Just because race apparently makes the equation more accurate, does not mean that race is the correct variable. The allegation from UNOS I’ve already quoted earlier specifically states that “This has caused some Black patients to be identified with and treated for kidney failure at a much later stage of their disease, and delayed their access to transplantation.” In other words, the formula is hurting Black patients.
In other words, race most likely has nothing to do with it, since Black people from other countries do not fit the equation. So sure, I’ll agree that they have to find something else to make the equation provide better results, but that does not mean that they should keep using race as a variable until they find the actual answer.
And presumably it has also prevented some Black patients from being treated for a disease they do not have - which was the whole point of the adjustment. There are two sides to every coin.
Bottom line is this is all virtue signaling since no one is actually getting a transplant based on this estimation, no matter how accurate or inaccurate it may be. And I have a hard time believing that length of time from diagnosis is the primary factor in receiving a transplant, where some are dieing from their disease simply because a kidney went to a healthier person who has been on the waiting list longer.
I thought biological facts were optional these days?
Based on the observation of this cross-sectional sample, the available data set beginning at age 18 years through age 80 indicate that males and African American had more [skeletal muscle mass] than females and the other ethnic groups across the entire age range, even adjusting for weight and height.
They admit they couldn’t complete control for level of physical activity, but of course that doesn’t matter if it means certain groups have more muscles for whatever reason (associated with genetics or activity levels or anything else). More muscles will cause you to look worse on those kidney tests than you are otherwise, and including a racial prediction variable will be useful for incorporating that on average in the model.
So the science and models are sound and the progressives who don’t believe race exists think it’s critically important that black people, who are “no different than the rest of us biologically”, need to be prioritized for transplants they don’t need.
The Biological basis of race is discussed in Nicolas Wade’s book a troublesome inheritance
The evidence described in the book is mostly genetic, but there’s a good reason to believe that the races diverge
Here’s a good summary from a review of the book on Amazon
Around 200,000 years ago, modern humans emerged in Africa. They spent more than three quarters of their history in that continent, spreading to different niches within it and developing a genetic diversity which today is greater than that of all humans in the rest of the world. Around 50,000 years before the present, by the genetic evidence, a small band of hunter-gatherers left Africa for the lands to the north. Then, some 30,000 years ago the descendants of these bands who migrated to the east and west largely ceased to interbreed and separated into what we now call the Caucasian and East Asian populations. These have remained the main three groups within the human species. Subsequent migrations and isolations have created other populations such as Australian and American aborigines, but their differentiation from the three main races is less distinct. Subsequent migrations, conquest, and intermarriage have blurred the distinctions between these groups, but the fact is that almost any child, shown a picture of a person of European, African, or East Asian ancestry can almost always effortlessly and correctly identify their area of origin. University professors, not so much: it takes an intellectual to deny the evidence of one’s own eyes.
I didn’t know anything about the adjustments then, but I suppose I would have been in support, yes. I’m not blaming those people for doing what they did when they did it. But it looks like now we have some data that brings their decisions into question, so I’m in support of whatever UNOS decides.
This past weekend, I played poker with a Penn grad who was bragging about Goldfarb’s efforts and successes of his Do No Harm org. I’m glad to see that it is being reported somewhere.
This is New Zealand, and hopefully we won’t import their bad ideas. Favored races, ie not white or Asian, get priority in medical treatments, surgery, organs, waitlists, etc.
Doesnt that only perpetuate health inequities, rather than reduce them? If giving certain races lower priority is a problem, how is it a solution to give certain races a lower priority?
No need to import, the United States medical establishment is thoroughly racist. Here’s a case where New York State was distributing oral Covid medicine according to race. Scotus denied CERT because the medicines were no longer in shortage but Alito and Thomas say they’re looking for cases where race is used to ration medical care.
You may recall that I was the named plaintiff in a lawsuit filed in January 2022 in the Nothern District of New York against the NY State Health Commissioner over state health guidelines that prioritized non-whites for receipt of oral Covid therapeutics, which at the time were in short supply:
New York’s policy creates a racial hierarchy in the distribution of life-saving COVID-19 medication. Non-white and Hispanic/Latino individuals who test positive for COVID-19 automatically qualify for oral antiviral treatments, while an identically situated non-Hispanic/Latino white individual is ineligible unless he demonstrates a “medical condition” or “risk factor” that increases his risk for severe illness from COVID-19.
Early last month, the Association of American Medical Colleges (AAMC)—the organization that oversees the Medical College Admission Test (MCAT) and cosponsors the accrediting body for all medical schools— published a story claiming that black patients fare better with black doctors, an idea that has become popular across the health-care establishment…
The notion that patients benefit from seeing doctors who share their race is dubious… So is the implicit claim that lowering standards and elevating race in medical school admissions maximizes patient welfare. Indeed, the quality of the studies that AAMC cited to support these claims are as poor as one might expect.
plans are ostensibly held accountable to maintain appropriate “network adequacy” to manage the primary and specialty care needs of their enrollees, many MA networks are woefully inadequate to ensure access to the latest advances most likely to help beneficiaries with cancer. This is because the industry has accepted, even encouraged, under the banner of affordability and, ironically, the catchphrase “value-based care,” plans to develop narrow networks. And for those developing these networks, the focus is on cost containment, and not the attributes most valued by cancer patients: survival
The latest medicare for all by Bernie Sanders, the “socialist who caucuses with the Democrats”
Ironically, and in defiance of Americans demanding more health autonomy, Sen. Bernie Sanders has put forth a radical Medicare-for-All 2023 bill to impose the ultimate government control over health care – single-payer, socialized medicine. It not only controls the allocation of all medical care, but it explicitly outlaws private insurance competition with the government and creates a new “Office of Health Equity” that forces an extremist ideology on American taxpayers.
This is stupid. FEHB is extremely popular with competition of several private insurance companies. It would make so much more sense for the government to just roll out FEHB to everybody who is under 65 and does not qualify for Medicare/SSDI, maybe with less of a government subsidy for those above a certain income level. Easy peasy. Or they could lower the Medicare age to 60, but FEHB already exists, why not just roll that out to a bigger pool of people?
If you are sick, things are different. Consider a hypothetical middle-aged couple in Dallas earning $70,000 a year. Suppose they have two children, both of whom have serious birth defects. Although this family will pay no premium for a Blue Cross bronze plan in the ObamaCare exchange, they will face a $9,100 deductible for each child. Their total out-of-pocket exposure is $18,200 a year.
It gets worse. Patients with serious diseases often require the care of highly trained specialists who usually work at centers of excellence. But that family in Dallas will discover that their Blue Cross plan isn’t accepted at leading cancer providers nearby, including Baylor University Medical Center and the University of Texas Health Science Center, or MD Anderson Cancer Center in Houston.
The problem isn’t unique to Texas. ObamaCare plans have very skinny networks in every state. They tend to pay providers Medicaid rates or close to them. As a result, ObamaCare looks like Medicaid with a high deductible. A great many providers, including prestigious medical institutions, won’t accept Medicaid managed care—the version of Medicaid most recipients receive—or ObamaCare.
When a patient with ObamaCare coverage goes out of network, the plan usually pays nothing and the patient’s payment doesn’t apply to his deductible or out-of-pocket maximum.