Systemic Racism: Fact or Fiction: Comments on Bryan, Butler and Graboyes

   

We assume that there is structural racism in the health care system, but what is the evidence? Is there any evidence that the structure of the healthcare system is responsible for disparity in outcomes? Is there a difference between the application of healthcare for similarly situated populations? Is there a difference in access between poor whites and poor minorities in the same MSA? Certainly that once was the case in the Jim Crow south where, for example, my mother had to travel to an adjoining county to give birth because her home county hospital did not admit blacks. Do such practices still exist de facto? As Dr. Bryan notes, funding for healthcare often does not reach consumers but funds bureaucracies instead. Dr. Bryan notes “There is a better way to keep Americans healthy than by transferring wealth to experts.” Perhaps that way is to fund programs that encourage individual responsibility. Given that medical schools and the medical profession are among the institutions funding trendy programs on diversity and inclusion, there is scant evidence that all the monies spent on such programs result in any change in the behavior of participants and redound to changes in the provision of healthcare. Moreover, as Dr. Bryan points out, the incentive of newly minted doctors is to practice medicine where they can maximize their incomes rather than to assuage their social consciousness.

Dr. Graboyes’s essay commits the basic sin of questioning the illogical tenets of progressive zealots. For some it is heresy to criticize the creation of new words such as Latinx womxn. It is heresy to question the assertion that gender is non-binary. It is heresy to question Critical Race Theory, climate change, and anti-racism. Indeed, even though The New York Times’s 1619 project has been thoroughly discredited for presenting a false narrative, many professional historians are reluctant to criticize it for fear of being labeled as racists. The black zealots within the progressive ranks deny their own racism by claiming that blacks cannot be racist. Yet the prescriptions for change are clearly racist in prioritizing medical care by race. In the world of racial preferences it is ironic that whites must show their antiracism by discriminating against themselves and fellow whites. As to the interesting question of whether reparations can reduce or eliminate racial disparities in healthcare, one wonders if the advocates favor reparations as an incentive to alter personal behavior. If that were the case, then reparations by another name should be given to poor whites as well. 

Dr Butler’s essay dispenses with the caricature of black people prevalent today. Blacks as characterized in the media are alien to those blacks who are college educated and professionals. Butler notes that all of the privately funded black colleges and universities are in the old Confederate south. Why are there not any in the north? The answer lies in the fact that the establishment of HBCUs was a direct consequence of the overt systemic racism that existed in the south. The segregated south had two silos, one white and one black. Within the black silos, institutions arose to produce a professional class to primarily serve other blacks. Such was not the case in the legally integrated north, resulting in fewer college educated professional blacks. Butler’s insight is that systemic racism in southern higher education led southern blacks and northern whites to establish parallel institutions. The remarkable renaissance among southern blacks is evident in that once freed, slaves had no last name and were mostly illiterate with few marketable skills. Yet the business entrepreneurship, education, and wealth of southern black communities exceeded those of northern blacks. Moreover, Butler notes that capitalism, free markets, and private ownership were keys to black southern successes. These were not quashed by Jim Crow but flourished so long as blacks stayed “in their place” – e.g. their own silo. As we used to say when I was growing up in Atlanta (with respect to the Civil Rights anthem), “white folks didn’t mind us overcoming so long as we did not come over.”