Aotearoa / New Zealand

When thought about in the greater context of triaging patients this makes sense. Unfortunately its clickbait presentation does it no favours.

There are a bunch of different factors that are considered when prioritising patients: obviously the disease itself, but also factors intrinsic to the patient - age, comorbidities, prognosis, familial history, etc. It's a long list. And just like (for example) a familial history of a certain disease meaning someone should be a little higher on the priority list, ethnicity actually makes sense to consider, particularly if you look at overall cost to the health system.

Regardless of the reasons, it's been well studied that Maori and Pasifika have generally poorer health outcomes. This has a direct, measurable cost to NZ and it makes sense to try to reduce this. At a granular level, if you have two otherwise identical patients, where one is pakeha and the other Maori, it likewise makes sense to prioritise the Maori patient to try to reduce those overall costs.

It's not about special treatment (excuse the pun) for Maori/Pasifika. It's about doing the most cost-effective thing for the NZ Health System.

This seems to be the new New Zealand way - there's a problem, but rather than analyse the causes and implement remedies based on that, go full dipshit and implement a solution that doesn't address the actual problem and probably won't fix it.

It's like the "road to zero" that we've copied from other countries. Except in other countries they look at what makes a road dangerous, an apply fixes based on that - installing barriers, straightening corners etc. In NZ that's too hard, so just blanket lower the speed limit as a catch all fix.

So there is a problem with Maori and Pacific not getting the same access as other groups. It's obviously too hard for anyone to figure out why that is, so just apply a policy that doesn't address the root cause and likely won't fix the problem.

Is this a rage bait article? That's pretty maddening.

In some ways I get it. Yes Maori and pacifica have and are treated worse than Nz Europeans and have had horrible treatment in the past.

However forcing them to the top of the list to rectify this will just cause more health issues for those that need it as priority.

Lots of surgeries won't go ahead of you can't remove extra weight. Especially bariatric surgery. You need to show you can lose he weight first. I'm not sure forcing a patient who cannot manage that to get the surgery will solve anything.

Interesting

On One News this evening they were very clear that other factors (such as how long they've been waiting, how sick the person is) are still more important than the patient's ethnicity.

The key thing is that clinical priority absolutely predominates the score anyone gets.

https://www.1news.co.nz/2023/06/19/pm-defends-use-of-equity-system-for-surgery-prioritisation/

None of this was mentioned in the NZ Herald piece. Barry Soper, the author, is a political hack who should not be trusted. He gives journalism a bad name and discredits the publication he writes for. I absolutely can't stand the guy and am disappointed in anyone who uncritically promotes his work.

Fuck me, I was just reading comments on reddit...

Yes, this policy is racist, by definition. In an ideal world, all citizens will be treated equally. In an ideal world, there will be no racism, everyone will have the same access and the same healthcare outcomes.

But we don't live in a perfect fucking world, do we? Jesus Christ, can people not understand this? Maori and Pacifica are systemically worse off in health outcomes than Pakeha. Per the report, even when all other factors are accounted for, they are worse off. So what's left? Race.

Let's assume that our goal for our society is the betterment of everyone. If that is the case (and it bloody should be!), then we have two options here. Solve the inequalities in society, or include race as one small metric. Obviously the first option is the best, right? But that takes a long time, and what do we do in the mean time? Let the inequality continue? Let Maori and Pacifica die at higher rates? That seems fucking cruel to me.

So what's left? The policy we have. It's just like having specific scholarships for Maori students. Yes, objectively, it is racist. But the goal is to reduce racism in society as a whole (through the lens of reducing the systemic educational inequality). Once that inequality has been eroded, then the race specific scholarships should go. But in the mean time, because I understand we don't live in a magical fairytale perfect world, I'm more than happy for those who are disadvantaged because of their skin color to get a small helping hand to try and remove some of this disadvantage. I genuinely don't understand why anyone would object to this.

I'm so incredibly sick of this mentality, and it needs to change.

Just because one group of people have been treated poorly in the past, doesn't mean the solution is to treat a different group badly in response. Tit for Tat isn't the way forward.

There's no evidence that the inequities are caused by racist mis treatment. After reading the report this policy is based from it's seems the cause is obesity rates.

I understand the thinking and idea on pushing this type of a thing, but naming it “Equity Adjustor Score” just screams that the system has been designed by some pencil pusher who doesn’t know the reality of what their proposal. With that being said, if it helps inequality in our medical care for this disaffected people grea.