RUTHFULLY YOURS

‘A sick society must think much about politics, as a sick man must think much about his digestion,” C. S. Lewis wrote. “To ignore the subject may be fatal cowardice for the one as for the other.” In the national delirium of a presidential election, the maladies of politics impose themselves on our minds to an even greater degree.

Unfortunately, the current state of the medical field is not much of an analgesic. In recent years, left-wing ideology has thoroughly penetrated medicine. But new research undercuts one of the more popular academic buttresses of this blatant politicization. It’s more than enough to make one wonder if a movement that bills itself as pro-health might actually be iatrogenic.

Health care has not been immune from the whole-of-society effort by the Left to take control of institutions and subordinate them to its aims. Medical schools, journals, professional societies, continuing-education courses, and other institutions of the medical field now tilt left, as I documented last year.

Examples abound. The official publication of the American College of Emergency Physicians recently published a case for DEI in medicine. Harvard’s School of Public Health is offering a “Settler Colonialism” course. The Cleveland Clinic is currently being investigated for possible discrimination against white patients. The important roles academia and the government play in the medical field make this reality sadly unsurprising.

It still may have been a surprise to some when a related research paper became fodder for the Supreme Court. In her dissent from the Supreme Court’s majority opinion that overturned affirmative action last year, Justice Ketanji Brown Jackson wrote that the practice “saves lives” (indirectly), citing a 2020 study to claim that high-risk black newborns are twice as likely to live if they have a black physician. What the study actually found was that half as many black newborns died while being treated by a black physician as when treated by a white physician, while the survival rate was above 99 percent in either case.

There have been enough questions about this paper to justify reservations about its reliability. But a new study by Manhattan Institute fellow (and National Review alumnus) Robert VerBruggen and Harvard University economist George Borjas should inspire more. VerBruggen and Borjas argue that the previous study hadn’t sufficiently accounted for low birth weight. The original paper’s focus on the most common comorbidities for newborns had left out birth weights below a threshold (1,500 grams) that is strongly associated with infant mortality and below which black babies more frequently fall. Properly accounting for this, “the influential estimates of the impact of racial concordance on Black newborn mortality are substantially weakened and often become both numerically close to zero and statistically insignificant,” the researchers found. Any remaining correlation can plausibly be chalked up to the fact that low-birth-weight babies are sent to specialists, who are more likely to be white doctors, and who are then associated with higher mortality rates. “Black newborns attended by White doctors are more likely to have a vulnerability closely linked to mortality,” as VerBruggen and Borjas put it.

Their findings do more than justify skepticism about the original research. They should also call into question the uses to which that research has been put. The original paper casts itself as part of a consensus that “hospitals and other care organizations” should fight the “stereotyping and implicit bias” that “contribute to racial and ethnic disparities in health” by investing “in efforts to reduce such biases and explore their connection to institutional racism.” Prioritizing a diversified medical field would also serve this goal, hence Justice Jackson’s interest in the study.

But if an unaccounted variable, not doctors’ race, is chiefly responsible for the slightly increased rate of infant mortality among black newborns, these imperatives seem less relevant. “In this case, we took another look at the data, and we found, I think, a really clear explanation” for the differences in infant mortality, VerBruggen told me. “And it’s not something that necessarily has a whole lot of import to the affirmative-action debate because it’s a matter of health differences as opposed to the race of a doctor.”

This is not to dismiss the problem of low birth weights for black newborns, a disparity that VerBruggen and Borjas acknowledge. Indeed, VerBruggen considers it an “entirely legitimate line of research.” It is, however, to suggest that addressing these issues through political transformations in the medical field might not be productive. Health-care spending in the U.S. may be growing, but resources remain finite; a dollar spent on more DEI training is one that doesn’t go to a new incubator.

In this light, affirmative action and similar, related programs now offered by schools that are trying to skirt or openly defy the Court’s recent decision look, at best, like virtue-signaling. At worst, if the goal is to provide the best possible care to patients, the de-prioritization of merit that such programs represent is actively harmful.

The proper response to the Left’s politicization of medicine is to drive politics as far out of medicine as possible. That will involve political action. And it will almost certainly set Republicans (who at this time are the only ones taking this problem seriously) against the Left. But what may seem like a typical partisan conflict captures something bigger, and possibly more powerful: a politics of depoliticization.

The Right often faces a disadvantage: A coalition to reduce the importance and lower the stakes of political life can appear outmatched by highly motivated individuals and coalitions that want to expand the scope of politics. But if the practical risks and drawbacks of a left-wing ideology that is infecting medicine aren’t sufficient motivation, the heightened rancor that comes with it could rally many to the cause of keeping politics out of the hospital.

The diagnosis is clear: As Lewis put it, a political monomania that “was undertaken for the sake of health has become itself a new and deadly disease.” In this case, we are the patients — and the cure.