The American Medical Association (AMA) released a new “Strategic Plan to Embed Racial Justice and Advance Health Equity” over the next three years.
The eighty-six page document leans heavily on Critical Race Theory (CRT), a movement that grew out of Critical Theory, which was rooted in Marxist ideology and Freudian psychology. Critical Theory was concerned with why communist revolutions hadn’t occurred in the West – that is, why the oppressed masses never rose up to overthrow capitalism and democracy to create a workers’ paradise.
The organization said, “Advancing health equity through the AMA’s efforts entails a dedicated, coordinated and honest approach. It recognizes the harmful effects of the AMA’s past and targets the systemic inequities in the health care system and other social institutions. And it charts a path toward a more promising and equitable future for all.”
Dr. Michelle Cretella is executive director of the American College of Pediatricians, “a national organization of pediatricians and other healthcare professionals dedicated to the health and well-being of children.” The organization advocates “for children at all stages of development, from conception to young adulthood” and is a strong voice for marriage, family, parental rights, and ethical and scientific standards.
She expressed concern over the plan, telling The Daily Citizen, “The AMA’s proposed ‘Organizational Strategic Plan to Embed Racial Justice and Advance Health Equity’ is rooted not in science and the medical ethics of the Hippocratic Oath, but in a host of Marxist ideologies that devalue the lives of our most vulnerable patients and seek to undermine the nuclear family which is the single most critical institution to child well-being.”
The strategic plan follows from a 2017 decision by the AMA Board of Trustees to appoint a Health Equity Task Force “with ten members drawn from a number of the AMA constituencies with special interest and expertise in health and health care disparities, diversity and inclusion.”
The group met over a series of months and developed a definition of health equity: “Health Equity is optimal health for all.” The task force presented this definition to the board, along with a plan for “continued progress toward health equity.” In 2019, the AMA launched a Center for Health Equity and hired a Chief Health Equity Officer.
The AMA says the strategic plan “serves as a three-year roadmap to plant the initial seeds for action and accountability to embed racial justice and advance health equity for years to come (their emphasis).”
The plan begins with an “invocation-like recognition of ‘land and labor acknowledgment’”:
We acknowledge that we are all living off the taken ancestral lands of Indigenous peoples for thousands of years. We acknowledge the extraction of brilliance, energy and life for labor forced upon people of African descent for more than 400 years. We celebrate the resilience and strength that all Indigenous people and descendants of Africa have shown in this country and worldwide. We carry our ancestors in us, and we are continually called to be better as we lead this work.
The plan then lays out some of the approaches it will take to bring about equity and social justice in health care. These include proposals to:
- Build the AMA’s capacity to understand and operationalize anti-racism equity strategies via training and tool development.
- Develop structures and processes to consistently center the experiences and ideas of historically marginalized (women, LGBTQ+, people with disabilities, International Medical Graduates) and minoritized (Black, Indigenous, Latinx, Asian and other people of color) physicians.
- Push upstream to address all determinants of health and the root causes of inequities.
- Center, integrate and amplify historically marginalized and Black, Indigenous, Latinx and people of color who are health care investors and innovators.
- Foster pathways for truth, racial healing, reconciliation and transformation for the AMA’s past.
The document clearly lays out its ideological roots, as its “Equity Primer” explains key CRT terms and concepts:
We operate in a carefully designed and maintained system that normalizes and legitimizes an array of dynamics—historical, cultural, institutional and interpersonal—over time that routinely advantage white (also wealthy, hetero-, able-bodied, male, Christian, U.S.- born) people at the expense of Black, Latinx, Indigenous and people of color (also low wealth, women, people with disabilities, non-Christians, and those foreign-born) and that is currently reinforced by policies that are blind to power (political and financial) imbalances and realities.
The AMA plan explains that “the ‘equality’ framework” – which it defines as people having “equal value” and as “providing the same amounts and types of resources across populations” – has failed.
Instead, the AMA proposes “equity,” saying, “Where equality is a blunt instrument of “sameness,” equity is a precise scalpel that requires a deep understanding of complex dynamics and systems with skill and practice in application.”
The AMA says, “Equity can be understood as both a process and an outcome. It involves sharing power with people to co-design interventions and investing and redistributing resources to the greatest need—with explicit consideration for how racism, gender and class oppression, ableism, xenophobia and English language supremacy impact outcomes.”
Christopher Rufo is the founder and director of Battlefront, a public policy research center. He recently wrote an article for Hillsdale College’s Imprimis, “Critical Race Theory: What It Is and How to Fight It,” where he explains some of the problems with CRT. Rufo describes CRT’s use of the term “equity” as “little more than reformulated Marxism” and of euphemisms such as “equity,” “social justice,” “diversity and inclusion.” The AMA document is rife with this jargon.
Rufo offers reasons why CRT can be so hard to battle, “Its premise—that American history includes slavery and other injustices, and that we should examine and learn from that history—is undeniable.”
The AMA was, in fact, discriminatory and unjust in its past, excluding African American physicians from membership. After the Civil Rights movement in the 60s, the association took steps to rectify some of its past actions, and in 2008, the organization apologized to the National Medical Association, a group representing more than 30,000 African American physicians and health care professionals.
But Rufo goes on to explain that CRT’s conclusion and proposed remedies, “that America was founded on and defined by racism and that our founding principles, our Constitution, and our way of life should be overthrown,” don’t necessarily follow.
As Dr. Cretella stated above, this is exactly what the AMA is proposing. The organization says our entire healthcare system was “designed and maintained” to be discriminatory, privileging “white (also wealthy, hetero-, able-bodied, male, Christian, U.S.- born) people” at the expense of all others. Thus, it must be overturned and replaced with a structure built on woke, political ideologies.
One wonders if the majority of physicians and healthcare workers agree with AMA leadership and support this initiative. Is this what they signed up for when they went through medical training? Or, do they simply want to get on with the work of saving lives and bringing health and healing to individuals?
Photo from AMA