The AMA's Primer on Equity Is Anything But
Julio Gonzalez, M.D., J.D.
Last I heard, the medical profession was still based on science. If one proffers a theory or explanation, one must immediately find the supporting data to back it up. In medicine, for example, one cannot simply say that amoxicillin is effective against strep throat, or that hip replacement surgery is amongst the most effective health improving surgeries out there. One must gather the data and prove the point. It follows then, that if one were to make an argument regarding medicine and the delivery of healthcare it should, at the very least, be based to some degree on scientific observation or analysis.
On May 11, the American Medical Association, published "Organization Strategic Plan to Embed Racial Justice and Advance Health Equity" where it essentially embraced critical race theory as a valid sociological model to explain the disparities in healthcare. I immediately scorched the paperas divisive, hateful, and offensive. But its abhorrence is only part of the problem. The AMA's white paper, as well as its position on race relations, is also devoid of any scientific support.
Take its claims about equality, equity, and justice, for example:
We operate in a carefully designed and maintained system that normalizes and legitimizes an array of dynamics—historical, cultural, institutional and interpersonal—over time that routinely advantage white (also wealthy, hetero-, able-bodied, male, Christian, U.S.- born) people at the expense of Black, Latinx, Indigenous and people of color (also low wealth, women, people with disabilities, non-Christians, and those foreign-born) and that is currently reinforced by policies that are blind to power (political and financial) imbalances and realities. AMA, "Organizational Strategic Plan to Embed Racial Justice and Advance Health Equity," May 11, 2021, p. 11.
The statement, which sets the tone of the rest of the paper, speaks more about the AMA's mindset and tarnished soul than it does about any American sociopolitical reality.
First, who is the "we" to which the AMA refers in its claim? Is it the American people? Is it American physicians only? Or perhaps the AMA is referring to the whole world when it denotes a system in which we operate.
Second, who "carefully designed and maintained" the system in which the AMA claims "we operate"? Is it God? The Founding Fathers? The Romans? Abraham when he entered into his covenant? Knowing exactly of whom we are speaking is extremely important because it informs the corrections that need be taken; yet the AMA does not identify the crafter of the decrepit system it describes. Clearly, rectifying the work of the Founding Fathers requires a radically different approach than the correction of a problem dating back to the antiquities. And if the AMA is trying to take on God–which on issues like abortion and gender identification it clearly has–then count me out.
Third, what in the world is a Latinx? I ask this in earnest because if the AMA is claiming that Latinx(es)–is that even right?–are being disadvantaged, where does that leave me, an American-born, second generation descendant of Cuban exiles who would never call himself a Lat. . . (I apologize, but I cannot even finish the word in reference to myself; it is so offensive). According to the Pew Research Center, only about 3% of Hispanics use the term Latinx when describing themselves, yet the AMA employs it to describe a whole sociopolitical subgroup within the United States? Is it the three percent to whom the AMA is referring, or all Hispanics (my offense over to the use of the term notwithstanding)?
I am a second generation, Cuban descendant whose family hastily fled to the United States in fear of communism, am I not included in the AMA's description of the disadvantaged? It seems that I would be, but the AMA's white paper is so biased that it fails to capture me. I am an orthopaedic surgeon, lawyer, former state representative, author, and a former naval officer, am I still disadvantaged? Or did I lose the disadvantage because I achieved?
How about Clarence Thomas, is he disadvantaged? Or Condoleezza Rice? Is she intersectionally disadvantaged or did she lose the title because she also achieved? If people like Thomas and Rice are disadvantaged, how did so many like them in race and gender become so successful? Alternatively, if the AMA no longer considers Thomas and Rice disadvantaged, then isn't its model for systemic injustice inapplicable since the characteristics of the disadvantaged can be shed?
Let's have the AMA, which is so inculcated in pointing out the inherent injustices of the "carefully designed and maintained system" answer this inconvenient question: In what other country, could we have a Condoleezza Rice, a Barrack Obama, a Clarence Thomas, a Sonia Sotomayor, or a Susan Rice, among countless others? Does the AMA honestly believe that Obama could have ever been the President of Kenya? Could Clarence Thomas have been able to rise from the darkest recesses of poverty and elevate himself to the pinnacle of his profession in Columbia? Mexico? Sweden? How about answering the same questions about second generation Americans like Ted Cruz and Marco Rubio?
It seems then that there are serious gaps in the AMA's adopted model for interracial relations, but like any great non-scientist, it chooses not to address them.
Here's another question the AMA fails to address: how does a system that disadvantages people with disabilities and "non-Christians" advantage white, wealthy, heterosexual, male, U.S.- born citizens? I'm sorry, but I do not see the relationship between disadvantaged disabled non-Christians and white, male privilege, nor does the AMA point it out. And relatedly, how is an individual's physical disability in any way the result or object of the machinations of the "we" the AMA fails to identify?
Like the racist, hate-filled producers of the dogma the AMA is now trying to disseminate, they offer no scientific basis for their claims. It does this purposely because its theorem falls apart under the weight of even the slightest scrutiny, yet it lays it out there as if these mischaracterizations and anti-American propaganda were accepted facts.
Just as importantly, the AMA fails to address the alternative scenario. What if the system "blind to power (political and financial) imbalances and realities", is really the only way to administer justice and provide opportunities for all unencumbered by oppression, favoritism, and tyranny? The AMA does not consider this possibility, yet it sells it as fact. By ignoring the consequences of manipulating outcomes, the AMA also dismisses its perverted take on equality and equity.
But the discussion on the conflation of equity and equality must wait for another, not-too-distant day.
Dr. Julio Gonzalez is an orthopaedic surgeon and lawyer living in Venice, Florida. He served in the Florida House of Representatives. He is the author of numerous books including The Federalist Pages, The Case for Free Market Healthcare, and Coronalessons. He may be contacted through his website: www.thefederalistpages.com.