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So, I can often be found posting on here complaining about bias in medicine (although I disagree about some of the kinds of bias with quite a few posters here).
We do have something of an update to a long running story that’s worth sharing.
Meddit link for more discussion and detail: https://old.reddit.com/r/medicine/comments/1jotpzz/follow_up_on_the_study_showing_discrepancies_in/
Basically, awhile back there was a headline about how black babies received worse outcomes when care for by white doctors. Apparently, this went so far as to get cited in the supreme court.
Sometime later someone on Meddit (which is still quite pro-woke) noticed that they forgot to control for birth weight, which would likely completely kill the effect size (explanation: white physicians have more training and take care of sicker babies who have worse outcomes). At the time there was a significant amount of speculation essentially going “how do you miss this? That would be the first you would control for.”
Well, it turns out that someone filed a FOIA request and well, to quote Reddit:
“A reporter filed a FOIA request for correspondence between authors and reviewers of the article and found that the study did see a survival benefit with racial concordance between physician and patient, however it was only with white infants and physicians. They removed lines in the paper *stating that it does not fit the narrative that they sought to publish with the study.” *
While I often criticize medicine for being political, I’m often found here telling people to trust the experts when it comes to (certain aspects) of COVID or whatever, and well this kinda stuff makes it very very hard.
The initial findings were passed around very uncritically and sent up all the way to the supreme court.
How can people trust with this level of malfeasance? How do we get the trust back? How do we stop people from doing this kind of thing? I just don’t know.
I think one thing that American liberals / institutionalists desperately need to recover is an understanding that most people don't see themselves in some universal, internally sympathetic class with our well-credentialed elites, and thus that the claim of such elites earning and maintaining trust is itself nothing like a default. And "But I did well on the test administered by elites like me" isn't enough. I think that's a really hard pill to swallow for people who have put all their chips on the current meritocracy, though, and it's understandable, because we were all born into a world that once had more default institutional trust.
It's interesting, because I don't think these ideas are hard to get across in the abstract.
I've asked before, as an example, some well-credentialed liberals I knew if they would accept universal health care funded and run by the government, with the constraint that it would be entirely run and maintained by experts from the Communist party of China, with their own internal methods for determining who was an expert. And (it should go without saying), I have not got any takers - and honestly, it's a bit interesting to try to tease out why exactly. And yet, realistically, for many Americans, administration by the current system internally gatekept and administered by American liberals is obviously not that dissimilar to that thought experiment for large swathes of Americans who are entirely alienated from those liberal gatekeepers too. They could well be forgiven for suspecting that the American liberal gatekeepers, as a class, despise them much more, and are much keener to socially engineer away their communities, than a similar program administered by the Chinese might be. At the very least, they can go read what the American version are actually saying in English about them on social media.
I get why it's a tough spot, emotionally, to be in for the winners of the meritocracy I'm gesturing at. It's really nice to get free institutional legitimacy, and it totally sucks to lose that if you were accustomed to having it, especially if you are the tail end of a long process of drawing down that legitimacy that had been built up by your forbearers who understand power and public trust in deep ways that they apparently didn't pass on (which I personally think is an accurate description of the institution builders of the progressive era compared to their "progressive" great-grandchildren). But from shirt sleeves to shirt sleeves in 3 generations is a thing. And I think American liberals simply no longer have the luxury of being oblivious to the realities of where power and legitimacy come from, and thus how they absolutely HAVE to rigorously publicly police themselves and their institutions to regain that trust. This stuff isn't magic. But I see a whole lot of behavior that looks like magical thinking, with a complete obliviousness to cause-and-effect when it comes to public trust.
Even if "Racism is a public health emergency" made any sense at all, people who want public power have to be smart enough to understand that you can't announce that stuff and then be surprised and huffy when large amounts of white people ignore your authority when you announce you intend to squirt novel fluid in their kids arms via flu vaccine. There's a total misunderstanding about the role of "consent of the governed", and how it means something much bigger in the way Americans organize themselves culturally than just questions about law and the Federal government...
That's a wonderful hypothetical.
They seem to be coming around though!
https://x.com/tracewoodgrains/status/1906727995307381025
Summary: TracingWoodgrains ran a poll for both left and right respondents, asking if they'd rather have their opposite running the world vs. China.
For left respondents, China won handily, opposite for right-responders. Obvious selection bias and all, but troubling. The days of substantial fifth-columnism may be returning.
This might just be a measure of partisanship, though. Two years ago, would the results be different?
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