New Zealand forces surgeons to consider race when prioritizing patients
A recent policy from Health New Zealand is forcing surgeons to consider race an important factor when prioritizing patients for surgery.
Health New Zealand introduced its “Equity Adjustor Score” in February, though only last week did Newstalk ZB discover that it called for race-based care. The Equity Adjustor Score uses an algorithm to prioritize patients based on clinical need, time on the waitlist, deprivation level, geographic location and ethnicity.
Those from Māori tribes or of Pacific Island ethnicity are prioritized above patients of European or Asian ethnicity.
A leaked email sent in April from Health New Zealand Business Support Manager Daniel Hayes said: “Hi team, Heads up. This is going to be the new criteria for outsourcing your patients going forward. Just putting this on your radar now so that you can begin to line up patients accordingly. Over 200 days for Māori and Pacific patients. Over 250 days for all other patients.”
Many surgeons have expressed discomfort with the policy.
“It’s ethically challenging to treat anyone based on race, it’s their medical condition that must establish the urgency of the treatment,” an Auckland surgeon told the NZ Herald. “There’s no place for elitism in medicine and the medical fraternity in this country is disturbed by these developments.”
Speaking for the Association of General Surgeons, Dr. Vanessa Blair said considering race is too “simplistic”.
"We feel that it's a little bit simplistic for what is a very complex problem with many underlying contributing factors," said Blair.
New Zealand’s Opposition slammed the policy as racist.
"We've got a Government that is actually actively promoting racial discrimination now and it's got to stop," said ACT Leader David Seymour.
"Well it's pretty simple race shouldn't play any part in surgical need and determining surgical need and that's our position," said National Leader Christopher Luxon.
But some medical establishment operatives have been making race a prominent factor in medical care for years.
In 2020, Auckland District Health Board’s (DHB) then-Chairman Pat Snedden told the board that COVID-19 was an opportunity for a “reset” and to prioritize minorities for medical care.
“Our current system privileges some groups already. Māori and Pasifika are not in that group usually. It is important to be explicit about this. Covid gives us a big-bang opportunity to reset,” Snedden proposed to the board in May 2020.
By June 2020, at least ten DHBs throughout the country had resolved to prioritize Māori and Pacific patients over others.
The campaign for race-based care stretches across the globe, as countries like the United States make racism a focal point of healthcare.
According to a new policy this month by the American Medical Association (AMA), determining obesity by measuring a person’s body mass index (BMI) is now racist.
Calculating a patient’s BMI — their weight divided by the square of their height — is the most common method physicians use to diagnose obesity. A BMI score of 30 or above is considered obese.
But the AMA says BMI will now be dropped as the prevailing method because of “racist exclusion”.
“Under the newly adopted policy, the AMA recognizes issues with using BMI as a measurement due to its historical harm, its use for racist exclusion, and because BMI is based primarily on data collected from previous generations of non-Hispanic white populations,” says the policy.
Instead, physicians should rely more on “measurements of visceral fat, body adiposity index, body composition, relative fat mass, waist circumference and genetic/metabolic factors.”
The Association of American Medical Colleges, which claims that America’s health systems are racist, enforces diversity, equity and inclusion (DEI) at medical colleges through its accreditation arm, the Liaison Committee on Medical Education (LCME). The LCME makes DEI a requirement for accreditation and has had the desired effect, as DEI is taught zealously in medical schools across the country.
