On Systemic Racism

Liberty Fund Publishes My New Healthcare Essay

Painting: “Cityscape,” by Alanna S. Graboyes, asgraboyesart.com

Throughout October, the Liberty Fund will publish a series of essays on the idea of systemic racism in healthcare and education. This morning, my essay, “Tempering Systemic Racism in Healthcare,” was the first in the series to go live. To read it, you’ll have to go to the Liberty Fund site, but here’s a summary.

(NOTE: All the indented paragraphs below are direct quotes from my essay.)

Systemic racism … is the notion that overt racial discrimination in the past (e.g., slavery and Jim Crow laws), has left a residue on the structure of American institutions that yields ongoing inertial patterns of discrimination. … This is a reasonable and legitimate concern—and certainly true in some respects. Unfortunately, many of the policy prescriptions aimed at rectifying these patterns fail to consider the magnitude of their present-day impact, the efficacy of proposed solutions, or the tradeoffs with other societal concerns. 

While many conservatives and libertarians are skeptical of the very idea of systemic racism, the concept has its analogs in their own classical liberal thinking:

Economist Dierdre McCloskey postulates that prior to Western Europe’s “Great Enrichment,” wealth and income had been perpetually depressed by a gauzy anti-entrepreneurial attitude that hung over society, sustained by the rhetoric of various societal institutions. Economist Donald Boudreaux refers to this unwritten phenomenon as a “dishonor tax.” Structural racism could be said to constitute a parallel “nonwhiteness tax.”

And, for a literary analog:

[S]tructural racism can be seen as an analytical equivalent to William Faulkner’s maxim that, “The past is never dead. It's not even past.”

For context, my own origins are relevant:

I grew up in small-town, Jim Crow-era Virginia. For my first 15 years, Virginia’s government was monomaniacally focused on “massive resistance” to racial integration and on denying full rights of citizenship to African Americans. Conditions in my hometown today suggest to me that the damage done in those years has far from vanished.

While acknowledging the reasonableness of the concept of systemic racism, there are legitimate and profound concerns over the policy responses to the concept, including:

• Empirical studies by Thomas Sowell, Roland Fryer, and others suggest that, despite existing disparities, present-day impacts are relatively small.

• Disparities in health outcomes do not prove the culpability of systemic racism. Genetics, measurement errors, personal actions, etc., also matter.

• Theorists and popularists of systemic racism encourage victimization and derogate personal responsibility.

• In their search for curatives, theorists and popularists turn to authoritarian policies and Orwellian speech codes—and for permanent regimes of retaliatory discrimination, including racial preferences in the distribution of lifesaving medications.

• The movement often exhibits an intolerance for dissent and outright rejection of countervailing evidence or logic.

My overall message is, acknowledge the concept, but question the prescriptions:

[S]ystemic racism is a plausible concept with some degree of veracity. However, policy advocates have a tendency to overstate the actual impacts of this phenomenon, and some have offered startlingly illiberal policy prescriptions as a remedy. The challenge for policymakers is to weigh the evidence, measure the effects, and seek policy prescriptions that are effective and that take into consideration the tradeoffs with other social goals.

A middle path has its virtues—even when it barely exists.