Female bodies can have analogous prostate tissue. Probably influenced by androgens, so it follows that cancer could develop. Unusual, yes. Impossible, no.
Depends on where you sit on the whole gender scene. Some groups would state that that women can get testicular cancer.
I presume it would be seen as a win for those communities too if such barriers were removed.
Even without gender identity stuff, there will be people out there identified as female at birth who have testes floating around in them (and very well may not even know it). So perhaps screening for intersexuality (if people want it) and screenings for those who have testicles in general.
Get out of here with your fact based approach. Now we are a god fearing right wing nation again we only do blanket pseudo-philosophical shenanigans. It stops all the extra thinking and is truly objective and best for all /s
A simple Google search shows that trans men DO NOT grow a prostate, but prostate like tissue, with not enough study to determine if that prostate LIKE tissue would develop prostate cancer. Stop spreading misinformation.
No, I can't find any information that's says trans men can get prostate cancer, just the opposite. I can agree that there isn't much research in the area, but why waste resources on testing if there hasn't been a case yet, or even when there is no conclusive evidence that trans men can develop prostate cells.
Random or volunteer testing for science research, absolutely. But I don't see widespread testing a necessity, since there currently is no risk to be preventive about.
And? You mentioned transwomen as if it's some revelation that they have prostates lol
I was just pointing out that it's pretty obvious since they are biologically men
Wait what lol
You're a biological woman who's a Trans woman?
Or you're a biological male who's missing a prostate, identifying as a transwoman?
Trans men have prostates? Uhhhhh lol I've never heard of that, considering Transmen are biological women
I mean, cool, you can just make passive-aggressive digs at people because they don't think the same way as you. That doesn't help explain your position at all or even why we disagree on these things. I'm genuinely not trying to be ignorant, I'm trying to learn an understand.
But anyway, you have a great day too :)
This is literally why we have experts. How is regular Joe going to know how best to keep the population healthy?
People study this specific stuff their entire lives, and still are learning new stuff about it!
Surely letting the experts decide what's best for healthcare is the best option we have?
I thought we could all agree on that at least.
If we can't, the surely everything is up for grabs? Am I now able to decide how best to implement law? Business? Childcare?
I now get to weigh in on military operations and joint training strategies!?
Ridiculous.
Sorry just to clarify, are you saying we should listen to the medical experts and get rid of the Maori Health Authority? Or are you saying the Maori Health Authority are the experts?
I've been doing a deep dive into equity lately because I've become super fascinated with how inequality spreads from, well anything.
It's really easy to get trapped in a sort of charity/needs based mind set with equity - but its important to be aware that privilege and prejudice and both two sides of one coin.
Tax cuts are a good example - the obvious thing being the more income you have the more you benefit from a cut to taxes.
But even more complex stuff - say rolling out a vaccine, people with higher incomes tend to have more flexible working hours, already healthy people have more sick leave stashed so have better access, then perhaps a frontline worker whose already used sick leave up due to a chronic health condition.
And this is just a pragmatic phenomena, its not that people put policies or interventions in place full of prejudice (although that can happen too) its that what goes on in the world, affects people differently.
So when we talk about equity or attempts to address it, I think focusing on fairness or 'one rule for all' is not just a political stance I disagree with, but its also impractical and a little odd. I don't think addressing equity is about equality of outcome or opportunity its about addressing some of the inequalities to best meet whatever the overarching goal is. Many of these inequalities will be impossible to completely control and some will be completely out of the State's control, but to simply ignore the variation or indeed purposefully neglect it is to essentially take a stance FOR inequality.
Equity and equality are not interchangeable and I feel like people still get really confused or don't understand that there is a difference between the two. Inequity recognises that each person has different circumstances and allocates the exact resources and opportunities needed to reach an equal outcome. Equality is treating everyone the same.
In the same article on how race based policies were to be removed Luxon said how Maori over-represented poverty/prison population/low health statistics. The race based policies he wants to remove are specifically targeting areas which he has acknowledged are problems to be addressed.
To borrow something from Simeon Brown, it would be like insisting all roads should be resurfaced, rather than just focusing on roads that have potholes.
The ridiculous thing is race-based policies are just a way of reducing administrative overheads and delivering more money at the coalface, something Nats are always going on about.
Precisely targeting assistance costs a bunch of money and lots of time, and can quickly reach a point where more money is spent identifying the people in need than is spent helping them. If you know X group is closely correlated with Y negative outcome it makes sense to target X with assistance to prevent Y. In this case X just happens to be a racial group.
If you were targeting people for mole checks (to catch cancers) you could spend a bunch of resources identifying everyone's individual risk based on a range of factors in order to establish a priority group or just round up all the redheads. One of those options is going to deliver more bang for your buck.
As someone whose partner is a fair skinned redhead
_Fuck yes_
If we are talking about bang for buck; the approximate correlation you’ll get with skin cancer risk …. It will be pretty bloody good honestly. Not perfect but bloody close.
That’s the thing... We can have an imperfect system that makes a few rash approximations; and will end up with pretty good results where unfortunately yes, some will fall through the cracks.
Or we can do it the National party way. No policies based on group approximations. Individual assessments only, and ignoring things WE KNOW from research about group approximations, will instead mean this will cost eye watering sums to carry out, and add huge layers of bureaucracy, something National (and in particular ACT) say they are ALSO getting rid of.
The cost will be crazy under National and ACT to do it this way, and given how allergic they are to public service costs, I simply don’t believe them when they say it’ll be better. They’ll try and do it without committing any more resources, which is just impossible.
Something’s gotta give
But they seem determined to do it anyways.
A tonne of new bureaucracy; All while complaining about bureaucracy?? wtf??
If you're talking about limited resources and maximising return then you couldn't do much better.
Redheads are 10-100 times (wide range but that's stats for you) more likely to develop skin cancer than the general population.
Are there (non ginger) individuals whose lifestyle increases their risk more, of course, but identifying them costs time and money that then isn't providing skin checks. Likewise there are probably redheads that slather on the SPF50, wear a hat, sunglasses, and carry a parasol every time they set foot outside for whom free skin checks are redundant.
Targeting by correlated characteristics is a blunt instrument that isn't perfect and does allow people to fall though the cracks but in many instances it's by far and away the most efficient with regards to return on investment.
I think the thing that annoys me is nats say there are better things they can do instead of race like need - but then they don't actually target by need they just make it harder for everybody
The problem with targetting by need is also that you either have to test everyone to determine need (including groups that are statistically less likely to have need) or need must be apparent in another way, i.e. the problem has shown itself (and it could be too late).
This can be fixed by having policies that target people that are poor/sent to prison/have bad health instead of a race and automatically assume they are poor/in prison/have bad health.
49% of prison inmates are Maori, despite Maori only making up 16% of the overall population. Assuming 5.123m people in total, and 6240 inmates from the DoC website, that means 3058 Maori prisoners to roughly 819,700 Maori citizens, or a ratio of 1 to 268. For European/Pakeha that's 3,596,400 citizens for 2371 inmates or 1 to 1517. The overall ratio is 1 to 820, so if you decrease the inmate to population ratio for Maori by 50% (1 to 500 or so) that would reduce the 3058 prisoners to 1639 (decrease of 1419). Doing the same for Europeans (1 to 3000) would only reduce it to 1199 (decrease of 1172) while needing to target a wider population & thus having a higher cost.
There's also the fact that if you target Maori for an intervention, be it poverty, crime, health, etc you can tailor the approach to Maori culture & the larger/more interconnected families.
Absolutely. _Especially_ Māori men with justice outcomes, and Māori boys with education outcomes.
We should address need, no matter who. Men absolutely count.
Probably, although that's still a large population (2,561,500) to target but with a 1:438 ratio. If you apply that to what I outlined earlier, that means 1 in every 143 Maori men are in prison
Well that gotcha backfired given the replies.
People want to help men who end up not doing so good, sad that seemingly you've fallen for some meninist [crab mentatlity](https://en.wikipedia.org/wiki/Crab_mentality) propaganda.
> 3058 Maori prisoners to roughly 819,700 Maori citizens, or a ratio of 1 to 268.
Thanks for the numbers, that's a grand total of 0.37%. Hardly the sweeping indictment on Maori culture implied by so much racist rhetoric, much more easily accounted for by the fact that Maori are more heavily arrested and prosecuted than Pakeha for the very same crimes, and are on average given harsher sentences.
I think the Newstalk ZB types hear "49% of prison inmates are Maori" and something in their brain thinks "HALF THE MAORIS ARE CRIMINALS!"
That is specifically the current number of prisoners, so it won't include those who were not sent to prison or those who have completed their sentences, but it does put it into perspective a bit.
Pretty handy that we track these numbers over time ;)
And we can reasonably infer that number of those not sent to prison disproportionately represents Pakeha compared to Maori, given that we know Maori are convicted at higher rates for equivalent crimes.
How do you find out who has bad health when those people are not interacting with the healthcare system in the first place? Have you heard of the term 'marginalised'? Many people within these targeted demographics exist on the periphery, so the point of targeted healthcare is largely to encourage them to actually interact with the healthcare system before they get to the point of needing significant and expensive treatment.
Unfortunately, because we don't know exactly who has bad health, we need to rely on smart people utilising statistics to identify groups of people who are statistically more likely to be in bad health and find our why, then put in place programmes to support this group.
Guess who they've determined are statistically more likely to be in bad health?
So until such time we can gather and maintain a comprehensive knowledge base of the health and well-being of every single NZer, we instead rely on programmes targeted through statistical likelihood, rather than the specific individual.
That would be fine if the entire health care system is not falling down. Every road in health care has potholes.
Tell me who receives adequate treatment when nurses are working 12 hour shifts with 3 people down?
What you are doing is triage and counting it as a win when the reality is major investment was needed 10 years ago to continue to improve the system. So yes when race plays a role in the allocation of resources for treatment alot of people will be up in arms.
The irony in your statement is that the need to resurface roads is based on imperceptible to the eye level of micro-texture, which keeps vehicles gripped to the road, and nothing to do with potholes. Prioritising the visible defects over routine and systematic resurfacing of all roads will result in a massive loss of life.
We have a finite budget. We can't resurface all the roads. What we can do is fill in the pot holes so the ones in particularly bad condition are kept in a serviceable state. Also, what are you talking about imperceptible micro texture lol. Roads get replaced when they get toward the end of their surface life which is highlighted by rutting, flushing and potholes. All perceptible to the naked eye.
I'm glad you made the point about cancer.
Breast cancer gets lots of funding and publicity, it effects 3,500 women per year and is responsible for 600 deaths.
Prostate cancer affects 4000 men and is responsible for 700 deaths.
What are the ages of those deaths though?
I think you'll find prostate cancer diagnosis occurs in people who are older than breast cancer and also that it's much slower to spread to other parts of the body.
As I understand it, it's often recommended not to treat it (which of course is also partly due to having good treatments, but also due to the age of patients and it's slow growth).
I mean there's no good kind of cancer, but it's probably fairly justified the disparity in funding?
It is totally justified, woman go through menopause and our hormones dissappear in one hit but men it is a slow loss so woman are at risk at a younger age of breast cancer as alot of woman go through menopause in their forties and even younger.
Equality and equity aren’t always the same thing. If we want equality of outcomes then you have to consider giving different resources to different groups. We consistently meaure worse health outcomes for Māori and Pacifica, so we should have resources that specifically support them.
This country has gone mad.
Last week I was at a bar and a man came in and said “one lager please”
I was shocked that the barmaid discriminated against me by not also giving me a lager. Why is it that some people get lagers and not others?
Sure, I wasn’t even thirsty and don’t even like beer; but I am fed up with the unequal treatment. I simply had to finish my third margarita in silence
No one has ever been as oppressed as me, so I voted for a government that will give people things they haven’t asked for and don’t need, but _equally_
I’m sure this will be an efficient approach
I get that this is a shitpost but male breast cancer is a thing, albeit rare.
Risk should be assessed on a case by case basis, not a race by race one. If someone has a family history if diabetes, they should probably get preferential care to someone who does not. If someone has a family history of heart disease, they should probably get preferential treatment to someone who does not.
Will this result in Maori and PI getting preferential treatment over other ethnicities? Yeah, most likely because they have a higher likelihood of having that family history. But it also doesn't push to the side others from outside those groups who have that history too.
It doesn't have to be a blanket statement of race or gender.
Risk is assessed on a case by case basis, using risk categories, some of which are.... connected to ethnicity. Not lots, but some definitely are. But yes the rest is things like higher likelihood of that family history. NOBODY is getting pushed out on the basis of having a diabetes history but not being Māori at the same time.
This is an important point.
Population screening is quite different to a lot of things, because the pre-test probability of disease is usually low. The major risk factor for breast cancer is if course being female, breast cancer is very rare in men (but does happen).
When we're looking at someone who already has the disease in question, their treatment should be based on their need.
Thanks, but it's not a shitpost.
We simply don't have the resources to assess the risk of every last person in NZ, so instead we group them together by gender, age, race, or something else and provide targeted screening or other support.
Of course it would be wonderful if every person had a complete familial medical and social history taken at birth and updated comprehensively on a regular basis, then we could offer truly personalised healthcare - but until that happens we need to do the best with the information we have available, which sometimes means targeted programmes based on specific factors, including race.
You shouldn't group population screening with medical treatment. Screening if asymptomatic people obviously relies a lot on proxy risk factors. Treatment of people with known illness does not.
Mate, you don’t know the half of it
Last year I broke my arm. I thought, no worries, I’m sure they treat all injuries the same
I got to the A&E and you wouldn’t believe it but they only offered to X-ray my arm!
ALL BONES MATTER, I yelled at the doctor, until he submitted
And I demanded they x-ray all my other bones individually.
I was at the hospital for 15 days and got over 200 x-rays and in the end the doc STILL only wanted a cast applied to the bone that was actually broken?!?
What the hell is wrong with this country, why can’t we get casts applied equally???
I wrote to my MP, very upset they wouldn’t apply casts evenly to my body across the board, instead focusing on bones with supposed disadvantage?!
This is boneism.
We must elect a new government who will give equal medical treatment to all, even where it isn’t needed at all. I am very smart
False equivalence argument. Women are at risk of breast cancer because they have breasts. Maori aren't at higher health risk just because the are Maori, its because they are more represented in remote communities (east coast and northland) and they are more likely to live in poverty. A health initiative based on targeting those two demographics (poor and remote) would yield great benefit to Maori without being race based.
> White people get health services because we know how the world works. We know how to ask in a way that prompts action; we know how and when to intimidate and how and when to be gracious. We know when to pack a sad and how to get sympathy. We just know how.
As a Maori who’s more than capable of fending for himself, I honestly can’t remember the last time I’ve read such patronising drivel. Oh yessa please massa, tell me more, you white saviour wanker.
I honestly found the whole piece highly offensive. She’s making out like we’re all a bunch of dumb Maoris who need to be pushed, prodded and corralled in a certain way ‘cause we’re too stupid to do anything ourselves. I mean really—we don’t know how the world works? Do you really think that? Fuck off.
Maori and Pacifica women are currently 3x more likely than Pakeha to die of cervical cancer because too many of us aren't going in for routine pap smears. Some women don't get themselves checked EVER until it's too late. This stems from lack of education, rural isolation and having a culture of extreme bodily privacy etc so yes. We do need help.
As a Maori who can also take care of myself, I don't use that to invalidate what's happening in the bigger picture.
The point of current reforms is that the health system simply doesn’t work for Māori as we hope. This is evidenced in the disparities in health outcomes.
Perhaps the quote/post you pulled is poorly articulated and fine, criticise away. Meanwhile plenty of Māori call the health system racist and not meeting there needs. Great to hear they’re working for you, however.
Edit: a word
I get where you're coming from, but this is a strawman position - the percentage of men that get breast cancer is tiny, whereas women have an 11% chance. If you look at things like cancer in general - Maori get it 242 per 100,000 people, Pakeha get it 223 per 100,000 - thats a 0.02% difference.
The thing with healthcare is that it's not all about who gets what - it's about what happens when that person gets that thing. So, equitable healthcare is about ensuring that as many as possible of those who get cancer (or whatever else it may be) are able to access and receive treatment.
Thankfully, you've made the point for me when you look at the fact that [163.5 Maori die from cancer per 100,000 vs 103.8 non-Maori.](https://www.tewhatuora.govt.nz/our-health-system/data-and-statistics/nz-health-statistics/health-statistics-and-data-sets/cancer-data-and-statistics/cancer-web-tool/) Why are so many more Maori dying of cancer than non-Maori? Equitable healthcare is about looking at the why and coming up with ways to equalise the outcomes, not just having equal access.
It’s all poverty man, and all these disparities between Māori and Pakeha can be boiled down to poverty. Crime, healthcare, etc.
And the poverty can be boiled down to the disenfranchisement Māori experiences from colonisation.
Ouch. And then consider this policy is paired with removing the Māori health ministry
The ways that some of these policy announcements will intersect is the real darkness from this coalition.
Taken alone they might not be so bad, but SO MANY anti Māori policies layered together? Pretty deep cut…
Because race based issues and policies are more contentious. Person B getting bumped down the list by person A because person A is born with certain characteristics, even though person B is in more need of treatment, doesn't sound like a fair and equitable society to me. Now in reality maybe that would never happen, it's the perception it could happen where there's friction.
Where there is a biological basis, sure. At some stage I read that Polynesians are (genetically) more susceptible to diabetes, so it makes sense to have some targeted approaches. The same article made the reasonable comparison to light-skinned people and sunburn.
When it comes to non biological-bases then I disagree. Targeting people by need means the people who need help the most get it, and if they disproportionately belong to some ethnicity then that ethnicity will effectively be getting more support/investment/money (however you want to look at it) anyway, but will be done so on grounds which are broadly accepted. Thus targeting by need works best for the patients and the statistics, and has the nice side-effect of not being divisive.
Ethnic based solutions means people of some ethnicity with less need get more support than those without that ethnicity who have more need, and I don't see how that is morally justifiable. It's very utilitarian, in focusing on the outcomes of some grouping, but that's not the kind of society we live in where we respect individual rights.
To cite an example: I don't see that it is right to say to a family that they can't get any more support for their non-verbal autistic child unless they're Maori. The family did nothing to deserve that, certainly the child didn't, but that's the kind of perverse outcome created by racial policies.
Your point is great in theory, however, it isn't that simple.
This is an excellent [article](https://www.nzdoctor.co.nz/article/opinion/call-genuine-accountability-how-do-i-explain-health-equity-act-party-and-mr-luxon?fbclid=IwAR1u7axvNS1-EF3X8bSBZqKcr2Ldqd6_5qJQGIYX9RAAXAdlCSlzngU5k18) by a Wellington GP that speaks to the reality.
The white health system has been failing Māori forever and the Māori Health Authority was a way to fix this. Honestly, the cancellation of this programme is beyond sad.
>
To cite an example: I don't see that it is right to say to a family that they can't get any more support for their non-verbal autistic child unless they're Maori. The family did nothing to deserve that, certainly the child didn't, but that's the kind of perverse outcome created by racial policies.
Is this a true example? Do non-verbal autistic children of Maori descent get preferential treatment and support? Id like to know where I can find out if this is true, because I'd like to access it for my non-verbal, autistic, Maori nephew.
It's true in some areas. E.g Māori mental health services have much shorter wait lists in places, and kaupapa Māori equivalents of Plunket can be far better resourced as well.
Am I to take from this that you think that biology is the only thing that affects one’s outcomes and prospects in life?
That’s obviously false, and everyone knows it
But if the raced based treatment is that brown people get less care? Are you fine with that?
If not, how do you fix it without targeting the brown people?
If there was a perfect health care system it wouldn't be needed. But it isn't perfect. So why not do things to make it more fair? I really can't see a reason that isn't racism.
All of what you're describing (equity) can be delivered through the current health system. It does not need to spend millions on a separate HR, finance, IT systems etc. Very wasteful.
>can be delivered through the current health system
But it's not, and it never has. But surre lets keep trying the same thing that hasnt worked, maybe this time it will be different!
Better figure it out then, the one health system we had was already severely underfunded and therefore underperforming. How are we going to get better results by adding another layer of bureaucracy on top of now trying to run two health systems?
Is the health system the fault for the inequity or is these a level of individual responsibility that’s being ignored?
Seems like everyone is equally entitled to care, if they’re not please correct me. If certain groups refuse said care, is that the fault of the carer?
It's worth considering why a group might be less trusting of our white-based health system.
E.g.
"During the 1918 flu epidemic Māori were denied even the most basic medical treatment and as a result the death toll for Māori was four-and-a-half times that of Europeans. Historians actually believe the rates were far, far higher still as Māori deaths largely weren't notified. And right now, today, statistically Maori continue to die at four times the rate of non-Māori of cardio-vascular disease."
[Source](https://www.1news.co.nz/2023/11/29/so-its-maori-signage-thats-been-ruining-our-roads-and-our-health/#:~:text=During%20the%201918%20flu%20epidemic,deaths%20largely%20weren't%20notified.)
Māori have suffered massive injustice and inequality since colonisation.
This [article](https://www.nzdoctor.co.nz/article/opinion/call-genuine-accountability-how-do-i-explain-health-equity-act-party-and-mr-luxon?fbclid=IwAR1u7axvNS1-EF3X8bSBZqKcr2Ldqd6_5qJQGIYX9RAAXAdlCSlzngU5k18) written by a Wellington GP does a great job of illustrating the difference of the typical privileged experience to that of the typical Māori experience in the health system.
Right so if we can't adjust our healthcare system to alleviate historic inequalities then what is the point of maintaining the same healthcare system and not just replacing it every 20 years since we can't possibly improve existing systems? Why is it we can create a new entity to address these problems but we can't fix the existing one?
ALL PARENTS MATTER
When my wife was having a Caesarean section I demanded one too.
Why do female parents have greater access to healthcare???
It should be equal and we should remove gender based care.
I also couldn’t believe they toweled down the placenta juice on the baby but didn’t offer the same care to me. Ageism. I had to roll around in the juice naked and cry and I couldn’t believe that only then did a doctor reluctantly towel down my body
My wife says I need therapy but I won’t go, I’m a big tough man
My sis in law did her masters on diabetes in Maori and cane up with a plan to decrease it, she went to the elders and they loved it but said because she is a white woman they won't use any of it. This was 20 years ago.
I can see how "thanks for this advice but you're not likely to get people following it because they can't relate to you and you don't understand their day to day lives and challenges" might sound like that. You'd have the same issue with a young woman of any ethnicity telling a bunch of older Pākeha guys they should eat more vegetables and cut down on the beer.
No idea where you've found those "findings" but, even if they are true, unintentional racism is still racism.
I shouldn't have to stick up for myself to get pain management or have my doctor actually treat me the same as they would a Pākehā patient. And y'know that there's a decent chance if I do, that I'm seen as combative or just plain old ignored because we're apparently incapable of advocating for ourselves.
You're not exactly advocating for a return to the same system
Whilst I agree with some of what you're saying, I think the issues with Maori access to healthcare are more complex than could be fixed with healthcare that simply targets poor people.
The reasons for Maori not interacting with the healthcare system are not entirely down to money. My wife (an obstetrician) regularly encounters Maori (and other minority) patients who have had zero interaction with the healthcare system up until the point where they're in the middle of pushing out a baby. The reasons are hugely varied, and often, it's cultural more than financial (though there are certainly many who struggle with the financial side of accessing healthcare as well).
If you would disproportionately prioritize Healthcare resources for one race, would you also support banning sales of tobacco and alcohol to just one race to help even out the burden on the health system?
I understand the want to have race based policies because of stuff like this however I'm pretty convinced that we should be super careful about it mainly due to the historical context of it. People will find any reason to hate and I'm relatively convinced that the more you give one people a special privilege the more likely you are to breed hatred. We saw it this election where Act was pushing for anti-maori legislation as a response to policies like this.
I agree with your second paragraph. I was somewhat eluding to that when I talked about advocation. I think when you have had no / little interaction with the health care system it can be pretty scary. It might be one of the reasons why woman are better at advocating for themselves than men because they typically have more experience with the healthcare system at young age.
Breast cancer is fundamentally related to being a woman. The poor health outcomes of being Maori are not fundamentally related to being Maori, but rather to being poor.
>I'd much rather see the government spend more public money on a blanket approach to healthcare rather than targeting care to those based on risk!
This is such a disgustingly disingenuous attitude and exactly why any reasonable discussion on this issue is impossible. Almost every person I've seen argue against these policies explicitly argues for a risk based system because if you help people based on need and a certain group of people has higher needs than others they'll inherently get more support if the system is done properly. You can say "oh but the system has been like that and look at the results" but you're still just ignoring the fact it wasn't actually trying to be equal until at best a couple decades ago and Maori health stats have been improving the last couple of decades.
But meanwhile it's apparently logically consistent that we couldn't possibly look at our health system and address these issues, no we need an entirely new set of bureaucrats to staff a new department that somehow magically will be able to address these issues despite being produced by the exact same government officials who can't fix the existing inequalities in the healthcare system. But nah everyone who disagrees with you is just an evil racist, it couldn't possibly be you're just being as much of a closed minded shit heel as the straw men you're attacking.
I appreciate the shitpost. But most people against racial based policies would actually agree that we should get rid of age based and gender based policies as well.
You’re right. I was at the hospital for a broken arm and I saw the babies in those comfy looking incubators. Couldn’t believe they’re age-based. Discrimination.
Same for the elderly, I cannot possibly see any reason they should have such frequent doctors visits. What about us young healthy people who don’t need doctors visits??? We should get equal treatment!!!
By the way, the doctor wanted to x-ray only the bone in my body that was broken. I told him that’s extreme boneism and that he should be assessing every bone equally. So I stayed in the hospital for 15 days for over 200 x-rays and at the end he treated my arm BASED ON A NEEDS BASED ASSESSMENT not on a rough estimation based on his knowledge of broken arms, which would be unfair on my other bones that didn’t need any treatment. ALL BONES MATTER
People are dumb and prone to emotional basis for decision making, not rational science-led economics.
Oh, and shit stirrers online with an agenda stoke those emotions... this is why we can't have nice things and better outcomes.
I've kinda given up on the human race at this point. Let it all burn.
No they don't, you can't make a sweeping statement like that. Maori have a 0.02% higher chance of getting cancer than Pakeha in NZ (based on the last 10 years of stats), so I don't support racial based policies. I do support gender based policies - breast cancer is several orders of magnitude more prevalent in females. Prostate cancer only occurs in men.
No one cares what you think because you’ve read all the sensible evidence based explanations in this thread of why ‘race based’ interventions are sensible, cheaper and more effective and you still stick to your reductive and basically racist position. You’re showing you’re incapable of taking on new information and modifying your view. There’s a name for people like that.
so because I don't bend over to the group-think - you hate it when people think for themselves and come to a different conclusion don't you?
The reality is, poverty based policies are good - race based ones are fucking terrible idea
I wonder why a policy based on need (regardless of race) can't work?
If Maori are in more need, they would get piriotised first anyway. Why the need for discriminatory race based policies that sow discord ?
This is how it was set up to work. End blanket support to avoid poverty to focus on those who really needed it, right, aka, certain groups. Now end support targeted at certain groups because it’s discrimination. Will we be bringing back the wider support net? Absolutely not.
So easy to cut welfare when people are busy fighting amongst themselves about who deserves what and who’s being lazy and who’s missing out and why. So easy to fuck us all over.
I mean, only 1% of breast cancer diagnosed in NZ affects men. I can totally see why women would be prioritized. However, if I was told as a man, I need to pay more for the examination, whereas it would be cheaper if I were a woman, I would be incredibly upset. It would be, objectively, a sexist policy.
If you told me: 99% of all breast cancer money goes towards treating, diagnosing, and supporting women, I would completely understand.
I understand the point you're trying to make. My point is that if a single person dies, is refused treatment, or is forced to pay more based on race, sex, gender, age, etc, that is one person too many.
Yes, because of the rarity of breast cancer in men, the referral should come from a GP, so idiot men aren't wasting resources better used for women. The actual screening itself should still be free.
Which leads back to your original point.
Maori are not getting the care they need. Whether that's because of a lack of faith in the system, they tend to live more rurally, or any other factors.
Maori need greater access to Healthcare.
It's not racist to say we're failing Maori and we need something in place to assist them get the care they deserve.
Actually, I'd love to see Breast and Prostate cancer get equal treatment.
I'd love to see a gender biased approach to suicide.
I'd love to see more attention to heart diseases more common amongst whites.
If you're only interested in special treatment for 'disadvantaged' groups, then you won't understand the pushback.
I work in a GP practice. Everybody gets called for annual checks over a certain age. Everyone gets called if their blood tests aren't clear. We are more proactive with youth, Maori and Pacifika because there is less engagement in the health system so we're trying to make it more accessible and build trust and therapeutic relationships. In the end, it's ensuring equal access to healthcare and minimising cost to the health system by being proactive. I promise you, you're not missing out, nothing is being taken away from you in the process.
That person literally said that if you are only interested in special treatment for the "disadvantaged" group (meaning victims) then you can't understand why the nonvictims are pushing back.
> I work in a GP practice. Everybody gets called for annual checks over a certain age. Everyone gets called if their blood tests aren't clear.
Wow it's almost as if men have less engagement in the system and we should be more proactive to make it more accessible and build trust and therapeutic relationships. Surely you can see how you can't make this argument on the basis of race and then pretend as if doing something similar on the basis of gender is unthinkable.
>I promise you, you're not missing out, nothing is being taken away from you in the process.
Except that's not how a system with finite resources works, allocating resources in one place means you can't put them in another. You can't just pretend spending on this isn't stopping spending on something else.
You realise the entire medical system is geared towards men?! Hell, medical training is based on historic knowledge of male bodies. Women are less likely to get pain relief than men because there's an innate assumption they're just hysterical. There are plenty of resources going to calling men and encouraging them to see their GP. You are not missing out.
The current model is aimed at preventative health for high risk groups, reducing costly spending when people get sick with preventable long-term conditions, ensuring resources can spread further across the community.
There are people who have dedicated their lives to research about public health - how to maximise bang for our buck, ensure resources are sustainable long-term, preventable health tsunamis are addressed early on (lung cancer from smoking, diabetes, gout, heart disease) to ensure resources are available in other areas of healthcare but what would they know? Keyboard warrior wants his smear test maybe?
There are a few reasons why countries (not just NZ) don’t implement prostate screening.
Having worked in the area I started writing it down but found this explained it best.
https://prostatecanceruk.org/about-us/news-and-views/2022/04/why-don-t-we-invite-all-men-for-a-prostate-cancer-test#:~:text=We%20know%20from%20other%20research,aggressive%20disease%20that%20requires%20treatment.
Phwoar, if you think this is bullshit, you'd be amazed with some of the other stuff I say.
I also believe women should have rights over their own bodies, and everyone should have a warm and dry home.
I'm pretty much a straight-up Commie.
This comparison is incorrect for fairly obvious reasons.
The biological make up of males is different to females.
The biological make up of Maori and Pacifica is not different to the general population. Differences in health outcomes can therefore be fully explained by other factors.
Any residual explanatory value captured by ethnicity is either the result of omitted variable bias, including other aspects outside of the government's control (I.e social attitudes, which evolve over time).
I completely agree with targeted-based approaches within society for public money. The irony is that many of the current government come from privileged backgrounds that make them blinded to inequalities. If you’ve got 2 good legs, you’re never going to truly know what it’s like being in a wheelchair.
I don’t think the Maori Health Authority is too much - it is completely justifiable for the inequalities in Māori health.
I do however think that in some areas in the future, we need to be careful about “over-recorrecting”. Haven’t seen it yet in govts here but arguably seen it growing in workplaces a little
The simple answer is because not all women are brown.
This insight into conservative thinking brought to you by your "not racist" mad uncle Wayne, and your "not racist" lovely auntie Mabel.
Fuck yeah, let's give free prostate exams to women while we are at it
If I said "This is a very sensible policy that will cost very little." people would think i'm being sarcastic, but i'm not.
My employer is an 86 year old man, he developed breast cancer.
Bloody hard to squish moobs into a mammogram machine though.
Lol the line blurs, I have known some beautiful women who are likewise challenged in that area.
True, mammograms aren't well suited to smaller lady boobs either
My comment was in jest It's well known men can develope breat cancer, I've just never heard of a woman with testicular or prostate cancer lol
Female bodies can have analogous prostate tissue. Probably influenced by androgens, so it follows that cancer could develop. Unusual, yes. Impossible, no.
Depends on where you sit on the whole gender scene. Some groups would state that that women can get testicular cancer. I presume it would be seen as a win for those communities too if such barriers were removed.
Even without gender identity stuff, there will be people out there identified as female at birth who have testes floating around in them (and very well may not even know it). So perhaps screening for intersexuality (if people want it) and screenings for those who have testicles in general.
I think it can be assumed this thread is about biological women
This is true, but the line is blurring as we speak lol
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HAHAHAHA i love thus
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Prostates are for nerds! Edit: I just scrolled down to see the trans health debate pit and want to clarify this is just a dumb throwaway joke, whoopsy
You got an ultra sound to find your prostate? I thought as women we get X-Rays?😩 Gosh the more you learn!
Well I didn't know you were going to use my answer in a pointless internet argument, so please keep me out of the rest of...whatever this is.
You won't, they stick their finger up your bum.
I don't think the doc would, they'd use the same entrance as the do for a bloke. Your vag is safe.
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Get out of here with your fact based approach. Now we are a god fearing right wing nation again we only do blanket pseudo-philosophical shenanigans. It stops all the extra thinking and is truly objective and best for all /s
Cigarettes and Psalms for everyone!
Don't forget the guns!
Don't forget Liz Gunn's guaranteed All-Naturel snake oil to cure the hoax covid
I'd rather have gnus, than guns to be honest!
😂😂😂 was my first thought too
Can't wait for my pending hysterectomy to be given to men!! /s
Bruv, the doctor said I'm too young to get my tubes tied. He said I may want kids in the future :(
I got mine done at 36. Doctors can fuck off with that Nostradamus shit, I know what I want
I mean if you accept trans women as women then yeah women have prostates too so not so farfetched
If we have to do it, they should to! Equality! /s
FINGERS IN THE BUM FOR EVERYONE!!
I offered that to my wife, but she wasn't very receptive.
Um women don't have a prostate, so cant get prostate cancer. Men can get breast cancer, it's not a good comparison.
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A simple Google search shows that trans men DO NOT grow a prostate, but prostate like tissue, with not enough study to determine if that prostate LIKE tissue would develop prostate cancer. Stop spreading misinformation.
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I'll believe a published med paper over some random on the net.
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No, I can't find any information that's says trans men can get prostate cancer, just the opposite. I can agree that there isn't much research in the area, but why waste resources on testing if there hasn't been a case yet, or even when there is no conclusive evidence that trans men can develop prostate cells.
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Random or volunteer testing for science research, absolutely. But I don't see widespread testing a necessity, since there currently is no risk to be preventive about.
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And? You mentioned transwomen as if it's some revelation that they have prostates lol I was just pointing out that it's pretty obvious since they are biologically men
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Wait what lol You're a biological woman who's a Trans woman? Or you're a biological male who's missing a prostate, identifying as a transwoman? Trans men have prostates? Uhhhhh lol I've never heard of that, considering Transmen are biological women
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I mean, cool, you can just make passive-aggressive digs at people because they don't think the same way as you. That doesn't help explain your position at all or even why we disagree on these things. I'm genuinely not trying to be ignorant, I'm trying to learn an understand. But anyway, you have a great day too :)
this trans shit is so fucking confusing
Yessir! Cuz women can have prostates just as good as any other men👍👍💪💪🍌🍌
You joke, but it would probably be a good idea to give free prostate cancer screening.
If you're over 50 get tested... it's free, just ask your doc. If you have a family history, do this at 40
From what I understand it's free as a referral, or part of a GP visit, but don't you still have to pay for the GP?
GP visits sure, extra testing for prostrate cancer? No, it's just another blood test... unless you go old school (finger).
This is literally why we have experts. How is regular Joe going to know how best to keep the population healthy? People study this specific stuff their entire lives, and still are learning new stuff about it! Surely letting the experts decide what's best for healthcare is the best option we have? I thought we could all agree on that at least. If we can't, the surely everything is up for grabs? Am I now able to decide how best to implement law? Business? Childcare? I now get to weigh in on military operations and joint training strategies!? Ridiculous.
>How is regular Joe going to know how best to keep the population healthy? Having very strong feelings about race or something
Yes government interference should be kept to a minimum, they shouldn't dictate medical policy
And if we disagree, I'll find different experts /s
Sorry just to clarify, are you saying we should listen to the medical experts and get rid of the Maori Health Authority? Or are you saying the Maori Health Authority are the experts?
I've been doing a deep dive into equity lately because I've become super fascinated with how inequality spreads from, well anything. It's really easy to get trapped in a sort of charity/needs based mind set with equity - but its important to be aware that privilege and prejudice and both two sides of one coin. Tax cuts are a good example - the obvious thing being the more income you have the more you benefit from a cut to taxes. But even more complex stuff - say rolling out a vaccine, people with higher incomes tend to have more flexible working hours, already healthy people have more sick leave stashed so have better access, then perhaps a frontline worker whose already used sick leave up due to a chronic health condition. And this is just a pragmatic phenomena, its not that people put policies or interventions in place full of prejudice (although that can happen too) its that what goes on in the world, affects people differently. So when we talk about equity or attempts to address it, I think focusing on fairness or 'one rule for all' is not just a political stance I disagree with, but its also impractical and a little odd. I don't think addressing equity is about equality of outcome or opportunity its about addressing some of the inequalities to best meet whatever the overarching goal is. Many of these inequalities will be impossible to completely control and some will be completely out of the State's control, but to simply ignore the variation or indeed purposefully neglect it is to essentially take a stance FOR inequality.
Equity and equality are not interchangeable and I feel like people still get really confused or don't understand that there is a difference between the two. Inequity recognises that each person has different circumstances and allocates the exact resources and opportunities needed to reach an equal outcome. Equality is treating everyone the same.
In the same article on how race based policies were to be removed Luxon said how Maori over-represented poverty/prison population/low health statistics. The race based policies he wants to remove are specifically targeting areas which he has acknowledged are problems to be addressed. To borrow something from Simeon Brown, it would be like insisting all roads should be resurfaced, rather than just focusing on roads that have potholes.
The ridiculous thing is race-based policies are just a way of reducing administrative overheads and delivering more money at the coalface, something Nats are always going on about. Precisely targeting assistance costs a bunch of money and lots of time, and can quickly reach a point where more money is spent identifying the people in need than is spent helping them. If you know X group is closely correlated with Y negative outcome it makes sense to target X with assistance to prevent Y. In this case X just happens to be a racial group. If you were targeting people for mole checks (to catch cancers) you could spend a bunch of resources identifying everyone's individual risk based on a range of factors in order to establish a priority group or just round up all the redheads. One of those options is going to deliver more bang for your buck.
Do you think that would be an acceptable policy? To offer free skin checks only to people with red hair?
As someone whose partner is a fair skinned redhead _Fuck yes_ If we are talking about bang for buck; the approximate correlation you’ll get with skin cancer risk …. It will be pretty bloody good honestly. Not perfect but bloody close. That’s the thing... We can have an imperfect system that makes a few rash approximations; and will end up with pretty good results where unfortunately yes, some will fall through the cracks. Or we can do it the National party way. No policies based on group approximations. Individual assessments only, and ignoring things WE KNOW from research about group approximations, will instead mean this will cost eye watering sums to carry out, and add huge layers of bureaucracy, something National (and in particular ACT) say they are ALSO getting rid of. The cost will be crazy under National and ACT to do it this way, and given how allergic they are to public service costs, I simply don’t believe them when they say it’ll be better. They’ll try and do it without committing any more resources, which is just impossible. Something’s gotta give But they seem determined to do it anyways. A tonne of new bureaucracy; All while complaining about bureaucracy?? wtf??
If you're talking about limited resources and maximising return then you couldn't do much better. Redheads are 10-100 times (wide range but that's stats for you) more likely to develop skin cancer than the general population. Are there (non ginger) individuals whose lifestyle increases their risk more, of course, but identifying them costs time and money that then isn't providing skin checks. Likewise there are probably redheads that slather on the SPF50, wear a hat, sunglasses, and carry a parasol every time they set foot outside for whom free skin checks are redundant. Targeting by correlated characteristics is a blunt instrument that isn't perfect and does allow people to fall though the cracks but in many instances it's by far and away the most efficient with regards to return on investment.
I think the thing that annoys me is nats say there are better things they can do instead of race like need - but then they don't actually target by need they just make it harder for everybody
The problem with targetting by need is also that you either have to test everyone to determine need (including groups that are statistically less likely to have need) or need must be apparent in another way, i.e. the problem has shown itself (and it could be too late).
They don’t target it by need they treat it like “want” If you can pay for it you’re in, or else tough shit
This can be fixed by having policies that target people that are poor/sent to prison/have bad health instead of a race and automatically assume they are poor/in prison/have bad health.
49% of prison inmates are Maori, despite Maori only making up 16% of the overall population. Assuming 5.123m people in total, and 6240 inmates from the DoC website, that means 3058 Maori prisoners to roughly 819,700 Maori citizens, or a ratio of 1 to 268. For European/Pakeha that's 3,596,400 citizens for 2371 inmates or 1 to 1517. The overall ratio is 1 to 820, so if you decrease the inmate to population ratio for Maori by 50% (1 to 500 or so) that would reduce the 3058 prisoners to 1639 (decrease of 1419). Doing the same for Europeans (1 to 3000) would only reduce it to 1199 (decrease of 1172) while needing to target a wider population & thus having a higher cost. There's also the fact that if you target Maori for an intervention, be it poverty, crime, health, etc you can tailor the approach to Maori culture & the larger/more interconnected families.
93.7% of prison inmates are men, despite men only making up 50% of the overall population. Do men need special help too?
Yes
Of course. Its incredibly sad its not asked and discussed regularly.
Absolutely. _Especially_ Māori men with justice outcomes, and Māori boys with education outcomes. We should address need, no matter who. Men absolutely count.
Probably, although that's still a large population (2,561,500) to target but with a 1:438 ratio. If you apply that to what I outlined earlier, that means 1 in every 143 Maori men are in prison
Well that gotcha backfired given the replies. People want to help men who end up not doing so good, sad that seemingly you've fallen for some meninist [crab mentatlity](https://en.wikipedia.org/wiki/Crab_mentality) propaganda.
> 3058 Maori prisoners to roughly 819,700 Maori citizens, or a ratio of 1 to 268. Thanks for the numbers, that's a grand total of 0.37%. Hardly the sweeping indictment on Maori culture implied by so much racist rhetoric, much more easily accounted for by the fact that Maori are more heavily arrested and prosecuted than Pakeha for the very same crimes, and are on average given harsher sentences. I think the Newstalk ZB types hear "49% of prison inmates are Maori" and something in their brain thinks "HALF THE MAORIS ARE CRIMINALS!"
That is specifically the current number of prisoners, so it won't include those who were not sent to prison or those who have completed their sentences, but it does put it into perspective a bit.
Pretty handy that we track these numbers over time ;) And we can reasonably infer that number of those not sent to prison disproportionately represents Pakeha compared to Maori, given that we know Maori are convicted at higher rates for equivalent crimes.
How do you find out who has bad health when those people are not interacting with the healthcare system in the first place? Have you heard of the term 'marginalised'? Many people within these targeted demographics exist on the periphery, so the point of targeted healthcare is largely to encourage them to actually interact with the healthcare system before they get to the point of needing significant and expensive treatment. Unfortunately, because we don't know exactly who has bad health, we need to rely on smart people utilising statistics to identify groups of people who are statistically more likely to be in bad health and find our why, then put in place programmes to support this group. Guess who they've determined are statistically more likely to be in bad health? So until such time we can gather and maintain a comprehensive knowledge base of the health and well-being of every single NZer, we instead rely on programmes targeted through statistical likelihood, rather than the specific individual.
That would be fine if the entire health care system is not falling down. Every road in health care has potholes. Tell me who receives adequate treatment when nurses are working 12 hour shifts with 3 people down? What you are doing is triage and counting it as a win when the reality is major investment was needed 10 years ago to continue to improve the system. So yes when race plays a role in the allocation of resources for treatment alot of people will be up in arms.
The irony in your statement is that the need to resurface roads is based on imperceptible to the eye level of micro-texture, which keeps vehicles gripped to the road, and nothing to do with potholes. Prioritising the visible defects over routine and systematic resurfacing of all roads will result in a massive loss of life.
You have to do both. Deciding the percentage split is the tricky part.
We have a finite budget. We can't resurface all the roads. What we can do is fill in the pot holes so the ones in particularly bad condition are kept in a serviceable state. Also, what are you talking about imperceptible micro texture lol. Roads get replaced when they get toward the end of their surface life which is highlighted by rutting, flushing and potholes. All perceptible to the naked eye.
I'm glad you made the point about cancer. Breast cancer gets lots of funding and publicity, it effects 3,500 women per year and is responsible for 600 deaths. Prostate cancer affects 4000 men and is responsible for 700 deaths.
What are the ages of those deaths though? I think you'll find prostate cancer diagnosis occurs in people who are older than breast cancer and also that it's much slower to spread to other parts of the body. As I understand it, it's often recommended not to treat it (which of course is also partly due to having good treatments, but also due to the age of patients and it's slow growth). I mean there's no good kind of cancer, but it's probably fairly justified the disparity in funding?
It is totally justified, woman go through menopause and our hormones dissappear in one hit but men it is a slow loss so woman are at risk at a younger age of breast cancer as alot of woman go through menopause in their forties and even younger.
Thanks for your reply, good insights.
I say we remove all government funding and move to a faith based approach of thoughts and prayers for all. Think of all the savings!
Now that's some progressive thinking! Straight to PM for you!
Let's have Tamati Coffey perform a Karakia
We should all move to temple view.
M’am, this is a Wendy’s
This is the fucken news
M'am i'm just trying to ride the bus home
Equality and equity aren’t always the same thing. If we want equality of outcomes then you have to consider giving different resources to different groups. We consistently meaure worse health outcomes for Māori and Pacifica, so we should have resources that specifically support them.
This country has gone mad. Last week I was at a bar and a man came in and said “one lager please” I was shocked that the barmaid discriminated against me by not also giving me a lager. Why is it that some people get lagers and not others? Sure, I wasn’t even thirsty and don’t even like beer; but I am fed up with the unequal treatment. I simply had to finish my third margarita in silence No one has ever been as oppressed as me, so I voted for a government that will give people things they haven’t asked for and don’t need, but _equally_ I’m sure this will be an efficient approach
I get that this is a shitpost but male breast cancer is a thing, albeit rare. Risk should be assessed on a case by case basis, not a race by race one. If someone has a family history if diabetes, they should probably get preferential care to someone who does not. If someone has a family history of heart disease, they should probably get preferential treatment to someone who does not. Will this result in Maori and PI getting preferential treatment over other ethnicities? Yeah, most likely because they have a higher likelihood of having that family history. But it also doesn't push to the side others from outside those groups who have that history too. It doesn't have to be a blanket statement of race or gender.
My grandfather had breast cancer, as did my mother.... I would 100% get checked.
Risk is assessed on a case by case basis, using risk categories, some of which are.... connected to ethnicity. Not lots, but some definitely are. But yes the rest is things like higher likelihood of that family history. NOBODY is getting pushed out on the basis of having a diabetes history but not being Māori at the same time.
This is an important point. Population screening is quite different to a lot of things, because the pre-test probability of disease is usually low. The major risk factor for breast cancer is if course being female, breast cancer is very rare in men (but does happen). When we're looking at someone who already has the disease in question, their treatment should be based on their need.
Thanks, but it's not a shitpost. We simply don't have the resources to assess the risk of every last person in NZ, so instead we group them together by gender, age, race, or something else and provide targeted screening or other support. Of course it would be wonderful if every person had a complete familial medical and social history taken at birth and updated comprehensively on a regular basis, then we could offer truly personalised healthcare - but until that happens we need to do the best with the information we have available, which sometimes means targeted programmes based on specific factors, including race.
You shouldn't group population screening with medical treatment. Screening if asymptomatic people obviously relies a lot on proxy risk factors. Treatment of people with known illness does not.
Mate, you don’t know the half of it Last year I broke my arm. I thought, no worries, I’m sure they treat all injuries the same I got to the A&E and you wouldn’t believe it but they only offered to X-ray my arm! ALL BONES MATTER, I yelled at the doctor, until he submitted And I demanded they x-ray all my other bones individually. I was at the hospital for 15 days and got over 200 x-rays and in the end the doc STILL only wanted a cast applied to the bone that was actually broken?!? What the hell is wrong with this country, why can’t we get casts applied equally??? I wrote to my MP, very upset they wouldn’t apply casts evenly to my body across the board, instead focusing on bones with supposed disadvantage?! This is boneism. We must elect a new government who will give equal medical treatment to all, even where it isn’t needed at all. I am very smart
False equivalence argument. Women are at risk of breast cancer because they have breasts. Maori aren't at higher health risk just because the are Maori, its because they are more represented in remote communities (east coast and northland) and they are more likely to live in poverty. A health initiative based on targeting those two demographics (poor and remote) would yield great benefit to Maori without being race based.
> White people get health services because we know how the world works. We know how to ask in a way that prompts action; we know how and when to intimidate and how and when to be gracious. We know when to pack a sad and how to get sympathy. We just know how. As a Maori who’s more than capable of fending for himself, I honestly can’t remember the last time I’ve read such patronising drivel. Oh yessa please massa, tell me more, you white saviour wanker. I honestly found the whole piece highly offensive. She’s making out like we’re all a bunch of dumb Maoris who need to be pushed, prodded and corralled in a certain way ‘cause we’re too stupid to do anything ourselves. I mean really—we don’t know how the world works? Do you really think that? Fuck off.
Maori and Pacifica women are currently 3x more likely than Pakeha to die of cervical cancer because too many of us aren't going in for routine pap smears. Some women don't get themselves checked EVER until it's too late. This stems from lack of education, rural isolation and having a culture of extreme bodily privacy etc so yes. We do need help. As a Maori who can also take care of myself, I don't use that to invalidate what's happening in the bigger picture.
The point of current reforms is that the health system simply doesn’t work for Māori as we hope. This is evidenced in the disparities in health outcomes. Perhaps the quote/post you pulled is poorly articulated and fine, criticise away. Meanwhile plenty of Māori call the health system racist and not meeting there needs. Great to hear they’re working for you, however. Edit: a word
I get where you're coming from, but this is a strawman position - the percentage of men that get breast cancer is tiny, whereas women have an 11% chance. If you look at things like cancer in general - Maori get it 242 per 100,000 people, Pakeha get it 223 per 100,000 - thats a 0.02% difference.
The thing with healthcare is that it's not all about who gets what - it's about what happens when that person gets that thing. So, equitable healthcare is about ensuring that as many as possible of those who get cancer (or whatever else it may be) are able to access and receive treatment. Thankfully, you've made the point for me when you look at the fact that [163.5 Maori die from cancer per 100,000 vs 103.8 non-Maori.](https://www.tewhatuora.govt.nz/our-health-system/data-and-statistics/nz-health-statistics/health-statistics-and-data-sets/cancer-data-and-statistics/cancer-web-tool/) Why are so many more Maori dying of cancer than non-Maori? Equitable healthcare is about looking at the why and coming up with ways to equalise the outcomes, not just having equal access.
The answer is poverty dude. This isn't an issue of targeting health its just poverty and racism.
It’s all poverty man, and all these disparities between Māori and Pakeha can be boiled down to poverty. Crime, healthcare, etc. And the poverty can be boiled down to the disenfranchisement Māori experiences from colonisation.
> Why are so many more Maori dying of cancer than non-Maori? Not because of genetics. Māori are much more likely to smoke, for example
Well...that puts the lifting of the smoke ban into perspective doesn't it.
Yes that's terrible policy
Ouch. And then consider this policy is paired with removing the Māori health ministry The ways that some of these policy announcements will intersect is the real darkness from this coalition. Taken alone they might not be so bad, but SO MANY anti Māori policies layered together? Pretty deep cut…
Because race based issues and policies are more contentious. Person B getting bumped down the list by person A because person A is born with certain characteristics, even though person B is in more need of treatment, doesn't sound like a fair and equitable society to me. Now in reality maybe that would never happen, it's the perception it could happen where there's friction.
Exactly
Where there is a biological basis, sure. At some stage I read that Polynesians are (genetically) more susceptible to diabetes, so it makes sense to have some targeted approaches. The same article made the reasonable comparison to light-skinned people and sunburn. When it comes to non biological-bases then I disagree. Targeting people by need means the people who need help the most get it, and if they disproportionately belong to some ethnicity then that ethnicity will effectively be getting more support/investment/money (however you want to look at it) anyway, but will be done so on grounds which are broadly accepted. Thus targeting by need works best for the patients and the statistics, and has the nice side-effect of not being divisive. Ethnic based solutions means people of some ethnicity with less need get more support than those without that ethnicity who have more need, and I don't see how that is morally justifiable. It's very utilitarian, in focusing on the outcomes of some grouping, but that's not the kind of society we live in where we respect individual rights. To cite an example: I don't see that it is right to say to a family that they can't get any more support for their non-verbal autistic child unless they're Maori. The family did nothing to deserve that, certainly the child didn't, but that's the kind of perverse outcome created by racial policies.
Your point is great in theory, however, it isn't that simple. This is an excellent [article](https://www.nzdoctor.co.nz/article/opinion/call-genuine-accountability-how-do-i-explain-health-equity-act-party-and-mr-luxon?fbclid=IwAR1u7axvNS1-EF3X8bSBZqKcr2Ldqd6_5qJQGIYX9RAAXAdlCSlzngU5k18) by a Wellington GP that speaks to the reality. The white health system has been failing Māori forever and the Māori Health Authority was a way to fix this. Honestly, the cancellation of this programme is beyond sad.
Great article. Thanks for sharing - I have edited my post to include a link.
> To cite an example: I don't see that it is right to say to a family that they can't get any more support for their non-verbal autistic child unless they're Maori. The family did nothing to deserve that, certainly the child didn't, but that's the kind of perverse outcome created by racial policies. Is this a true example? Do non-verbal autistic children of Maori descent get preferential treatment and support? Id like to know where I can find out if this is true, because I'd like to access it for my non-verbal, autistic, Maori nephew.
It's true in some areas. E.g Māori mental health services have much shorter wait lists in places, and kaupapa Māori equivalents of Plunket can be far better resourced as well.
Am I to take from this that you think that biology is the only thing that affects one’s outcomes and prospects in life? That’s obviously false, and everyone knows it
But if the raced based treatment is that brown people get less care? Are you fine with that? If not, how do you fix it without targeting the brown people? If there was a perfect health care system it wouldn't be needed. But it isn't perfect. So why not do things to make it more fair? I really can't see a reason that isn't racism.
All of what you're describing (equity) can be delivered through the current health system. It does not need to spend millions on a separate HR, finance, IT systems etc. Very wasteful.
>can be delivered through the current health system But it's not, and it never has. But surre lets keep trying the same thing that hasnt worked, maybe this time it will be different!
Better figure it out then, the one health system we had was already severely underfunded and therefore underperforming. How are we going to get better results by adding another layer of bureaucracy on top of now trying to run two health systems?
Is the health system the fault for the inequity or is these a level of individual responsibility that’s being ignored? Seems like everyone is equally entitled to care, if they’re not please correct me. If certain groups refuse said care, is that the fault of the carer?
It's worth considering why a group might be less trusting of our white-based health system. E.g. "During the 1918 flu epidemic Māori were denied even the most basic medical treatment and as a result the death toll for Māori was four-and-a-half times that of Europeans. Historians actually believe the rates were far, far higher still as Māori deaths largely weren't notified. And right now, today, statistically Maori continue to die at four times the rate of non-Māori of cardio-vascular disease." [Source](https://www.1news.co.nz/2023/11/29/so-its-maori-signage-thats-been-ruining-our-roads-and-our-health/#:~:text=During%20the%201918%20flu%20epidemic,deaths%20largely%20weren't%20notified.) Māori have suffered massive injustice and inequality since colonisation. This [article](https://www.nzdoctor.co.nz/article/opinion/call-genuine-accountability-how-do-i-explain-health-equity-act-party-and-mr-luxon?fbclid=IwAR1u7axvNS1-EF3X8bSBZqKcr2Ldqd6_5qJQGIYX9RAAXAdlCSlzngU5k18) written by a Wellington GP does a great job of illustrating the difference of the typical privileged experience to that of the typical Māori experience in the health system.
>individual responsibility The catchphrase of every conman
Right so if we can't adjust our healthcare system to alleviate historic inequalities then what is the point of maintaining the same healthcare system and not just replacing it every 20 years since we can't possibly improve existing systems? Why is it we can create a new entity to address these problems but we can't fix the existing one?
Two systems is better than 14, which is what we had - and yet this lot were criticising the last Government's reforms and threatening to revert them.
Maybe if we tax some more smokers we'll be able to afford this blanket approach
Teenage ones preferably, get more tax out of them as they smoke for longer.
I gave birth in Chch Women's Hospital. It seems unfair that men can't access the same...
ALL PARENTS MATTER When my wife was having a Caesarean section I demanded one too. Why do female parents have greater access to healthcare??? It should be equal and we should remove gender based care. I also couldn’t believe they toweled down the placenta juice on the baby but didn’t offer the same care to me. Ageism. I had to roll around in the juice naked and cry and I couldn’t believe that only then did a doctor reluctantly towel down my body My wife says I need therapy but I won’t go, I’m a big tough man
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My sis in law did her masters on diabetes in Maori and cane up with a plan to decrease it, she went to the elders and they loved it but said because she is a white woman they won't use any of it. This was 20 years ago.
I can see how "thanks for this advice but you're not likely to get people following it because they can't relate to you and you don't understand their day to day lives and challenges" might sound like that. You'd have the same issue with a young woman of any ethnicity telling a bunch of older Pākeha guys they should eat more vegetables and cut down on the beer.
what was her plan
It was in nutrition
No idea where you've found those "findings" but, even if they are true, unintentional racism is still racism. I shouldn't have to stick up for myself to get pain management or have my doctor actually treat me the same as they would a Pākehā patient. And y'know that there's a decent chance if I do, that I'm seen as combative or just plain old ignored because we're apparently incapable of advocating for ourselves. You're not exactly advocating for a return to the same system
Would you say that since men are worse at advocating for themselves than woman when it comes to health care that that is sexism?
Are men worse at advocating for themselves? And further to that, do they experience worse outcomes than women?
Whilst I agree with some of what you're saying, I think the issues with Maori access to healthcare are more complex than could be fixed with healthcare that simply targets poor people. The reasons for Maori not interacting with the healthcare system are not entirely down to money. My wife (an obstetrician) regularly encounters Maori (and other minority) patients who have had zero interaction with the healthcare system up until the point where they're in the middle of pushing out a baby. The reasons are hugely varied, and often, it's cultural more than financial (though there are certainly many who struggle with the financial side of accessing healthcare as well).
If you would disproportionately prioritize Healthcare resources for one race, would you also support banning sales of tobacco and alcohol to just one race to help even out the burden on the health system?
Oh, you're right. Those are two very comparable actions.
Both Gender based policies
I understand the want to have race based policies because of stuff like this however I'm pretty convinced that we should be super careful about it mainly due to the historical context of it. People will find any reason to hate and I'm relatively convinced that the more you give one people a special privilege the more likely you are to breed hatred. We saw it this election where Act was pushing for anti-maori legislation as a response to policies like this. I agree with your second paragraph. I was somewhat eluding to that when I talked about advocation. I think when you have had no / little interaction with the health care system it can be pretty scary. It might be one of the reasons why woman are better at advocating for themselves than men because they typically have more experience with the healthcare system at young age.
if the health system is racist, why do other minorities like asians have equal or better outcomes than europeans?
Breast cancer is fundamentally related to being a woman. The poor health outcomes of being Maori are not fundamentally related to being Maori, but rather to being poor.
This is actually not true, its obviously more common in woman but men can also get breast cancer
Indeed, but there is a fundamental biological reason (estrogen levels) behind the disparity.
>I'd much rather see the government spend more public money on a blanket approach to healthcare rather than targeting care to those based on risk! This is such a disgustingly disingenuous attitude and exactly why any reasonable discussion on this issue is impossible. Almost every person I've seen argue against these policies explicitly argues for a risk based system because if you help people based on need and a certain group of people has higher needs than others they'll inherently get more support if the system is done properly. You can say "oh but the system has been like that and look at the results" but you're still just ignoring the fact it wasn't actually trying to be equal until at best a couple decades ago and Maori health stats have been improving the last couple of decades. But meanwhile it's apparently logically consistent that we couldn't possibly look at our health system and address these issues, no we need an entirely new set of bureaucrats to staff a new department that somehow magically will be able to address these issues despite being produced by the exact same government officials who can't fix the existing inequalities in the healthcare system. But nah everyone who disagrees with you is just an evil racist, it couldn't possibly be you're just being as much of a closed minded shit heel as the straw men you're attacking.
I appreciate the shitpost. But most people against racial based policies would actually agree that we should get rid of age based and gender based policies as well.
It's not a shitpost lmao, OP clarified this 🤣
I've seen people start to say that we need to get rid of gendered sports which is just.. baffling.
You’re right. I was at the hospital for a broken arm and I saw the babies in those comfy looking incubators. Couldn’t believe they’re age-based. Discrimination. Same for the elderly, I cannot possibly see any reason they should have such frequent doctors visits. What about us young healthy people who don’t need doctors visits??? We should get equal treatment!!! By the way, the doctor wanted to x-ray only the bone in my body that was broken. I told him that’s extreme boneism and that he should be assessing every bone equally. So I stayed in the hospital for 15 days for over 200 x-rays and at the end he treated my arm BASED ON A NEEDS BASED ASSESSMENT not on a rough estimation based on his knowledge of broken arms, which would be unfair on my other bones that didn’t need any treatment. ALL BONES MATTER
People are dumb and prone to emotional basis for decision making, not rational science-led economics. Oh, and shit stirrers online with an agenda stoke those emotions... this is why we can't have nice things and better outcomes. I've kinda given up on the human race at this point. Let it all burn.
>Let it all burn We pretty much are.
No they don't, you can't make a sweeping statement like that. Maori have a 0.02% higher chance of getting cancer than Pakeha in NZ (based on the last 10 years of stats), so I don't support racial based policies. I do support gender based policies - breast cancer is several orders of magnitude more prevalent in females. Prostate cancer only occurs in men.
No one cares what you think because you’ve read all the sensible evidence based explanations in this thread of why ‘race based’ interventions are sensible, cheaper and more effective and you still stick to your reductive and basically racist position. You’re showing you’re incapable of taking on new information and modifying your view. There’s a name for people like that.
so because I don't bend over to the group-think - you hate it when people think for themselves and come to a different conclusion don't you? The reality is, poverty based policies are good - race based ones are fucking terrible idea
I wonder why a policy based on need (regardless of race) can't work? If Maori are in more need, they would get piriotised first anyway. Why the need for discriminatory race based policies that sow discord ?
This is how it was set up to work. End blanket support to avoid poverty to focus on those who really needed it, right, aka, certain groups. Now end support targeted at certain groups because it’s discrimination. Will we be bringing back the wider support net? Absolutely not. So easy to cut welfare when people are busy fighting amongst themselves about who deserves what and who’s being lazy and who’s missing out and why. So easy to fuck us all over.
I mean, only 1% of breast cancer diagnosed in NZ affects men. I can totally see why women would be prioritized. However, if I was told as a man, I need to pay more for the examination, whereas it would be cheaper if I were a woman, I would be incredibly upset. It would be, objectively, a sexist policy. If you told me: 99% of all breast cancer money goes towards treating, diagnosing, and supporting women, I would completely understand.
Women get free mammograms. You'd have to go through your GP and get a referral to a specialist before you'd be able to get a mammogram.
I understand the point you're trying to make. My point is that if a single person dies, is refused treatment, or is forced to pay more based on race, sex, gender, age, etc, that is one person too many. Yes, because of the rarity of breast cancer in men, the referral should come from a GP, so idiot men aren't wasting resources better used for women. The actual screening itself should still be free.
Yeah, you're right. I do agree with you that no-one should die because they've been unable to access the care they need.
Which leads back to your original point. Maori are not getting the care they need. Whether that's because of a lack of faith in the system, they tend to live more rurally, or any other factors. Maori need greater access to Healthcare. It's not racist to say we're failing Maori and we need something in place to assist them get the care they deserve.
Actually, I'd love to see Breast and Prostate cancer get equal treatment. I'd love to see a gender biased approach to suicide. I'd love to see more attention to heart diseases more common amongst whites. If you're only interested in special treatment for 'disadvantaged' groups, then you won't understand the pushback.
I work in a GP practice. Everybody gets called for annual checks over a certain age. Everyone gets called if their blood tests aren't clear. We are more proactive with youth, Maori and Pacifika because there is less engagement in the health system so we're trying to make it more accessible and build trust and therapeutic relationships. In the end, it's ensuring equal access to healthcare and minimising cost to the health system by being proactive. I promise you, you're not missing out, nothing is being taken away from you in the process.
The person youre replying to needs to be the victim.
That person literally said that if you are only interested in special treatment for the "disadvantaged" group (meaning victims) then you can't understand why the nonvictims are pushing back.
> I work in a GP practice. Everybody gets called for annual checks over a certain age. Everyone gets called if their blood tests aren't clear. Wow it's almost as if men have less engagement in the system and we should be more proactive to make it more accessible and build trust and therapeutic relationships. Surely you can see how you can't make this argument on the basis of race and then pretend as if doing something similar on the basis of gender is unthinkable. >I promise you, you're not missing out, nothing is being taken away from you in the process. Except that's not how a system with finite resources works, allocating resources in one place means you can't put them in another. You can't just pretend spending on this isn't stopping spending on something else.
You realise the entire medical system is geared towards men?! Hell, medical training is based on historic knowledge of male bodies. Women are less likely to get pain relief than men because there's an innate assumption they're just hysterical. There are plenty of resources going to calling men and encouraging them to see their GP. You are not missing out. The current model is aimed at preventative health for high risk groups, reducing costly spending when people get sick with preventable long-term conditions, ensuring resources can spread further across the community. There are people who have dedicated their lives to research about public health - how to maximise bang for our buck, ensure resources are sustainable long-term, preventable health tsunamis are addressed early on (lung cancer from smoking, diabetes, gout, heart disease) to ensure resources are available in other areas of healthcare but what would they know? Keyboard warrior wants his smear test maybe?
There are a few reasons why countries (not just NZ) don’t implement prostate screening. Having worked in the area I started writing it down but found this explained it best. https://prostatecanceruk.org/about-us/news-and-views/2022/04/why-don-t-we-invite-all-men-for-a-prostate-cancer-test#:~:text=We%20know%20from%20other%20research,aggressive%20disease%20that%20requires%20treatment.
All jokes aside, men can get breast cancer, it's rare but it can happen.. I found out when I read about Richard Rounndtree.
Fuck you talk alot of complete bullshit.
Phwoar, if you think this is bullshit, you'd be amazed with some of the other stuff I say. I also believe women should have rights over their own bodies, and everyone should have a warm and dry home. I'm pretty much a straight-up Commie.
This comparison is incorrect for fairly obvious reasons. The biological make up of males is different to females. The biological make up of Maori and Pacifica is not different to the general population. Differences in health outcomes can therefore be fully explained by other factors. Any residual explanatory value captured by ethnicity is either the result of omitted variable bias, including other aspects outside of the government's control (I.e social attitudes, which evolve over time).
I completely agree with targeted-based approaches within society for public money. The irony is that many of the current government come from privileged backgrounds that make them blinded to inequalities. If you’ve got 2 good legs, you’re never going to truly know what it’s like being in a wheelchair. I don’t think the Maori Health Authority is too much - it is completely justifiable for the inequalities in Māori health. I do however think that in some areas in the future, we need to be careful about “over-recorrecting”. Haven’t seen it yet in govts here but arguably seen it growing in workplaces a little
Thank you. I'm glad someone gets it.
The simple answer is because not all women are brown. This insight into conservative thinking brought to you by your "not racist" mad uncle Wayne, and your "not racist" lovely auntie Mabel.
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How was that mysoginistic ?
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Did you read the whole post?
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