The political costs of racial preferences
Donald Trump had a rally this weekend in Arizona:
Former President Donald Trump on Saturday claimed that white people are being discriminated against and sent to the “back of the line” when it comes to receiving COVID-19 vaccines and treatment.
Speaking during a rally in Florence, Arizona, Trump alleged that coronavirus vaccines and treatments are being unfairly “rationed” and withheld from white Americans in some states.
“The left is now rationing life-saving therapeutics based on race, discriminating against and denigrating, just denigrating white people to determine who lives and who dies,” Trump said during his speech. “You get it based on race. In fact, in New York state, if you’re white, you have to go to the back of the line to get medical help. If you’re white, you go right to the back of the line.”
In my post last week, I argued that using race/ethnicity as risk factors when allocating Paxlovid is justified if our goal is to minimize deaths and there is evidence that Blacks/Hispanics are more vulnerable to omicron than Whites, and I criticized the New York Department of Health for not providing the relevant evidence on vulnerability. Here I want to briefly discuss the political and legal costs of using race/ethnicity as a risk factor. These costs need to be considered by policymakers even if a policy can be justified on the merits.
The political cost of using explicit racial preferences is clear: policies that appear to favor Blacks and other disadvantaged groups are unpopular. This is why, for example, voters in highly Democratic California rejected a constitutional amendment to allow affirmative action in public hiring and higher education by a margin of 14 points.
The fact that racial preferences and quotas are unpopular does not mean that they are never justified, or that policymakers should never use them to reduce racial disparities. It does mean that using race-based policies often has a significant political cost. It drives some swing voters who might otherwise support Democratic candidates to vote for Republicans. When policymakers at the NYDH use race and ethnicity as risk factors, this plays into the hands of Republicans who use race as a wedge issue to win elections despite their relatively unpopular positions on social economic policy. As Trump’s speech illustrates, this is not at all a hypothetical risk.
Explicit racial preferences are also vulnerable to legal attack. Under existing Supreme Court rulings, policies that are not facially race-neutral need to meet a high standard of justification. There is a real risk that a poorly justified policy that appears to favor Black/Hispanic people over Whites in access to a lifesaving drug will be struck down by the Court. Even worse, the Court may well use such a contentious policy to set a precedent that will make it harder to sustain other race-conscious policies, including affirmative action.
Again, this risk is far from hypothetical. Efforts to ensure that Black farmers and Black-owned businesses receive pandemic aid were both enjoined by the courts. The Justice Department fears that an appeal in the case concerning Black farmers will lose.
I am not saying that any of this is fair. It’s not. Racial inequities in the United States are appalling, and sometimes explicitly racial policies are the best way to address them. But politics ain’t beanbag, and it’s not a morality play. This is a dangerous moment, and proponents of racial justice need to consider the political and legal implications of their choices carefully.
It is unclear if there is any justification on merits to preferentially allocate Paxlovid to non-whites as a matter of policy.
If non-whites are at greater risk of death from the Indian and South African plagues, then non-whites will present for medical care in greater numbers and should, as a demographic, receive more Paxlovid simply because of that. No race-based policy intervention should be necessary.
If a doctor has one course of Paxlovid and two patients, one white and one non-white, the doctor sure as hell shouldn’t be told to kill the white guy to make up for structural injustices.
Race-based allocation of care towards non-whites would not appear to be justified on merits and looks much like the product of anti-white racism or even a deliberate attempt to provoke a pro-GOP racist backlash.
 Assuming non-racist allocation of care by doctors and administrators.
 In much the same style as the model of ‘all whites are collectively guilty’ corporate diversity training that gave the GOP the idea to manufacture a moral panic over CRT in schools.
The reason that nobody says that is because realism is an unfortunate consequence of here and now, a place rarely visited and even more seldom discussed.
I would base my choice on whether the person is vaccinated or not. Not interested in expending vital medications to someone too stupid to try and take care of themselves.
The vaccinated are not eligible for Paxlovid unless they are immune compromised. It is interesting that this has not created much political controversy.
There are lots of possible objections to the NYDH guidelines besides the use of race/ethnicity as a risk factor (which in my view could potentially be justified) and the prioritization of the unvaccinated. Should we favor people who have a longer life expectancy if they survive covid? Should we favor parents of young children? Also, the risk assessment tool in NY is pretty crude, it might be possible to have a more elaborate system that did a better job ranking patients. Other states use a point system.
I think Blacks/Hispanics are in fact unlikely to get a fair share of Paxlovid, for reasons I will discuss in a subsequent post. The guidelines create a large political cost without effectively addressing the underlying problem.
I’m sure there are some anti-White racists out there, but not very many, and I don’t think that anti-White racism is a significant factor in the NYDH guidelines. I certainly don’t think the guidelines are a deliberate attempt to provoke a pro-GOP backlash. Why would presumably democratic liberals at NYDH do this? It seems to me that the guidelines simply reflect a kind of naive thinking about policy and politics, coupled with the usual risk of making a mistake when you are making decisions with limited information under huge time pressure.