"Let the fuckers die"

That's the reaction of one of NZPundit's commentators to the statistics on Maori death rates (scroll down and look for "wibblefish"):

If it's bad lifestyle choices then let the fuckers die. Likewise for culture - you choose to live a culture that kills you my sympathy is nil. Helps there - ask for it or die quietly somewhere your corpse won't stink up the place.

If it's genetic then for the long-term good of NZ let the fuckers die early. Darwinist processes will take care of it - eventually.

The irony of course is that we happily fund all of those things for pakeha. Lifestyle choices? Try smoking, heart disease and drink-driving. Genetics? Here it becomes trickier because we're talking about near-invisible predispositions which interact with lifestyle in interesting ways rather than obvious genetic disease - but I think an excellent example is melanoma. Pakeha have a genetic predisposition towards this (something that is literally a matter of the colour of their skin), yet we are happy to throw money at both prevention and treatment for people who are still stupid enough to lie about in the sun all day (or unlucky enough to catch that high-energy photon while getting off the bus). And of course we happily treat those who have a family history of a particular disease. No doubt wibblefish would draw on his seeming axiom of personal responsability to say that we shouldn't, but then his position boils down to "you're all fuckers, and you should all die". Charming.

The reason we have a public health system in this country is to insulate people from risk so that they are free to pursue their vision of the good. Or, in english, to ensure that being born poor, catching meningitis, being hit by a truck, breathing Christchurch's air, or having a genetic predisposition towards heart disease or skin cancer does not prevent you from living a normal life. We do this because of our egalitarian vision - we want all New Zealanders, regardless of race or wealth, to have a "fair go".

Two big consequences for the "race debate" are:

• People with greater need require greater funding. To the extent that we abstract away from individuals to funding per capita (as we do with DHBs), we need to take this into account in a statistical fashion. So, if statistically speaking Maori have greater need, then it makes sense to adjust funding for the racial makeup of the area. Interestingly, we do this for age - both the old and the young have statistically greater health needs - and nobody objects.
• If we want the services to be effective, they need to be accessible to all. Studies have repeatedly shown that government services have not always been accessible to Maori - which is why government departments started sprouting bilingual letterhead in the 80's and 90's. The 2003 New Zealand Census-Mortality Study made specific mention of barriers to Maori accessing the health system. If we want the health system to be effective, and for Maori to get a fair go, then those barriers need to be reduced.

Denying either of these means denying Maori the same opportunities enjoyed by other New Zealanders. Maori health funding is not a matter of "privilege" - it's a matter of ensuring the same basic equality of opportunity that everbody else enjoys.