America, Intolerant – The Health Care Blog


Historically, the great tension between freedom and authority has been between the government embodied by the ruling class and its subjects. Marauding barbarians and warring city-states meant that society gave a certain class within society great powers to protect the weaker members of society. It was quickly realized that the ruling class could use these powers for their own benefit on the very people they were supposed to protect, so society first set out to preserve individual freedoms by recognizing certain rights that the rulers did not dare to violate in order not to risk rebellion. The natural next step was the establishment of some kind of body to represent the interests of the governed, from whom the rulers sought agreement and advice, and became the forerunner of the modern English Parliament and the American Congress. Of course, progress in governance did not end with rulers imbued with the divine right to rule held in check by third parties. The right to rule eventually ceased to be a divine right, and instead came through the occasional election of the governed in the form of elections. The power now wielded over those who would rule led some to question whether there was any reason to limit the power of a government which was now the embodiment of the will of the people.

But the reality of the rule of the people, which was realized by the emergence of democratic republics throughout Europe, and especially America, quickly made a mockery of the lofty ideas of self-government for which the people thought they stood. It turns out that the “people” who hold power in this system can be completely separated from those over whom power is exercised. Self-governance was not the rule of everyone for himself, but of everyone over everyone else (JSM, On Freedom). The threat of the majority to the individual was well known to America’s founders, and the early implementation of the American experiment did not disappoint.

Alexis de Tocqueville, A Frenchman who toured young America at the beginning of the 19th century and wrote a volume considered the greatest critique of the American democratic experiment entitled “Democracy in America”, observed:

In America, the majority erects very heavy barriers to freedom of thought: within these barriers the author can write whatever he wants, but he will repent if he ever crosses them. It is not that he is exposed to the horrors of auto-da-fe, but he is tormented by the slights and persecutions of daily slander. His political career is closed forever, because he offended the only authority who is able to promote his success. Any kind of compensation, even a famous one, is refused to him. Before he published his opinions, he imagined that he held them in common with many others; but as soon as he has openly declared them, he is loudly censured by his overbearing opponents, while those who think without the courage to speak, like him, leave him in silence. Finally, he gives in, pressed by the daily efforts he made, and sinks into silence, as if he is tormented by a guilty conscience for telling the truth.

This was the America that allowed freed slaves to vote in the North, yet didn’t see black people vote in elections so they wouldn’t be harassed if they had the audacity to actually show up at the polls. It was America that in 1812 saw mobs destroy the offices of Federalist newspapers because their editors were against the war against Britain in 1812 and published an anti-war text. A mob gathered, destroyed the newspaper offices, killed one of the editors, and left the other editor badly beaten.

In this world, legal protection or rights that the government ‘protects’ are not important. A more formidable power at the disposal of society is its ability to ostracize the individual by practicing social tyranny that extends far beyond the political and legal system. After all, what good is legal protection if punishment for thought crimes can be your livelihood?

The new wrinkle is about the growing power of an intransigent minority fueled by social media to force society to bend to its preferences. It turns out that you don’t need a majority to control society, a small number of intolerant virtuous people is enough. John Stuart Mill, in his classic 1859 essay, described this phenomenon as the will of the most active part of society, but it has recently been best described by the mathematician/philosopher Nassim Nicholas Taleb as the dictatorship of a small minority. On a relatively benign front, the apathy of the flexible majority means that most everything you buy to drink is kosher. More importantly, it means that the moral values ​​of society do not derive from the consensus of the majority, but from the virtues of the most intolerant minority.

Sites like twitter, facebook and reddit allow these factions to coordinate within minutes. In 1812, in Baltimore, a mob was to leave the comfort of their homes, take up arms, and travel to the headquarters of a Federalist newspaper to wreak havoc on the hapless editors who held unpopular opinions. In 2020, it only takes a few keystrokes and tagging an employer in a tweet to cancel a life and tarnish a reputation or organize a violent mob to target a federal building.

While all ideological lines can use these tools to wreak havoc on civil society, it is always the outgroup that bears the brunt of the condemnation. In a previous age, social institutions were used to censor Jews and those with too much melanin. There’s a new sheriff in town today, and there’s a new group labeled by influencers and their sheeple as disgusting and unfit for decent society. For four years, the social elite was free to label the Republican president as an illegitimate puppet of Russia, attend political rallies and participate in marches that turned into riots by some extremist minority without fear of not being allowed to go to work the next morning. But attending a Trump rally on January 6th and going back to your hotel to watch the violent shenanigans that followed runs the very real risk of leaving you devastated and destitute.

The tyranny of the Democratic Republic is all-encompassing precisely because it doesn’t require a government with a camera watching your every move, it enlists your even more ubiquitous virtuous neighbors to do its dirty work. Putin may fabricate charges against his political opponents to put them in jail, but it wasn’t some repressive government that fired Google engineer James Damore. It was his colleagues who leaked his internal memo and then demanded that he be eliminated. According to Damore, the punishment for thought crime at Google was severe – “employees who expressed views that diverged from the majority at Google on political topics raised in the workplace and relevant to Google’s employment policy and its business, such as the ‘diversity’ hiring policy ‘ , ‘sensitivity to prejudice’ or ‘social justice’ were singled out, harassed, systematically penalized and removed from Google”.

Even America’s long-respected medical facilities are overwhelmed. The publication of a peer-reviewed descriptive paper on the history of affirmative action in medicine led to the cardiologist author of the article being immediately demoted and removed from interaction with interns at a teaching hospital as a Twitter mob labeled the article’s views ‘racist’. In the midst of a major pandemic that experts told us was so bad that everyone had to isolate themselves in a basement for two years, the Centers for Disease Control (CDC) created a vaccine distribution strategy that suggested considering race to “promote justice.” ” and “alleviating health disparities,” despite the fact that prioritizing this particular factor over race-neutral risk factors such as age and health status would result in higher overall deaths.

After all, the CDC’s goal now is not only to maximize benefits relative to harms, but also to mitigate health inequities, as the ethics table from that document makes clear. It would be a laudable goal to improve health care for all, of course, but the practical translation of this ethos is to deliberately and systematically treat certain racial groups worse in order to balance the scales. Apparently, for the people writing these guidelines, more people dying from COVID is less of a concern if the deaths are more racially balanced.

It is important to understand that the reason for this openly racist enterprise does not come from some fringe group, but from the headquarters of our most respected institutions because fringe groups control the institutions.

“Older populations are whiter,” public health expert Dr. Harold Schmidt of one of our esteemed universities told The New York Times in early December. “Society is structured in a way that allows them to live longer. Instead of giving additional health benefits to those who already had more, we can start to level the playing field a bit.”

It is little wonder why these messages go unchallenged in these institutions. Unless you’re rich yourself or have tenure, keep your mouth shut about opinions that run counter to today’s consensus if you value your work. Although some may take solace in the fact that the contemporary price paid in civilized democratic republics for opinions that fly against the prevailing winds is different from that meted out to Socrates by his fellow Athenians (death by drinking hemlock), or to Christians by the Romans (thrown to lions), it should it should be reasonably obvious that these are far from enlightened times.

Anish Koka is a cardiologist. Follow him on twitter: @anish_koka