Have you ever seen racial discrimination and segregation in health care? I have. And I worry it’s coming to America.
I grew up in apartheid South Africa, where the color of your skin determined everything. Being “colored” — of mixed racial heritage — I was treated as a second-class citizen. And the medical services people like me had access to were third-rate, at best.
The crowded hospitals black and brown people could go to had much longer wait times than whites-only hospitals. The physicians and other medical professionals we could see were trained separately from their white counterparts and not allowed to attend to white patients. Medications and treatments were generally less available because of our skin color.
Add it all up, and racial discrimination limited our chances to lead the healthiest, happiest life.
I left South Africa in 1986 for America. I came here because my children could have the opportunities I never did — including the chance to see the best doctors, go to the best hospitals and get the highest-quality care. And now the discrimination I left behind is threatening American health care, just from a different direction.
The federal government, under the Biden administration, has wholly bought into the claim that health care suffers from “systemic racism.” So it’s pursuing a strategy to embed “anti-racism” into medical principles and practice. While that language may sound positive, it’s simply another name for racial discrimination. No less than anti-racism’s founder, Ibram X. Kendi, has made that clear by saying, “The only remedy to past discrimination is present discrimination; the only remedy to present discrimination is future discrimination.”
Sure enough, the federal government is sowing the seeds of medical discrimination. Since the year’s start, it has paid a “bonus” to physicians who accept Medicare to “create and implement an anti-racism plan.” This is effectively a mandate on all of health care since more than 90% of primary-care physicians are covered and the extra pay is almost impossible to turn down. As physicians try to abide by this policy, they will find it harder and harder to provide equal access to care.
Why? Because Washington explicitly wants to force physicians to focus on their patients’ race, to the point of asking themselves: “What population(s) will I prioritize?” A physician must then create “target goals” and “milestones” for different racial groups instead of focusing on each patient as a unique individual. Such race-based decision-making creates the risk of preferential care based on skin color — which, by the way, is exactly what activists are demanding. It smacks of the very discrimination that led me to leave apartheid South Africa.
What’s more, the federal government recently announced it will collect racial and demographic data on every American patient. This sounds like a national database that puts race at the center of health-care policy. Based on the explicitly discriminatory goals of “anti-racism,” this information will likely be used to push physicians to provide different standards of care for different people. As I know firsthand, once authorities zero in on skin color, it becomes the lens through which they see everything, and it affects the way they treat everyone.
Beyond the Biden administration, there’s a rapidly growing push for patients to see providers who share their skin color. The name for that is segregation, and it will surely hurt the black and brown patients it’s supposed to help. Having grown up in a country that typically required patients and physicians to be of the same racial category, I’m convinced we shouldn’t care what our physician looks like. We should only care that he or she is the most qualified to provide us the personalized medical care we require.
At least two states — Massachusetts and Michigan — mandate that physicians undergo routine implicit-bias training too. The premise is that some physicians are inherently and irredeemably prejudiced against people of different backgrounds. But that merely sends patients the message that they can’t trust physicians who don’t look exactly like them. Not only does that undermine the doctor-patient relationship, it once again pushes health care toward de facto segregation.
I’ve been there before. It should go without saying that what’s happening in America isn’t nearly as awful or total as the apartheid I endured in South Africa. But that doesn’t change the fact that health care is spiraling downward, morally and medically. It’s moving toward racial discrimination and segregation, based on the dangerous claim that these evil ideas are somehow superior. They never are — and Americans shouldn’t have to find out the hard way.
Benita Cotton-Orr is a senior fellow at Do No Harm.