介绍一个新的联邦纳粹法案:H.R.5942 和 S.3660

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前两天无意中看到一个今年五月在众议院提出来的一项有关改善公共医疗的法案,H.R.5942。 这一法案的全名是:“H.R.5942 – Health Equity and Accountability Act of 2018。” 这个法案是有关医疗的,但却其重点却是种族,而且把亚裔细分、种族细分打包装进这个法案了。 这个法案又臭又长,但只要看看里面的几条就下一大跳:

“Subtitle B—Strengthening Data Collection, Improving Data Analysis, And Expanding Data Reporting

“SEC. 3431. HEALTH DISPARITY DATA.

“(a) Requirements.—

“(1) IN GENERAL.—Each health-related program operated by or that receives funding or reimbursement, in whole or in part, either directly or indirectly from the Department of Health and Human Services shall—

“(A) require the collection, by the agency or program involved, of data on the race, ethnicity, sex, primary language, sexual orientation, disability status, gender identity, and socioeconomic status of each applicant for and recipient of health-related assistance under such program—

“(i) using, at a minimum, standards for data collection on race, ethnicity, sex, primary language, sexual orientation, disability status, gender identity, and socioeconomic status developed under section 3101;

“(ii) collecting data for additional population groups if such groups can be aggregated into the race and ethnicity categories outlined by standards developed under section 3101;、

“(iii) additionally referring, where practicable, to the standards developed by the Institute of Medicine in ‘Race, Ethnicity, and Language Data: Standardization for Health Care Quality Improvement’; and

“(iv) where practicable, through self-reporting;

“(B) with respect to the collection of the data described in subparagraph (A), for applicants and recipients who are minors, require communication assistance in speech or writing, and for applicants and recipients who are otherwise legally incapacitated, require that—

“(i) such data be collected from the parent or legal guardian of such an applicant or recipient; and

“(ii) the primary language of the parent or legal guardian of such an applicant or recipient be collected;

“(C) systematically analyze such data using the smallest appropriate units of analysis feasible to detect racial and ethnic disparities, as well as disparities along the lines of primary language, sex, disability status, sexual orientation, gender identity, and socioeconomic status in health and health care, and report the results of such analysis to the Secretary, the Director of the Office for Civil Rights, each agency listed in section 3101(c)(1), the Committee on Health, Education, Labor, and Pensions and the Committee on Finance of the Senate, and the Committee on Energy and Commerce and the Committee on Ways and Means of the House of Representatives;

“(D) provide such data to the Secretary on at least an annual basis……

这些话的大意就是,在提供医疗服务的时候,要搜集细分数据,不光是种族和民族细分,而且对性别,语言,性取向,收入等等也要细分(目前各个医院不搜集这么细的数据)。 请特别注意这一段“systematically analyze such data using the smallest appropriate units of analysis feasible to detect racial and ethnic disparities”(使用尽可能最小的适当的分析单位,系统地分析这些数据,以检测种族和民族差异)。  这个意思就是在搜集数据的时候,尽可能细分,分到无法分下去为止,这样来找出种族和民族的差异。  我来举例说明一下这个过程:假设今天医院里收到了500个病人,那么医院有责任搜集这500个病人的详细的种族和民族数据。 详细到什么程度呢? 首先不能光说这个病人是亚裔,那个病人是拉丁裔,那是不行的。 要细致到这个病人不但是亚裔,而且还是越南后裔,然后还是越南后裔中的苗族, 等等。 拉丁裔里面要分成墨西哥裔,古巴裔,波多黎各裔,等等。 

他们这样细分究竟是要干什么呢?  这个法案毫不掩饰,细分的目的,就是找出所谓的“HEALTH DISPARITY DATA”。 这就是看看不同族裔和种族的病人,他们在健康方面有些什么差异。  接着呢? 这就是要找出那些“underrepresented”群体:

“IN GENERAL.—The Secretary of Health and Human Services, …… shall develop and implement an ongoing and sustainable national strategy for oversampling underrepresented populations within the categories of race, ethnicity, sex, primary language, sexual orientation, disability status, gender identity, and socioeconomic status as determined appropriate by the Secretary in Federal health surveys and program data collections. Such national strategy shall include a strategy for oversampling of Asian Americans, Native Hawaiians and Pacific Islanders.”

这个意思就是对那些群体欠发达或不突出的小群体要特别注意数据取样(oversampling – 过取样)。  这好比一个医院一年只收到了17个苗族的病人,那么如何调查这17个苗族病人中患某种疾病的比例呢? 这就是要采用“oversampling”的统计学办法。  

然后呢? 根据采集的种族细分数据,下面要做的事情很有趣:

“SEC. 110. SAFETY AND EFFECTIVENESS OF DRUGS WITH RESPECT TO RACIAL AND ETHNIC BACKGROUND.

(a) In General.—Chapter V of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 351 et seq.) is amended by adding after section 505F the following:

“SEC. 505G. SAFETY AND EFFECTIVENESS OF DRUGS WITH RESPECT TO RACIAL AND ETHNIC BACKGROUND.

“(a) Preapproval Studies.—If there is evidence that there may be a disparity on the basis of racial or ethnic background as to the safety or effectiveness of a drug, then—

……

“(1) IN GENERAL.—If there is evidence that there may be a disparity on the basis of racial or ethnic background as to the safety or effectiveness of a drug for which there is an approved application under section 505 or a license under section 351 of the Public Health Service Act, the Secretary may by order require the holder of the approved application or license to conduct, by a date specified by the Secretary, postmarketing studies to investigate the disparity.

“(2) LABELING.—If the Secretary determines that the postmarket studies confirm that there is a disparity described in paragraph (1), the labeling of the drug shall include appropriate information about the disparity.”

这几段的大意是,要研究一下不同的种族或民族对于同一种医药的有效性和最大剂量是不是有所不同。 如果有此差异的话,那么对新上市的药品进行对该药品的种族差异性的研究,并且在药瓶标签上注明此差异。 

这就是最典型的“Race Based Medicine”(基于种族的医学,简称种族医学)。 这个意思就是说不同种族的人的身体是不同的,在提供医疗服务的时候要区别对待。 言外之意,我们的种族决定了我们的健康状况,这当然不可能不包括精神健康状况。 继续往下推理,这种理论就可能让我们认定有些种族生下来就健康些,有些种族生下来就不健康,甚至有的种族生下来就是大脑健全的,而有的种族甚至可能一生下来就是“脑残”。   

八十多年前,有一个人认为世界上有一个种族生下来就不健康,就会传播伤寒、鼠疫等疾病,因而这个种族就该被斩尽杀绝。 后来这个“不健康”的种族确实被屠杀了600多万人,这就是犹太人。 那个认为犹太人生下来就不健康的,该被统统杀死的,叫阿道夫希特勒。 他那个党叫纳粹党。

八十多年后,美国居然有人重弹希特勒的老调,对种族进行细分,然后根据种族医学的理论对不同种族的病人实行不同的医疗方案,实质上就是一个纳粹法案。 这个法案通过数据统计和种族和民族细分的方法把人类分成三六九等,这样一来就能看出有的种族就是老生病,有的种族就是天生的健康。 因此将来的某一天,那些病歪歪的种族就要被特殊对待,今天或许要让他们一辈子服药,或许对他们特别的好,明天呢? 或许某个伟大人物上台,根据这个科学理论,决定干脆把那些“病歪歪”的种族或民族全部杀死。 

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犹太人被送往奥斯威辛集中营

这就是今年5月民主党众议员,加州的Barbara Lee 提出,71个众议员联署的H.R.5942 法案。 这个提案自提出后一直动静不大,因为众议院是共和党占多数,这个提案很难通过。 但是上个月,来自夏威夷的民主党参议Mazie K. Hirono 提出了相应的参议院法案”S.3660 – Health Equity and Accountability Act of 2018″, 下个月众议院换届, 民主党将占多数,该法案就会被提交讨论,而通过该法案的可能性越来越大。

本文题头图是一位黑人学者批判种族医学的发言时的照片。 请去谷歌搜索“Race Based Medicine”,她的发言的视频就在那上面。  美国的医学界对于race based medicine早就在批判和唾弃了,而今天却有国会议员将此再次提起。 

这个法案还不光是提出要为种族灭绝进行理论研究,而且还制定了一整套race based medical training,以此限制我们亚裔在医疗卫生界发展,这里最突出的是医学人才的培训。 

明尼苏达州的Zoe 女士研读了这个法案后,看出这个法案提出了“一系例comprehensive program 包括financial incentives to promote diversity 培养医疗工作者。”  但这是“打着diversity的名义。跟哈佛是一筒子出气。”  “华裔不算unrepresented minority in healthcare profession。 印裔,华裔和其他几个亚裔少数民族靠自己的努力考上医学院做医生和其他医务人员。在明州大学50%的医务人员是印中韩越等亚裔。在其他医疗单位,亚裔人数都不少,例如Mayo Clinic, 休斯顿 Medical Center 等等”。 “这个bill 比哈佛歧视还要糟糕!不进哈佛,以前也能进医学院。以后医学院比现在卡得还紧,断了亚裔孩子们的从医梦!”  “以后非裔拉丁裔gpa2.5都能进医学院,华裔4.0都不一定能进。”

这个法案很长,我也还在进一步研读这个纳粹法案。 

该法案的众议院版本在这: https://www.congress.gov/bill/115th-congress/house-bill/5942/ (点击本文下方的“阅读原文”或者“Read more”可以直达这个法案的网页)

该法案的参议院版本在这:https://www.congress.gov/bill/115th-congress/senate-bill/3660

请同胞们不分党派都来看看这个法案并思考一下这个法案今后对我们华裔社区,亚裔社区,乃至整个美国社会的恶劣影响,我们一起来想办法阻挠这个纳粹法案在参众两院的通过。  

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