A pair of doctors at Brigham and Women’s Hospital last month outlined a pilot program that, they said, would offer “preferential care” to patients of color. The proposal, published in Boston Review, accuses hospitals across the country of practicing “medical apartheid”—something they said must be addressed through “race-explicit interventions.”
Those interventions may violate civil rights laws, and Brigham and Women’s Hospital assured the Washington Free Beacon that they are “not currently underway at the hospital.” That hasn’t stopped one of its authors, Dr. Michelle Morse, from moving on up: She is now the chief medical officer of New York City.
In her new post, Morse will wield enormous influence over New York’s hospital system, and she has promised to use it to “advance health equity.” Part of her job will be serving as a liaison between the health department and local medical centers, including three she singled out as examples of “de facto segregation”: Montefiore, New York-Presbyterian, and Mount Sinai. She was also named the deputy commissioner for the Center for Health Equity and Community Wellness, a division within the New York City health department.
Morse’s ascent reflects the larger trajectory of progressive activism, which has migrated from the fringe of academia to the heart of public health bureaucracies. Vermont’s health department announced this month that people of color will get first dibs on the coronavirus vaccine as a part of the state’s commitment to “health equity.” And in December, the Centers for Disease Control proposed vaccinating essential workers before the elderly because the elderly skew white.
Morse did not respond to a request for comment.
Morse’s march through the institutions—from foundations to fellowships and finally to a top government post—reveals how radicalism gains influence. Supported by an incestuous network of left-wing nonprofits that credentialize activists and funnel them into positions of power, activists like Morse use studies funded by those same nonprofits to give their agenda a veneer of scientific credibility. And since the nonprofits combine charity with activism, it is easy for them to launder the latter as the former, further insulating them from critique.
Take EqualHealth, which Morse cofounded after the 2010 earthquake in Haiti. What began as a support system for Haitian health care workers soon became an effort to stem “the miseducation of health professionals on the root causes of illness.” Those root causes, per the group’s website, are racism and capitalism, which it seeks to combat through “disruptive pedagogy.”
In 2015, EqualHealth founded the Social Medicine Consortium, “a collective of committed individuals, universities and organizations fighting for health equity.” Morse received a $100,000 grant from the Soros Equality Fellowship three years later to launch the “Campaign Against Racism,” a network of health equity activists who work to “dismantle racial capitalism.”
All the while, EqualHealth continued its original work in Haiti—giving an air of humanitarian legitimacy to what became a radical group.
This sort of legitimation gives activists a foothold to further burnish their credentials. Morse went on to a Robert Wood Johnson Foundation fellowship that sent her to Washington, D.C., to work on “health equity priorities” with the House Ways and Means Committee. By the time she became New York’s chief medical officer, she had experience in both nonprofits and government, making her a prime candidate for the position.
Once in power, activists are buoyed by a flood of foundation-funded studies that serve to justify their agenda. Race-conscious policies of the sort Morse advocates have found a home in prominent medical journals such as the Lancet, which in February released a Soros-supported report calling reparations a public health measure. These studies cite others from the same nonprofit complex, giving activism an air of academic legitimacy.
The Brigham and Women’s Hospital proposal is a case in point. Every stage of the argument, from diagnosis to prescription, rests on foundation-funded critical race theory. The proposal borrows heavily from a paper—”Critical Race Theory, Race Equity, and Public Health: Toward Anti-Racism Praxis”—that was funded by the W.K. Kellogg Foundation and written by two “health equity” scholars, who argue race-conscious programs are better than colorblind ones at reducing racial health disparities. As evidence for those disparities, Morse cites her own 2019 study on the relationship between race and referrals for cardiac care—which itself draws on the Kellogg-funded paper to interpret its results.
“By assuming the existence of institutional racism across all American institutions,” Morse’s 2019 study reads, “we can turn from research focused on documenting disparities and inequities to implementation research directed towards correcting them.”
The Brigham and Women’s Hospital plan also calls for reparations as a form of “medical restitution,” citing a paper that claims to model their effect on COVID-19 transmission. That paper, which Morse co-authored, was likewise supported by nonprofit as well as government grants and rests on similar assumptions about institutional racism.
Estimates of disease transmissibility, the paper says, “seldom capture oppressive social forces including institutionalized racism and sexism,” an omission it describes as “the symbolic violence of R0.” Since reparations weren’t in place, ending coronavirus lockdowns “had a disproportionate adverse mortality effect on black people” and thus “resembled a modern Tuskegee experiment.”
But it is arguably doctors like Morse who are proposing medical experiments, on the very same patients they’re claiming to help.
If implemented, the pilot program at Brigham and Women’s Hospital would be an unprecedented act of social engineering. “Rather than rely on provider discretion or patient self-advocacy to determine whether they should go to cardiology or general medicine,” the program would encourage doctors to send black and Latino heart failure patients to cardiology, on the grounds that minorities are referred less often than whites.
But the hospital’s own data suggest that this could backfire, causing worse outcomes for minority patients.
Between 2007 and 2018, black heart failure patients were more than three times as likely as white heart failure patients to have end-stage renal disease, which requires a dialysis machine to treat. Since general care is used to referring patients for dialysis, patients with both heart and kidney failure may be a better fit for general care. Sending them to cardiology instead could delay life-saving treatments.
It could also lead to black patients getting too much care, rather than too little. A common critique of the American medical system is that it funnels patients to specialists instead of general care practitioners, resulting in misdiagnoses and unnecessary treatments. That excess care can have fatal consequences: Medical error is the third leading cause of death in the United States. So by increasing the rate at which black patients are referred to cardiac specialists, the program could hurt the very people it’s meant to help.
Brigham and Women’s Hospital may not pursue this particular medical experiment. But in her new role with the city of New York, Morse will have plenty of test subjects.
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