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July 27, 2009

ObamaCare could give birth to a new racial-spoils system

Topics: Political News and commentaries

As Americans grow more and more skeptical of the gargantuan new bureaucracy and the associated inefficiencies, costs, and rationing(especially for the elderly) ObamaCare envisions, have an additional concern - it could give birth to a new racial-spoils system:

[...] Among the provisions in the House version are special set-asides aimed at training "underrepresented" minorities in health-care professions. The idea is that some minority groups -- but not all -- will be better served if their doctors share their racial and ethnic background. It's an idea that has been floating around for years.

In 2002, the Institute of Medicine released a study entitled "Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care" that sparked a flurry of accusations that minority patients, especially African-Americans, receive bad health care because their doctors were biased.

The study said that "some evidence suggests that bias, prejudice and stereotyping on the part of health-care providers may contribute to differences in care." But as Dr. Sally Satel, a highly respected physician and author, observed at the time, the "evidence" in the study was thin. " 'Some,' 'suggests' and 'may,' " she wrote, "are all the kinds of words authors use when the data are flimsy and reputations are at stake."

There is no question that African-Americans, on average, die younger and have poorer health than whites. What is less clear is why that is the case. Socio-economic class and behavior both play an important role. Homicide is the leading cause of death for young black males between the ages of 15-24, for example. Obesity, drug and alcohol use, and other behavioral factors play an important role in determining overall health. But will insisting on preferences for African-American students applying to medical-school admission improve health care for blacks? Not likely.

As has been the case of affirmative action and disparate impact failing to positively affect Black underdevelopment and underachievement, adding yet another racial spoils system, this time to in a health-care bill, that is not only created on "flimsy" data but one that will do little to nothing to enhance imagined bias, prejudice and stereotyping on the part of health-care providers. Any differences in health within the Black community is primarily a black responsibility for cultural and behavioral changes.

As Shelby Steele has written in regard to affirmative action and disparate impact failing to result in changes in Black development and achievement, development and achievement today is primarily a black responsibility, not so much an effect having to do with discrimination. Rather, it has more to do with a need for profound cultural changes -- changes in child-rearing, a restoration of marriage and family, a focus on academic rigor, a greater appreciation of entrepreneurialism and an embrace of individual development as the best road to group development:

[...] Affirmative action has always been more about the restoration of legitimacy to American institutions than the uplift of blacks and other minorities. For 30 years after its inception, no one even bothered to measure its effectiveness in minority progress. Advocates of racial preferences tried to prove that these policies actually helped minorities only after 1996, when California's Proposition 209 banned racial preferences in all state institutions, scaring supporters across the country.

But the research following from this scare has been politicized and discredited. Most important, it has completely failed to show that affirmative action ever closes the academic gap between minorities and whites. And failing in this, affirmative action also fails to help blacks achieve true equality with whites -- the ultimate measure of which is parity in skills and individual competence. Without this underlying parity there can never be true equality in employment, income levels, rates of home ownership, educational achievement and the rest.

[... We argue over affirmative action and disparate impact because we don't know how to talk about our most profound racial problem: the lack of developmental parity between blacks and whites. Today a certain contradiction runs through black American life. As many of us still suffer from deprivations caused by historical racism, we also live in a society where racism is simply no longer a significant barrier to black advancement -- a society so sensitized that even the implication of racism, as in the Henry Louis Gates case, triggers a national discussion.

We blacks know oppression well, but today it is our inexperience with freedom that holds us back almost as relentlessly as oppression once did. Out of this inexperience, for example, we miss the fact that racial preferences and disparate impact can only help us -- even if they were effective -- with a problem we no longer have. The problem that black firefighters had in New Haven was not discrimination; it was the fact that not a single black did well enough on the exam to gain promotion.

Today's "black" problem is underdevelopment, not discrimination. Success in modernity will demand profound cultural changes -- changes in child-rearing, a restoration of marriage and family, a focus on academic rigor, a greater appreciation of entrepreneurialism and an embrace of individual development as the best road to group development.

Whites are embarrassed to speak forthrightly about black underdevelopment, and blacks are too proud to openly explore it for all to see. So, by unspoken agreement, we discuss black underdevelopment in a language of discrimination and injustice. We rejoin the exhausted affirmative action debate as if it really mattered, and we do not acknowledge that this underdevelopment is primarily a black responsibility.

So, instead of continuing to make the Black community a victim, this time in costly and unnecessary new programs in a health-care system, Obamacare would do far better to encourage the Black community to look within to taking steps to make those "profound cultural and behavioral changes" Shelby Steele points to. Continuing to "blame it on Whitey" just doesn't, and shouldn't, cut it anymore. The American people are waking up to the game Obama is playing.

Posted by Richard at July 27, 2009 6:53 AM

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