice....
we do tell black people that. we tell everybody exactly that.
oh, and i forgot a really important detail. the feds paused distribution of mAB (at least one mAB line, possibly more) because mAB appears ineffective for omicron. so still the point remains, you don't want to deal with the racist medical institutions, get vaccinated.
https://www.biopharmadive.com/news/covid-antibody-pause-distribution-omicron-lilly-regeneron/616555/
And did it at a time when Delta was still dominant, which probably killed a fair number of people.
"No speaka inglesa" should do it, along with a "How dare you assume I'm white, gringa!"
RACE DISCRIMINATION
N.Y. Rationing COVID Drugs Based on Race
Sick non-Hispanic whites can only get oral antivirals if they have a medical condition or unspecified "other factors that increase their risk for severe illness"; sick "[n]on-white[s]" and "Hispanic[s]" don't face such a requirement.
EUGENE VOLOKH | 12.31.2021 11:08 AM
That's from the N.Y. State Department of Health, . . .
Study that headline treatment. I think EV must have someone from REASON filling in for the holidays. I refuse to believe EV himself put together that stack of tendentious crap.
Parts of it are simply untrue. First, "ration," may not be the right word. It will only apply accurately if Whites with medical conditions suiting them for the described drugs get turned away. There is no showing that has happened.
Second, to the extent that NY proposes to allocate COVID drugs under those terms, it is doing so on the basis of medical conditions, not race. If you want to be forthright, you say that. You can then go on to add, forthrightly, that a policy has been created in favor of Blacks and Hispanics qualifying, so that a presumption substitutes for proof that relevant medical conditions apply to them particularly. You could then complain with intellectual honesty, if you thought that presumption was unwarranted, and have a debate with others who might insist it was warranted.
To run the whole thing under the red meat (and red color) banner, "RACE DISCRIMINATION," of course leaves nothing to talk about. It is an intellectual disgrace.
To publish that outlandish summary, and then conclude it with, "That's from the N.Y. State Department of Health," is simply false. Not a syllable of that summary was from New York. It was all made up by the headline writer.
This blog has been casting its headlines more and more in the direction of tendentious summaries of vulgar right-wing prejudices. Effects of that practice increasingly degrade the comments section. It is a shame to see it. Professor Volokh, do you suppose you add to the luster of your academic reputation by sponsoring material on the level of that headline treatment?
First, it's being "rationed" in that there's a limited supply and only those with certain conditions are being allowed to have it. If we had more, then presumably almost everyone with Covid could get it. The document says "Supplies of oral antivirals will be extremely limited initially".
Second, you can't say "not race" when it explicitly looks at race. It also looks at medical conditions, yes, but it *is* racial discrimination, in that otherwise identical people of different races will have different outcomes dictated by government.
I don't see what your issue is with the summary:
If your beef is just that those aren't all exact words of NYS DOH, I'll point out that there are quotation marks that indicate which parts of that are directly quoted from NYS DOH and which aren't. It doesn't appear to be misleading in any way; that appears to be an accurate summary. And it's immediately followed by a link to the full text and a screenshot of the text in case you don't want to click the link.
Davy C, I have mostly said what I needed to say.
One additional point of explanation is hiding in plain sight. Given the context, when it says, "Sick non-Hispanic whites can only get oral antivirals if they have a medical condition or unspecified "other factors that increase their risk for severe illness," the wording implies that limiting supply to people with a medical need is racially discriminatory—while describing a standard which is a legitimate medical standard. A medical standard for administration of anti-virals is not racially discriminatory, not even a little.
The problem is found in, "can only get," which implies arbitrary exclusion of some, and in adding, "unspecified" in front of, "other factors." New York did not say, "can only get," or that its other factors were, "unspecified," at least not in the text quoted in the OP. And it did link to the other standards.
Assuming supply sufficient to allow the medical standards to be followed, no one, White or otherwise, will be arbitrarily excluded. To achieve that, apparently many who do not show medical need for the drugs will be excluded. That is a reasonable policy.
But the policy is further made to look arbitrary by putting it under false subheads, saying, "RACE DISCRIMINATION," and more outrageously, "N.Y. Rationing COVID Drugs Based on Race," followed below by, "That's from the N.Y. State Department of Health," where the vague antecedent turns the mis-worded summary into an apparent confession. All this when there has been no showing that anyone with a legitimate medical need has been turned away, or will be.
To be forthright, we can imagine a future situation in which some Blacks or Hispanics without medical necessity got drugs at the expense of Whites who did have medical necessity, but could not get drugs because of shortages. That is all speculative. None of it is happening, as far the claims made here can show. Obviously, if such a situation arose, a policy correction could fix it.
If you can't see how misleading that presentation has been, I suggest you check the comments, to see how many people it misled. The comments section is a parade of hostile comments premised on a notion that there has been a confession of race discrimination with potentially deadly implications for White people.
This is as gaslighting as the Trumpkins' claims that nothing happened on January 6. The policy literally says exactly what you claim it doesn't say.
Nieporent, the policy literally says something—but not what the OP headlines implied it did—which is my objection. I think you were able to read as well as anyone my more-detailed discussion—in which I acknowledged some equivocal, (but not-very equivocal) points with the policy.
But recently you seem to have fallen in love with the term, "gaslighting," which may be why you didn't acknowledge that part of my discussion. So give, "gaslighting," another workout if it pleases you. After you get bored with it, and get it out of your system, maybe you won't feel the need to be so tendentious.
" a policy has been created in favor of Blacks and Hispanics qualifying, so that a presumption substitutes for proof that relevant medical conditions apply to them particularly."
SL,
If you cannot see that unethical medical practice, you're willfully blind.
If you don't understand how such positions drive working class whites into the Trump camp, you're politically ignorant.
If you can't stand reading this blog, read something else.
"My UCLA colleague Prof. John Villasenor points out this provision of the New York Constitution"
It was in relation to the New York Constitution that George Washington Plunkitt delivered himself of one of his most famous lines (at the end of the following paragraph):
"When the people elected Tammany, they knew just what they were doin'. We didn't put up any false pretenses. We didn't go in for humbug civil service and all that rot. We stood as we have always stood, for reward—in' the men that won the victory. They call that the spoils system. All right; Tammany is for the spoils system, and when we go in we fire every anti-Tammany man from office that can be fired under the law. It's an elastic sort of law and you can bet it will be stretched to the limit Of course the Republican State Civil Service Board will stand in the way of our local Civil Service Commission all it can; but say!—suppose we carry the State sometime, won't we fire the upstate Board all right? Or we'll make it work in harmony with the local board, and that means that Tammany will get everything in sight. I know that the civil service humbug is stuck into the constitution, too, but, as Tim Campbell said: "What's the constitution among friends?"'
https://www.gutenberg.org/files/2810/2810-h/2810-h.htm
It looks like Critical race theory, which is supposedly a right wing bogey man, is now enshrined in government policy. Gee, who would have thought that the AMA would sign onto something like that . . . .
The trouble with your argument ("It looks like critical race theory") is that the assumption on which it is based are true, many times measured, confirmed, re-confirmed, and well-known: Black patients in USA tend to get worse outcomes from most medical crises than White patients, whether the crisis is cancer, flu, diabetes, injury, childbirth, or COVID. The statistics are pretty much undeniable.
I agree that it would be better "optics" to base the policy on some more direct criterion rather than on race (low income, poor nutrition, bad health insurance, etc.), but the result would be the same.
No, the result wouldn't be the same. That statistically a disproportionate share of the prioritized patients would still be black is true. But that would be based on merit (or in this case need), rather than race. As a result, black patients who did not have special need would not be prioritized over white patients who did.
But even if race were such a close proxy for need such that the exact same individuals got priority, it's still not "the same" to decide based on race instead of need. Process matters, not merely outcomes. If I decide I'm only going to hire family members to work at my firm, there aren't going to be any blacks working there. But that doesn't mean that this policy is "the same" as a policy of automatically rejecting black job applicants.
As a result, black patients who did not have special need would not be prioritized over white patients who did.
Keep speculating. If the exigencies of medical supply ever appear likely to deliver that outcome, that will be time to move to a less-convenient but more-exacting policy. Let's see if it happens.
That. Is. What. The. Policy. Is.
Nieporent, responding on the basis of my previous career as a typographer, I am of course impressed with your no-doubt-costly expenditure on extra upper case, and superfluous periods. But I must counsel that your treatment makes your argument even more disjointed visually than it is logically.
Of course the intent of the policy is to reduce likelihood that the result you complain about will happen. If the policy works, great. If not, the policy will undoubtedly need revision.
My point has been that that provides very thin grounds indeed for legitimate complaint. It provides zero legitimate grounds for a typographical deception designed to promote belief that the policy has already failed when it has not, and that the (spurious) failure gratuitously put the lives of White people at risk for racist reasons.
Wow,
Based on your previous career as editing a neighborhood newspaper, blah, blah, blah.
Does "immigration status" factor in at all?
Is it possible that an individual of a certain
ethnicity who is residing in this country
illegally could obtain treatment priority ahead of
an American citizen of Caucasian descent?
Eugene,
Can we get a post on other examples of race-based rationing of medical care? How about kidney transplants? Perhaps do a post on how black patients with exactly the same lab numbers and other factors as white patients will be placed lower on the priority list for a kidney transplant because the tool used to calculate the severity kidney disease (GFR) just puts a fudge factor in based on race so that the GFR is higher (better) for black people with kidney dysfunction that white people with kidney dysfunction.
This is a nationwide problem and has been going on for decades. It contributes to black patients spending an average of four months longer on the kidney transplant list which, of course, leads to worse outcomes (whether because they die on the list or do worse once they get the transplant because their health deteriorated while waiting).
Here's a quick link to get you started: https://www.npr.org/sections/health-shots/2020/12/28/949408943/is-it-time-for-a-race-reckoning-in-kidney-medicine
It's absolutely unconscionable.
But I guess this sort of thing is just dog bites man, huh?
Or is Arthur right and the problem is that it doesn't feed the majority of commenters the same way?
NOVA,
You raise an interesting and legitimate question.
I read the NPR report and while I greatly respect the medical competence of the Mass Brigham Physicians, the quoted study fall short in i very significant way. BUT it does argue that more needs to be examoned in detail.
One has to have a double blind trial that compares the raw GFR, the "corrected" GFR and the gold-standard assessment method. That would show whether the "correction" is accurate, honest, racist or unnecessary.
I agree with you that the results of the study that was done, makes it scandalous that a rigorous scientific study is not done.
And I should update, the powers-that-be in the medical community responsible for setting these standards has responded to criticism and commissioned a rigorous review to come up with a new standard for estimated GFR (and I should have said, the standard used is a calculation of eGRF rather than GFR which is an actual number difficult to determine for each patient).
In other words, you are exactly right, Don Nico, and the medical establishment agrees. The old eGRF was not based on rigorous science.
A point that should be made: race is a social construct, not a rigorous scientific/medical category. The old eGFR, among other problems, also presumed to use "race" as a proxy for underlying genetic factors which may be correlated to race. I don't have the link now, but I read an article in which a patient had a "white" parent and a "black" parent. Based on phenotype and US cultural norms (and I think maybe his own socio-cultural identification), his physician classified him as "black" and, so, had a higher estimated eGFR and, consequently, a lower priority on the transplant list. But, it seems to me, skin color and cultural affiliation has pretty much nothing to do with the presumed genetic factors which, it was assumed, affected GFR of different "races" differently.
It's outrageous. What's also outrageous is it took something like 20 years for the medical community to become sufficiently uncomfortable with the facts that black patients are more likely to die of kidney disease, that they have to wait longer for transplants, and the eGFR makes assumptions about muscle mass and other factors presumably associated with race which potentially influence GFR which result in black patients being classified as lower priority.
It seems to me, given the history of this country (at minimum), if you are going to introduce a fudge factor to calculate estimated level of severity of a disease (whether kidney or hypertensive or others too) that disadvantages black patients, you should have extremely solid, irrefutable evidence and reasoning. Otherwise, better to err in possibly giving an "unfair" advantage to black patients by treating them equally with white patients. I mean, for fucks sake.
Well, in fairness your article says that it cuts both ways:
"Without the race correction, Inker says, Black patients' kidney function might look worse than it actually is. For patients with other medical conditions, she says that could mean less access to treatments, clinical trials and medications that they would otherwise have qualified for. For example, metformin is the first drug of choice to treat diabetes in patients with chronic kidney disease, but those with a GFR of 30 or below cannot use the drug, which means they might have to turn to other medications with more side effects."
So removing the current fudging might be good for a black kidney transplant candidate, and bad for black diabetics. Or not. The sense I get from the article is that it's complicated, and lots of people are trying their best to do the right thing. That doesn't seem outrageous to me.
Absaroka,
It's a fair point that, while fudging the eGFR disadvantages black kidney transplant candidates, it might help black diabetics with kidney disease. However, there remain two problems.
First, what do they mean by race? It is somewhat arbitrary to say an Igbo from Nigeria, and Amhara from Ethiopia, and a black American belong in the same genetic group for purposes of calculating eGFR for making treatment decisions for kidney disease. Does that grouping make any medical sense at all? If the fudge factor is has some validity for an Igbo or person with Igbo ancestry, but not for an Amhara, then, you are hurting people by using U.S.-specific cultural categories to make physiological assumptions for purposes of making medical decision.
The second problem, even assuming the broad racial classifications of white, Asian, black, make any sense in this medical context, the eGFR was never back by appropriately rigorous studies. If there is a medical reason for people with a GFR under 30 not to get metformin, for example, and the fudge factor is largely just made up, then you are hurting both black kidney transplant candidates AND black diabetics who are taking a contraindicated drug. In short, we know black transplant candidates are hurt, and black diabetics might be hurt also. Ditto for the other groups they may or may not qualify for based on flawed eGFRs.
But there is no way to know that without rigorous studies. (Also, maybe the eGFR is valid with respect to metformin, but not with respect to the transplant list, or vice versa.) And they didn't do that for two decades because, well, why? That's the question to which you have to have a good answer to be able to say people were trying their best to do the right thing.
It wasn't until this gained widespread notoriety outside the medical community, including probably the article I mentioned about the multiracial teen ability to obtain a transplant depended on what race his doctor assigned him (or which box he checked, I forget which). Then people said, oh, yeah, this eGFR does not have a sound medical basis to distinguish based on race. Anything that "good" people do nothing about until their doing nothing gains widespread notoriety is most likely outrageous.
The fact that people making potentially life and death decisions for others originally categorized people by race in a way that they knew disadvantaged at least some black patients without having any good studies to make that categorization and then left it unquestioned for so long, that seems outrageous to me.
https://www.wired.com/story/how-algorithm-blocked-kidney-transplants-black-patients/
You people are looking at this the wrong way. I don't see this as a brazen opportunity for the local rabble here to swell like toads and show their anti-racist bonafides. No. If this thinking can be nurtured we could soon have wedding cakes for everyone, Sikhs shooting at gun ranges and rape victims having medical care that doesn't involve an alley!