UPDATED AND REPOSTED
AND SUPPORTED BY
NORMAN J. CLEMENT RPH., DDS., MALACHI F. MACKANDAL PHARMD, JOSEPH SOLVO ESQ., BEVERLY PRINCE MD., JACK FOLSON RPH., NORMAN L.CLEMENT PHARM-TECH, REV. C.T. VIVIAN, JELANI ZIMBABWE CLEMENT, BS., MBA., WILLIE GUINYARD BS., BRAHM FISHER ESQ., JOSEPH WEBSTER MD., ESTER HYATT PHD., BERES E. MUSCHETT, STRATEGIC ADVISOR
THE MANIFESTO OF THE NORTH STAR PROJECT
“When you see THROUGHOUT LIFE most of your friends, colleagues, and classmates who are of degree being sanctioned, terminated, harassed, arrested, jailed, and imprisoned for the most minuscule violation of a regulation, or for just doing what they’ve been trained to do.
Then at some point, you are compelled to ask yourself when
ENOUGH IS ENOUGH
ARE WE NOT SEEN AS BEING HUMAN ???
THE ALGORITHM
According to Heidi Ledford in the October 24, 2019, issue of Nature Magazine, titled;
“Millions of Black People Affected by Racial Bias in Healthcare Algorithms”
“An algorithm widely used in US hospitals to allocate health care to patients has been systematically discriminating against black people, a sweeping analysis has found. (1)(2)
The study, published in Science on 24 October 2019, concluded that the algorithm was less likely to refer black people than white people who were equally sick to programs that aim to improve care for patients with complex medical needs. Hospitals and insurers use the algorithm and others like it to help manage care for about 200 million people in the United States each year.
WHAT HAS CHANGED? NO MATTER WHERE YOU LOOKED!!!
DR.NIA HEARD-GARRIS, MD: “No matter where you look, there are disparities in care for pretty much every racial and ethnic group that’s not white.”
click here for Garris, MD NPR Audio
In their January 23, 2024 report, Dr. Heard-Garris and her colleagues found,
” The strongest disparity evidence was found in pain management. Kids of color are less likely than their white peers to get painkillers for a broken arm or leg, for appendicitis or for migraines. “Those are some really severe examples of how this plays out,” says Dr. Monique Jindal, an assistant professor at the University of Illinois Chicago and one of the authors of the review.”
NIA Heard-Garris is a researcher at Northwestern University and a pediatrician at Lurie Children’s Hospital of Chicago. She and her colleagues reviewed dozens of recent studies examining the quality of care children receive. She says there are lots of examples of inequalities across specialties, whether it’s longer wait times to be seen, getting diagnostic imaging, or getting basic pain management.
“The researchers found that the algorithm assigned risk scores to patients based on total healthcare costs accrued in one year. They say that this assumption might have seemed reasonable because higher healthcare costs are generally associated with greater health needs. The average black person in the data set that the scientists used had similar overall healthcare costs to the average white person.
THIS IS THE RESURRECTION OF EUGENIC: And Carl Nelson: “This ain’t news.”
As outlined in SFGATE Magazine,
“Eugenics was the pseudoscience aimed at “improving” the human race. In its extreme, racist form, this meant wiping away all human beings deemed “unfit,” preserving only those who conformed to a Nordic stereotype.
Eugenics would have been so much bizarre parlor talk had it not been for extensive financing by corporate philanthropies, specifically the Carnegie Institution, the Rockefeller Foundation and the Harriman railroad fortune.
They were all in league with some of America’s most respected scientists from such prestigious universities as Stanford, Yale, Harvard, and Princeton. These academicians espoused race theory and race science and then faked and twisted data to serve eugenics’ racist aims.
Stanford President David Starr Jordan originated the notion of “race and blood” in his 1902 racial epistle “Blood of a Nation,” in which the university scholar declared that human qualities and conditions such as talent and poverty were passed through the blood.”
ARE WE NOT SEEING EACH OTHER AS? HUMAN?
Michelle Alexander MD., a graduate of the College of Medicine University of Florida and practicing physician in New York City, writes:
- Rampant racial bias in the healthcare algorithms used by hospitals and insurance companies
- Black patients receive lesser care than white patients who are equally sick
- Black healthcare professionals are forced to spend hundreds of hours to justify treatment.
- Black patients spend more money on less care.
- Algorithms used by hospitals and insurance companies failed to account for inherent historical social injustices that are built into the systems (6)
The common man or woman has very little understanding of how so-called drug policies directly affect their daily living until they are diagnosed with some chronic illness or have a loved one who may be facing death. Then, the importance of chronic illness and disease states is ever so critical.
THE HISTORY OF MEDICAL DISPARITY IS THE HISTORY OF EUGENICS
According to Dr. Ulche Blackstone, MD,
“By 1905, those Black medical schools had trained 1,465 doctors. Each of those doctors was poised to train a new generation of physicians, who would have gone on to train a generation of their own. And then, that promising legacy was abruptly extinguished.
The reason was the publication of the Flexner Report — a landmark document in U.S. medical history that had a devastating effect on the number of Black physicians in this country.
These schools were Howard University College of Medicine, established in D.C. in 1868; Meharry Medical College, established in Nashville in 1876; Leonard Medical School, established in Raleigh, N.C., in 1882; New Orleans University Medical College, founded in 1887; Knoxville College Medical Department, founded in 1895; Chattanooga National Medical College, founded in 1902; and the University of West Tennessee College of Physicians and Surgeons, founded in Memphis in 1904.
“…During the ’20s, Carnegie Institution eugenic scientists cultivated deep personal and professional relationships with Germany’s fascist eugenicists. In “Mein Kampf,” published in 1924, Hitler quoted American eugenic ideology and openly displayed a thorough knowledge of American eugenics…”
“Dr. Otmar Freiherr von Verschuer, a hero in American eugenics circles, functioned as a head of the Institute for Anthropology, Human Heredity, and Eugenics. Rockefeller’s funding of that institute continued both directly and through other research conduits during Verschuer’s early tenure. In 1935, Verschuer left the institute to form a rival eugenics facility in Frankfurt that was much heralded in the American eugenics press. Research on twins in the Third Reich exploded, backed by government decrees. Verschuer wrote in Der Erbarzt, a eugenics doctor’s journal he edited, that Germany’s war would yield a “total solution to the Jewish problem.”
CALIFORNIA THE EPI-CENTER OF THE WORLD EUGENICS MOVEMENT
In his November 9, 2003 article from SFGATE Magazine, called “Eugenics and the Nazis — the California Connection.” Edwin Black writes;
“In 1904, the Carnegie Institution established a laboratory complex at Cold Spring Harbor on Long Island that stockpiled millions of index cards on ordinary Americans as researchers carefully plotted the removal of families, bloodlines, and whole peoples.
From Cold Spring Harbor, eugenics advocates agitated in the legislatures of America, as well as the nation’s social service agencies and associations.”
“The Harriman railroad fortune paid local charities, such as the New York Bureau of Industries and Immigration, to seek out Jewish, Italian, and other immigrants in New York and other crowded cities and subject them to deportation, confinement, or forced sterilization.
Most importantly, Mr. Black further pointed out;
“Much of the spiritual guidance and political agitation for the American eugenics movement came from California’s quasi-autonomous eugenic societies, such as Pasadena’s Human Betterment Foundation and the California branch of the American Eugenics Society, which coordinated much of their activity with the Eugenics Research Society in Long Island.
These organizations — which functioned as part of a closely-knit network — published racist eugenic newsletters and pseudoscientific journals, such as Eugenical News and Eugenics, and propagandized for the Nazis.”
The Rockefeller Foundation helped found the German eugenics program and even funded the program that Dr. Josef Mengele, MD., worked in before he went to Auschwitz.
“AND CARL NELSON, THIS AIN’T NEWS
“My assistant, Dr. Josef Mengele (M.D., Ph.D.) joined me in this branch of research. He is presently employed as Hauptsturmführer (captain) and camp physician in the Auschwitz concentration camp. Anthropological testing of the most diverse racial groups in this concentration camp is being carried out with the permission of the SS Reichsführer (Himmler).”
“The practice of the Negro doctor will be limited to his own race, which in its turn will be cared for better by good Negro physicians than by poor white ones. But the physical well-being of the Negro is not only of moment to the Negro himself. Ten million of them live in close contact with sixty million whites. Not only does the Negro himself suffer from hookworm and tuberculosis, he communicates them to his white neighbors, precisely as the ignorant and unfortunate white contaminates him…” Abraham Flexner
Abraham Flexner, the White author of the report, was an education specialist who, at the turn of the 20th century, was employed by the Carnegie Foundation and the American Medical Association to assess the state of medical education in all 155 medical schools in the United States and Canada.
His report, published in 1910, led to the broad standardization of medical schools, with the top school in the country at the time—Johns Hopkins—held up as the example for all others to follow.
BLACK-OWNED PHARMACIES ARE SYSTEMATICALLY RACIALLY PROFILED
Let it further be clear, patients being treated for chronic pain who travel to a Black-owned pharmacy are called “RED FLAGS” by the DEA and these pharmacies are classified as imminent dangers to the “Public Health.” While the same patients travel to non-black-owned pharmacies with the same prescriptions, using the same payment methodology, the fictitious label of “red flags” does not indeed exist.
However, the large chain pharmacies and their parent companies clearly violate laws through false billings and even forged prescriptions on their part. At the same time, the DEA collects billions of dollars in what amounts to “extortion fines,” and the large chains are given a pass.
These warnings remain obliterated, and one cannot ignore the functions of race in these types of proceedings.
In October 2019, I read an article published in Nature magazine that I was immediately struck by. It explained what I and many of my colleagues already knew. This was that Black patients were systematically given lesser or poorer care than white patients with similar diagnoses who were equally sick.
The article reviewed a study published in Science, which documented what was described as rampant racial bias in the health care algorithms used by hospitals and insurance companies to determine the level of care required for patients, based on the data provided to them by the doctors treating these patients.
DO WE NOT SEE EACH OTHER AS BEING HUMAN?
These hospitals and insurance companies used these algorithms to help manage care for ~200 million people in the US. The article went on to explain that smaller studies have also documented racial bias in decision-making algorithms in everything from the criminal justice system to education.
It also explained the countless hours spent by my colleagues on telephones and emails to justify the care that they were providing to their patients (Black doctors and Black patients).
In many cases, doctors would be forced to provide care that was never reimbursed or lesser care because of these algorithms. Black patients were often sicker with co-morbidities such as diabetes, hypertension, and kidney disease, which often would require a greater level of care but did not receive it because of such algorithms.
This was also confirmed by the data in which Black patients received care at a cost of $1,800 less than given to a white person with the same number of chronic problems.
Needless to say, if doctors did not diligently pursue the necessary treatment, patients suffered. Not all health care providers are so diligent in this pursuit. We already know of the health care biases of humans due to racism and white supremacy.
The researchers of the study (Obermeyer et all) collaborated with the developers of the algorithm (Optum of Eden Prairie, Minnesota) to improve the algorithm to reduce racial bias. Changes were made to reduce bias by 84%. Optum said in a statement that the researcher’s findings were “misleading” because this was only one of the data points used for managing care.
It stated that the doctor’s expertise was the most important. However, what Optum failed to understand is the time consumption spent by the doctors of Black patients justifying such care, and often these many hours that would be unnecessary to receive such care. (4)(5)
The researcher points out that changing the variables to correct such bias is not straightforward. Racism and injustice is built into the systems and therefore is not easily fixed. It is also in part because of the lack of diversity among the algorithm designers and knowledge and training to these designers about the inherent social and political injustices historically in our systems.
As Black doctors, dentists, nurse practitioners, pharmacists, and ultimately patients, we deserve fair and equitable treatment and reimbursement for such care. This is a failure of the systems and must be rectified. These algorithms have been in place for decades. It boggles the mind about the cost of life and health due to such algorithms.
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END NOTES
- https://www.nature.com/articles/d41586-019-03228-6
- https://www.nature.com/articles/d41586-018-05469-3
- The Algorithmic Justice League’s mission is to raise awareness about the impacts of AI, equip advocates with empirical research, build the voice and choice of the most impacted communities, and galvanize researchers, policymakers, and industry practitioners to mitigate AI harms and biases. We’re building a movement to shift the AI ecosystem towards equitable and accountable AI.
- Actionable Auditing: Investigating the Impact of Publicly Naming Biased Performance Results of Commercial AI Products, Inioluwa Deborah Raji University of Toronto 27 King’s College Cir Toronto, Ontario, Canada, M5S 3H7 deborah.raji@mail.utoronto.com, Joy Buolamwini Massachusetts Institute of Technology 77 Massachusetts Ave Cambridge, Massachusetts, 02139 joyab@mit.edu
5. https://www.fastcompany.com/90525023/most-creative-people-2020-joy-buolamwini EXPOSING
