A rich non-white patient would be given priority over a poor white patient with precisely the same age and health conditions.

 

 

 

Minnesota Government: "Deprioritiz[e] Access for Patients" to COVID Drugs, Based Partly on Their Being White

A rich non-white patient would be given priority over a poor white patient with precisely the same age and health conditions.

 

Eugene Volokh, Reason

1.3.2022

 

From the Minnesota Department of Health's Ethical Framework for Allocation of Monoclonal Antibodies during the COVID-19 Pandemic (p. 8):

 

MOH uses the Monoclonal Antibody Screening Score-BIPOC+Pregnant (MASSBP) for MNRAP, which is a score adapted from Mayo Clinic's published Monoclonal Antibody Screeningá core (MASS). The MASSBP is calculated as follows, on a scale of 0-25: age 65 years and older (2 points), BMI 35 kg/m2 and higher (2), diabetes mellitus (2), chronic kidney disease (3), cardiovascular disease in a patient 55 years and older (2), chronic respiratory disease in a patient 55 years and older (3), hypertension in a patient 55 years and older (1), and immunocompromised status (4), pregnancy (4), or BIPOC status (2). The Science Advisory Team (SAT) has recommended, and MOH has directed, that sites de prioritize low MASSBP scores in response to appointment scarcity. This means MN RAP has been instructed to begin by deprioritizing access for patients with a MASSBP of 0, and to further be ready to deprioritize MAS5BP=l, MASSBP=2, and MASSBP=3 as scarcity deepens.

 

Note that people who lack "BIPOC status" (basically, non-Hispanic whites) would be "deprioritiz[ed]" precisely based on their race and ethnicity, not wealth, access to health care, being in a nursing home, or anything else. A rich non-white patient would be given priority over a poor white patient with precisely the same age and health conditions.

 

Here is the Department's rationale:

 

The score was adapted after consultation with the University of Minnesota and Mayo Clinic to specifically examine the import of including pregnancy and BIPOC status in examination of poor clinical outcomes. UMN found, in an analysis of 41,000 patient records, that both pregnancy and BIPOC status, after accounting for other covariates, were independently associated with poor clinical outcomes from COVID-19 infectionů.

 

The FDA has acknowledged that in addition to certain underlying health conditions, race and ethnicity "may also place individual patients at high risk for progression to severe COVID-19." FDA's acknowledgment means that race and ethnicity alone, apart from other underlying health conditions, may be considered in determining eligibility for mAbs. It is ethically appropriate to consider race and ethnicity in mAb eligibility decisions when data show elevated risk of poor COVID-19 outcomes for Black, Indigenous and other people of color (BIPOC populations), and that this risk cannot be adequately addressed by determining eligibility based on underlying health conditions (perhaps due to underdiagnosis of health conditions that elevate risk of poor COVID-19 outcomes in these populations). At the present time, MDH has found that available data show this elevated risk. While health systems should thus consider the elevated risks of progression to severe COVID-19 associated with race and ethnicity when making decisions about whether individual patients are eligible for mAbs, it is always the case that health care providers "should consider the benefit-risk for an individual patient."

 

As I noted in my post about the New York COVID race discrimination scheme, this is unconstitutional:

 

more, including links

https://reason.com/volokh/2022/01/03/minnesota-government-deprioritize-access-for-patients-to-covid-drugs-based-partly-on-their-being-white/