Understanding and Misunderstanding Freedom- By Professor Ornery Dragon

Understanding and Misunderstanding Freedom

By Professor Ornery Dragon

The other day a friend on FB posted a meme/captured Twitter thread about a woman who had been through the wringer with a medical issue that tragically claimed the life of her small child. The rant was about how the insurance company reneged on paying after they received a settlement, how the hospital immediately put a lien on her house to insure she’d pay the PICU bill, and how in the end, they got nothing and had to deal with all sorts of crap while mourning their son. It sounded horrible.

As I read through it, I had my doubts about some aspects of the story, but whatever. It wasn’t designed to be accurate, it was designed to hit you in the feels and make the reader angry at the injustice of the American insurance/health/medical industry. And it worked on my friend and those who responded to the post.

The friend who posted it lives in the UK. Another friend of his commented that she was soooo happy to live in the UK with the NHS. My friend said (paraphrasing): yeah, I have to laugh at Americans who always go on about freedom. He then went on about how Americans pay about the same in taxes but get nothing for it. He ended with “No health care. No job protection. No state support. Americans are free to starve, free to lose their homes, free to die in debt and penury. They are free in theory, but not in practice.”

I choked on that. Among many other things, that statement completely ignores the base level of care available via the NHS or the quality of council (subsidized) housing, or the unintended consequences of job protection, and the moral hazard of state support.

Remember the story a couple of years ago where NHS refused to allow parents to take their sick, dying child (https://thenewamerican.com/u-k-denies-treatment-to-baby-won-t-let-parents-take-him-to-u-s/) to New York for experimental treatment that might possibly have saved his life. The state decided it knew better than parents what should be done for their child. The child died. How the hell does a government get the ability and power to prevent parents from making critical decisions regarding their child’s health?? Is that what the freedom of “state support” means? How is that freedom? Freedom to or from what?

No job protection…that cuts the other way as well. Ever worked with someone who is useless? But can’t be fired? I have. Guy spent the day running sports betting pools (against company regs), never did any work, but the union said he couldn’t be fired because he had seniority. Job protection for him, sure. But what about everybody else? What about those employees downstream from him? What about the employer who was dropping money into a black hole? They couldn’t hire somebody more productive to replace that guy. (They got bought out by the competition just a couple years later. Go figure.)

Free to starve, lose their homes, die in debt and penury… If one is completely dependent on the state for housing, income, and health care…how is that not penury? You are not contributing to the system, you are completely in debt to it. And depending on how it’s structured, you may never be able to leave that system. That’s freedom from penury?

I love my friend, but he clearly DOES NOT understand how freedom really works or what it really means. Of course, it does mean different things for different people, and yes, freedom itself can be relative to what one experienced before. For example: Russians find the ability to travel without state permission to be incredibly free. But, as an American, I have a very American view of freedom that I don’t think my friend understands. And, as an extension, I think he’s not allowing himself to experience true freedom. In other words, the freedom to succeed or fail on his own merits. Under the structure that he prefers, citizens are NOT free from the state. In fact they are beholden to the state and subject to its whims. I think he misunderstands the concept of freedom.

It is understandable, though, why European citizens would view freedom in this way. The political and social structures of Europe have historically been top down. Russia is especially easy to explain…they’ve always had an autocratic system whether it was headed by a tsar, a General Secretary of the Politburo, or Vladimir Putin. Nothing has changed politically in Russia for centuries. Their view of freedom is likely much narrower than ours.

But what about the rest of Europe? They were all monarchies as well – all top-down governing systems. A long history of monarchies tends to instill a cultural understanding of the “proper” role of government. Monarchs were supposed to look out for the welfare of their kingdoms and that meant the well-being of their subjects as well (for various definitions of “well-being”). Therefore, those outside of aristocratic social levels learned that the monarch and the aristocracy took care of the lower classes, merchants, artisans, and peasants. Rewards came from the monarch or his/her representatives. For example, the patronage system for artists meant that in order to be a “working” artist you needed the support of one of your social and economic betters. That has translated into state support for artists. But the patron/state can remove that support if the artist does something they don’t like. The artist is constrained, and without true freedom to create.

Freedom, to me, means relief from those sorts of expectations. I’ll figure out what situation works best for me, thank you very much. Yeah, my decisions could mean I die alone, in debt, sharing food with the cat (somebody please take care of the cat if that happens). And, yeah, that’s a worry. On the other hand, I can see that the state is in no small part responsible for making it more difficult for me to move myself as far away as possible from that scenario. We just dealt with our taxes. There’s a big way the state makes it difficult to take care of oneself.

I want the freedom to make both good and bad decisions. I want the freedom to work without a net if that’s what I choose (I left a tenured position to write fiction on a full-time basis. Look Ma! No net!) I want the freedom to live where I choose, and not in required housing. I want the freedom to take risks…or not. I want freedom from government interference.

Europeans, and the American left, define freedom as “chaos” and that worries them. Who will control the chaos? Bring in the state! Big Brother will provide for all and watch over you.

Americans define freedom as a “choose your own story” adventure and that energizes us. And if there’s a little chaos along the way, well, that’s fun too.

So head out and choose your own story!

360 thoughts on “Understanding and Misunderstanding Freedom- By Professor Ornery Dragon

  1. Yep, they’re Free to do what the State wants them to do. [Sarcastic Grin]

  2. Among many other things, that statement completely ignores the base level of care available via the NHS

    Charlie Gard and Alfie Evans were unavailable for comment.

    1. Yup. There were two little boys that the NHS refused to allow treatment for, with the second happening a few months after the first. It really says a lot about how far some have fallen. The excuses provided by the NHS never would have been accepted *anywhere* at *any other* time in history. Other excuses might have been used. But those excuses would have focused on things such as travel restrictions or the like. The excuse given – “The patient will suffer, and it will probably be for nothing,” would have been roundly condemned by everyone.

      1. I would have assassinated the people trying to prevent me from taking my kid elsewhere. But Britain has so beaten their citizens down that they can’t even imagine revolting against tyranny. Unfortunately, neither can the liberals in this country. The Woke will receive a very rude awakening should they hit the right triggers here.

            1. Have long suspected Herself has a bit of Viking blood a few generations back.
              But she does try to assimilate with her new home, so perhaps we can convince her of the efficacy of tar, feathers, and good hemp rope.

              1. Waste of a perfectly good rope. Get blood or dirt on it and you’ll need to throw it away. Good battle axe is easy to clean, and almost infinitely reusable. And IIRC most axemen were built like brick outhouses.

                1. When they got endlessly tiresome for me (loooong before the recent… screwing up of the franchise…) $SISTAUR was a bit put off by my re-naming them the Dumb-eks. (Fwiw, I found the endless re-hashing of the cyberman likewise tiresome).

    2. Or the women denied certain treatments for breast cancer back when, because “the treatments cost too much.” Liverpool care pathway, anyone?

    3. My response to this kind of stuff has become a plain mic-drop.

      “Alfie Evans.”

      Before that, it was the Liverpool Pathway– slow, gentle, involuntary euthanasia.

    1. The US political spectrum (to the extent that it’s a one-dimensional line pace Pournelle et al) is skew to the European political spectrum. Their right is not the same as our right, nor their left really the same as our left. Trying to think about them as if they’re parallel or congruent is just going to make your head hurt.

  3. They do go on and on about this. The NHS is the great communal sacrament in the UK. You criticize it at your considerable peril.

    Number two son was born on the NHS. We did this only because I had private insurance to cover any problems, had we not had it my wife would have come back here. Also, we were winners in what they call the post code lottery and received the best care available in the UK, which is about on par with the bottom of the US.

    On the one hand, the NHS does certain things well. They make better use of their nurses by and large and routine “wellness” care is good. Your treatment will be fine. On the other hand, should you (e.g.,) break your leg on a Friday you might have to wait until Monday for a doctor while you lie on the second floor in an orthopedic hospital that doesn’t have patient elevators so they have to carry you up the stairs — this actually happened to my aunt. Every year the hospital system collapses from the flu and every summer heatwave causes the morgues to overflow since there’s no air conditioning in many of the hospitals. Don’t get me started in dentistry.

    Given scarcity, and I know the left has said that scarcity doesn’t exist, everything must be rationed/allocated somehow. In the US we do it by money, in the UK they also do it by money but since there’s no incentive to add supply they have a shortage and so appear to ration by time and quality.

    It’s a waste of time talking to them about it though. it’s an article of faith.

    1. And they get salty when one suggests that because they consume sheep flesh, they should be exterminated to clear the land for cattle grazing. Complain about Americans being loud, not getting that this ‘loudness’ is a difference in customs. 🙂

    2. former online acquaintance living in Cornwall was griping about the cost of some dental work to me once. “What? Thought you had that great NHS to take care of those things?” her- “I’d like it taken care of while the tooth is still in my head!” and some time later she applied for a job that, as a draw, had some health and full private dental care coverage.

      1. It is unpossible that such incentitves would be offered in the UK. All the Democrats tell me they don’t have to worry about losing their current care if they leave a job.

      2. I’m still amazed at the knee surgery and treatment. Out of pocket expenses were for the painkiller (and the requisite laxative. 🙂 ), a decent rolling walker, and a 4 footed cane. Medicare works, though having the Medigap policy is a very good idea…

        Dental: The weekend before knee surgery, one of 4 at-risk incisors broke. The nerve came out too, so it wasn’t a rush job. A few weeks later, I saw the dentist, and we set up the appointments. Needed two sets of impressions, at which point another of the incisors departed, but this was enough to build an interim partial prosthetic. (Final one happens in a year when the bone finishes remodeling.) All the incisors had to come out, and I got a couple of molars in the partial as a freebie. Total time since the first break, just over 2 months, though if circumstances allowed, could have been done in 1 month. All as non-emergency work.

        Total (non-insured patient, discount for immediate payment) cost was $1130. No, I wasn’t going to spend $6K and multiple months getting implants. Good care, ready when I was, so I’m pretty happy.

      1. Eek! (Note, do not follow that link if you still hold out hope for humanity and want to keep doing so).

        The NHS story was bad, but I think the Japanese ones were worse. I’m surprised I’ve never heard about the horrors of the Japanese health system before.

        1. Japan… well, there’s a reason they have a lot of Victorian-style storylines about people with mysterious illnesses who stay in the hospital forever and then die. Black Jack is the series that, in a fantasy way, gets big into “what’s wrong with the Japanese medical system” (and the answer seems to be, “Not enough violence against bad doctors,” but never mind that).

          1. There are excellent hospitals in Japan, but they come with big, big charges, and you often have to know somebody to get into one. And most people don’t know anybody. OTOH, there are clinics and such which can be excellent and may even be free, but you have to know where they are.

            A lot of sports injuries and sprains are literally treated by either your family doctor, or by your coach. A lot of martial arts include traditional medical training… and some of it is good and some is crud.

            But yeah, other than some of the animes/mangas, it’s amazing how little that Japanese people talk about how bad the Japanese health system often can be. There are these amazing holes and silences in acceptable subjects (like adoption and the treatment of orphans, or what happens to foreigners who protest their innocence when being arrested), and people tend to run up against them in real life and be horrified.

            And there might be a good way to deal with X problem, but how do you find out what the solution is? Especially if nobody admits that there is a problem?

      2. When I ruptured my quadriceps tendon, part of the ER visit included a CAT scan of the knee. (Weekend, and small hospital, so the MRI staff wasn’t available.) As best as I can tell, the CT room was a few steps away from my room. I know the complex has at least one other scanner. And this is in a county with 60,000 people all told.

        It took 10 days to get the surgery. I’m told the first 5 days are to let the swelling stabilize so a reasonable diagnosis can be done. The remainder was time needed to purge the warfarin in my bloodstream and some lab tests to ensure I didn’t die on the table… For some reason, we have *really* good orthopedic people here.

        Protip: If you need warfarin, avoid trauma. 🙂

    3. I’ve seen enough of the “NHS as religion” behavior to doubt that it exists, but I really don’t get it. My only hypothesis is that it’s like the worship of Zeus: you do it because you’re afraid of what he would do if you DIDN’T worship him.

      1. They’ve been told how wonderful the NHS is since they were babies and a whole slew of horror stories about how it was before. Call the Midwife is a classic example of how it’s done.

        My question is if it’s so wonderful, why do you continue to go on and on about it? it ought to speak for itself, no?

        1. “Who are you trying to convince?” Many times a day I feel like asking that of somebody who bangs on about the supposed superiority of some leftist hobbyhorse. To an audience of 99.9% other leftists.

        2. I was frankly shocked that in an episode of Call the Midwife, they dared to have the head nun protest leaving a badly deformed infant exposed to cold air to die. (Part of their whole whatever anti-nausea drug it was that caused so many birth defects.) Granted, other than her single scene of outraged angst over it, they never addressed it again, but I was surprised even THAT much made it in.

          (I do like the series, but I frequently have to pause and go looking for my eyeballs because they roll out of my head when they start in on the “NHS is so wonderful” garbage.)

          1. One of those babies went to school with me. He lacked arms. Wrote tests with his feet. Sorry, this was college, which at the time was almost impossible to enter (but free.)
            He was BRILLIANT and never lacked girls to push his wheel chair (his legs were foreshortened) or fetch and carry for him.

          2. Speaking of the NHS I can’t help but wonder how our Canadian cousins are faring under their version of that institution this past year when with the border closed they can no longer come across where they typically used to be half the patients in hospitals and clinics on the US side. All on their own dime of course, but generally cut the wait to be treated from weeks to just the duration of the drive over.

            1. Ah, the entrancing conversation online where a Canadian told us that we had to adopt their system because the whole world is laughing at us, and also so we stop acting as a relief valve for their system so they could fix it.

            2. There was also the way the US hospitals were NOT treating people. Like, any scheduled operation is obviously not necessary. (Even if it’s for an aortic aneurysm.)

        3. if it’s so wonderful, why do you continue to go on and on about it?

          For the same reason many a man sings praises of his wife, or a woman her husband: ‘twould be too dear to escape the arrangement.

            1. Right?
              I know she won’t toot her own horn. I gotta do it for her, (and she’s so beautiful when she blushes).

            2. Note that I used the modifier “many” which distinctly implies “not all.”

    4. I know the left has said that scarcity doesn’t exist

      Nonsense – don’t you remember Peak Oil? How about Water Conservation or Recycling To Preserve Scarce Resources?

      And don’t doubt they will go on about conserving Energy once we’ve eliminated all genuinely productive energy generation.

      1. Oh, among the more severe shortages they are in denial about is the shortage of brain power among them, a shortage which has induced them to inflate what they do have and dilute it with nonsense (sort of the way they attempt to stretch gasoline as fuel by adding engine corrosive corn liquor to it, or the way adulterating oatmeal with sawdust fills the belly without increasing the nutrition.)

              1. It depends. Not many in a simple idiot, but an educated idiot can contain enough to destroy worlds.

  4. Fundamentally, worldly constraints come from other human beings. If no other humans exist, no constraints can be imposed by them.

    Of course, the physical world would be pretty stark with a single human in existence.

    So, it is a trade off.

    There are several elements in being discerning enough to get good results from making that trade off.

    One is being attentive to the mind games used to make one accept constraints without getting any value in return.

    Another is being willing to walk away from the game. Once you treat health, food, ‘a living’, etc. as stuff you will pay any price to achieve, someone is going to try to extract a maximum price from you. Then, because part of that price is in giving up oversight and remedies, they will cheat you on delivering.

    Lastly, if one of your alternatives to negotiation is trying to kill them all, with enough resolve you can avoid being bullied by numbers or fear of losing.

    There is nothing in this world that is important enough for one’s most fundamental goals. Properly, the most fundamental goals should involve eternity. Being stubborn and resolute in saying ‘No’ is absolutely a victory, no matter what results occur in this world.

    All things of this world are side goals, artifacts of struggling for more important things. They are not worth making oneself truly vulnerable to the abusers.

    1. I think you either have a different definition of “worldy constraints” than I do, or you haven’t thought through your initial paragraph.

      1. Yeah, I had considered that ambiguity.

        I’ve not arguing consensus reality.

        It is slightly adjacent to ‘all speech is political power, and victim/oppressor division is real and important to understanding this’ aka critical theory. (I disagree with critical theory.)

        Your behavior is changed by the influence of others if a) humans are in a position to use force against you b) you have enough contact with other humans for social interaction.

        Is this influence for good or for ill?

        With free will, for a large enough population, some of the people will not resist their tendency towards evil. So for a case of a person with enough contacts, the aggregate influence of other humans includes some degree of evil. For extreme cases, where this influence is sufficiently evil, it is absolutely correct to label the influence worldly.

        My contention is that a) humans with zero human contact are rare enough that we can ignore the cases where a human isn’t getting any evil influence from other humans b) for a real ‘market basket’ of examples of influence by other humans, there is enough evil that ‘worldly’ can be a correct label for the more general phenomena. Perhaps with a side order of ‘no real world collection of humans has ever been without hierarchy, if for no other reason than not having identical levels of force of personality’.

        What would you use ‘worldly’ for, if not for things that work by way of social interaction?

        1. > What would you use ‘worldly’ for, if not for things that work by way of social interaction?

          “Worldly” to me means “being in or of the world.” So, the fact that I can’t run 100 miles per hour is a “worldly constraint” because that is a limitation that is in or of the world. All of the laws of physics are worldly constraints, and those have nothing to do with there being more than one person on the face of the earth. I tend to use “worldly” for concrete things, and social interaction is pretty abstract.

          1. Your inability to run 100 miles per hour is, from one perspective, a consequence of how homo sap sap has elected to define “miles” ad “hour” – and is thus a result of social interaction. Were we to define “mile” as a shorter distance and/or “hour” as a lengthier time period you would find it perfectly easy to “run 100 miles per hour.”

            Of course, that is the sort of “thinking” which has produced Modern* Magical Monetary Theory, Sustainable Energy and the Guaranteed Minimum Wage.

            CAUTION: prolonged use of such thought can produce permanent reductions in intelligence.

            *Because inserting “modern” in a title makes it ever so much more credible.

          2. There’s a Buddhist concept that gets translated as worldly, something to do with worldly attachments, and worldly illusions, etc. I’m not familiar with it. It would seem to include both the physical and social aspects of ‘being in the world’.

            There’s a Christian concept of worldly, that uses it to contrast with spiritual life, valuing The Lord and His plan, etc… Secular is not, strictly speaking, a perfect substitute for this sense.

            Whereas, for qualities of being in the world that are an artifact of physical principles, or physical laws, one can talk about physical principles or physical laws directly.

            The stuff resulting from physics, and resulting from biology, is why it is appropriate to describe the situation of a truly solitary human being as stark.

            1. “There’s a Buddhist concept that gets translated as worldly, something to do with worldly attachments, and worldly illusions, etc.” One word is “upadana;” roughly, “the desire to attach to things.” Freedom from attachment — nirvana — is the goal.

  5. Having been very ill while uninsured and then in debt to my eyeballs I call B.S. on all the nonsense about how they won’t take care of you if you are in that position. Yes, they tend not to knock off anything from the payments when you pay it off very very late, unlike a lot of other debt holders, but they never came after me or even turned the debt over to some collector who calls daily etc, and if you completely cannot pay, they take a few more minutes to get a social worker to sign off . . . Unless you are in a “Free Clinic, then you wait, but hey, those are about all run by a Gov’t of some sort. New Orleans Louisiana’s was horrendously slow (sat behind a lady having a heart attack who was in the emergency waiting room over 10 hours before they called her name. Luckily she had enough Nitro pills to get her by) as the only way to fast service was to be in handcuffs and bleeding.
    My then girlfriend was suffering tonsillitis and was waiting from 8 am until nearly midnight (she was a Ward of the State and turned 18 before graduating, so the girls home she was in couldn’t cover her with their insurance) to get her antibiotics and something for the pain. House mother wanted to “forget” she wasn’t covered and try to treat her at their usual hospital but GF didn’t want to get her in trouble.

    I also know of people who had emergencies while traveling. furinstance- Lady had a stroke in London and spent time in the NHS hospital (noted the nursing staff is paid less than a living wage for COL in London the cleaning was horrendous, and hubby bought bleach and cleaners to do her room), and she and her husband were encouraged to get into a private care place ASAP, and even there the quality was not what they expected (cleaning was about as bad but no sharing a room), then once well enough they flew home and she ended up sharing a room with a homeless lady who also has suffered a stroke, but had the exact same top doctor their high-end insurance was paying for and the room always smelled of disinfectant.

    1. Yes, they tend not to knock off anything from the payments when you pay it off very very late, unlike a lot of other debt holders

      I feel the need to point out that they were positively put-out with husband and I when we didn’t let them knock a bunch of the debt off after we were making payments but had to negotiate down a few times. (Thank you, Obama…..)

    2. … and the room always smelled of disinfectant.

      You want to be careful of your statements – if anybody with the NHS happens to read this they will soon have disinfectant scented room deodorizers installed in every hospital room, obtained via government procurement at only three times what it could be picked up for at a local Walmart … and running out of oil eight weeks before they change it.

  6. I was once told in an internet discussion by someone claiming to be a Canadian healthcare professional that economics doesn’t apply to healthcare. He was serious.

    1. The idea behind that argument is that you don’t get to choose when you need emergency care.

      It is a stupid argument with one tiny segment of possible situations blown up into a Huge Problem.

      1. You don’t get to choose when your car is wrecked in an accident, or your house burns down … so you buy insurance against such events. For some strange reason this hasn’t led to car and house prices ballooning, or cars and houses being paid for by employers instead of drivers and residents.

        It’s as if the State treating medical expenses differently from other expenses makes people do strange things that cost a lot more money than anyone would have believed possible…

        1. mmhmm

          And food is something that if you don’t get you die. So clearly the best food production will be from non-market sys…oh right.

        2. As for the insurance company wanting a piece of their settlement, they may have paid more of the bill, but with the proviso that, should they collect on a lawsuit, the insurance company had the right to claw some of their expenses back.
          Not uncommon when a lawsuit is likely.

        3. I saw a graph that showed how the government has ‘improved’ health care in the U.S. Compared to 1970, we have about twice as many doctors — and 32 TIMES more bureaucrats. And none of those bureaucrats can figure out why medical costs have increased four times faster than general inflation.

          Jimmy Carter’s Federal Department Of Education has spent 40 years and $2 TRILLION ‘improving’ our public schools. We don’t have any more teachers. They’re not doing a better job of teaching. All we have to show for it is the ‘teachers unions’ and a horde of bureaucrats.
          If a business tries something and it doesn’t work, they either stop doing it or they will go broke. If the government tries something that doesn’t work, they just keep shoveling our money into it forever.

          1. Compared to 1970, I think we have about twice as many legal residents, not to mention the “undocumented” residents who get turned away from NO emergency room.

          2. We had teachers unions long before Jimmy Carter. My elementary school in 1962 had a couple NEOTA (Northeast Ohio Teachers Association) days every school year. A day off for the students, union meetings and miscellaneous tasks for the teachers – I think down here they now call them Teacher Duty Days but it’s the same thing.
            The difference was the Feds hadn’t yet offered money with strings that required administrators to collect data and file opaque reports until there were sufficient administrators to take over the unions. That we can blame on Carter.

          3. There’s a similar graph that shows the relationship between the rise of ubiquitous health insurance, and the cost of healthcare. Hint: it’s a direct relationship, driven by insurance insisting that every fucking thing has to be itemized, each with its own price. So medical facilities said sure, we can bill for that… and that… and that….

            Watched the same thing happen (and I had a firsthand view) when pet insurance became a thing… insurance wanted everything itemized, so instead of “spay, $60” almost overnight that same procedure became a long list of items, each with its own price, totaling $600 (and no discount for economy of scale. EVERY bill includes “$5, sharps disposal” for that $4.95 container that holds 1000 needles.) And the result was prices going up at about 6x the rate of inflation, and profits apace (used to be all vets were one-man-bands; now they’re all fullscale “pet hospitals”). Mind you, this was with only 2% consumer uptake for pet insurance, and one major vet chain seeing the money being dangled there, but it changed the entire industry. And while specialty care was now within reach of any clinic, quality of general care went into the toilet, because there’s no money in it. (Hence the shit quality of routine vet surgeries nowadays. What’s with the ugly six-inch zipper on that tiny dog, have none of you people heard of a spay hook?? and if you can’t tell what you’ve got hold of without a giant window, you have no business rooting around in there in the first place.) /rant

            Back before insurance was common, ca.1980, uninsured-me saw a specialist as a walk-in for $10, and spent a day in hospital for $90. Plug that into an inflation calculator… and watch it start to smoke.

            1. We’ve had multiple pets for 42 years. Started with one dog, two cats adopted us. We’ve had as many as 5 cats. These days I get little discount. There is a $100 “credit” after getting $1600 in stamps. But each stamp is $100. So spend $150 get one stamp. Although the staff typically rounds up $190, etc. to two stamps. But point is those completed 16 stamps represents well more than $1600 for that $100 credit.

              Now in ’79 through mid ’90s we used to get immediate discounts if all the animals got boosters at the same time. Charged full price for first 3, rest were half price. When looking at 19 vaccinations for 6 animals, it saved a whole lot of money. Plus when getting shots, animals would get cursive wellness check up but we weren’t charged for it if vaccinations occurred.

    2. Anyone declaring “economics doesn’t apply to healthcare” is in actuality declaring his ignorance of economics – and raising questions about what else he is ignorant.

      It would be tedious to list all of the ways his argument is fallacious, but a few questions occur:

      1. Is he paid a salary? Could his employer not demand more hours at the same salary in order to treat more patients? Does he not realize that failure to attend more patients condemns people to die? Similarly, demanding more pay means the HealthCare System that employs him is less able to hire more “healthcare professionals” to serve more patients, which clearly means his greed and selfishness condemns people to die.

      2. Does the Healthcare Facility where he works have to buy electricity, water, and other basic utilities in order to properly operate? Do they not need MRI machines, CAT Scans, Respirators ad PPE, all of which cost money to purchase, operate and maintain? How are decisions about the life of such assets to be made, what factors should be considered if not economic ones?

      [/RANT MODE]

      Some people cannot seem to grasp that the more their expertise in one arena the less they are likely to know about other arenas … and their not knowing a thing does not render that thing unimportant.

      1. Economics is the study of cause and effect relationships in allocation of scarce resources that have alternative uses. That’s a definition (per Sowell).

        Does something require scarce resources that have alternative uses? “Scarce” in that there’s never enough to completely satisfy everybody who wants it. “Alternative uses”–can the time, effort, skills, materials, etc. (those “scarce resources”) be used for other things?

        If the answer is “yes” to both then economics applies, by definition.

    3. Nonsense. Economics apply fine to Canadian healthcare, if you’re looking at it from the other way around… such as young friend with elderly mom, both with cancer. Long story short: Youngster instantly and aggressively treated; mom allowed to die in untreated agony. Why? “You’re young, and will pay much future taxes. She’s retired, and all done paying taxes.” (Only lightly paraphrased.)

      See? applied Canadian healthcare economics.

  7. my wife is French and a very recent immigrant to the US … alot of our conversations start with her saying “I don’t understand why the Government doesn’t deal with X/Y or Z” and I default to “well in the US thats up to us the people to solve” … she still has the European “trust in Government” thing but lately the whole Covid nonsense has started to crack that belief …

    time after time over the last year I have said “They are imposing control not health with this last dictate” and she said but why would they do that ? because she simply can’t imagine a politician simply exercising power to gain yet more power ,,,

    and, every time, when it becomes obvious that the “health” dictates were not science or logic-based it has finally started to crack her faith in government …

    and coming face to face with the craziness of the left in the US has also had an impact …

    the other day she even commented … I think I’m becoming a Republican … I laughed and told her “Maybe a libertarian but probably not a republican …”

    1. my wife is French and a very recent immigrant to the US


      because she simply can’t imagine a politician simply exercising power to gain yet more power

      I… can’t imagine someone so sheltered from the real world that they can imagine a politician exercising power for anything other than to gain more power.

      the other day she even commented … I think I’m becoming a Republican … I laughed and told her “Maybe a libertarian but probably not a republican …”

      Congratulations! (again, to her, for slowly becoming an American)

      1. I’m a libertarian. The Republicans threaten my natural and inalienable rights in a couple of ways*. But the Democrats threaten them in almost every imaginable way. Therefore, I vote Republican.

        * (or could, if unopposed and given their head)

        1. I feel the same. I’m starting to believe that the Republicans are now trying to catch up with the Dems as fast as they can.

          1. Many self proclaimed “senior,” Republicans went to the same schools as the Ds, move in the same circles and may have basically inherited their party affiliation. What they are, is aristocrats. Which is why they come across as disappointed when voters choose obviously “unsuitable,” candidates like Trump.
            Many of them want to be seen as “good,” aristocrats, the sort who “look out for,” the common folk. They don’t understand why those commoners don’t give them the simple, wholehearted loyalty their efforts should evoke, but choose “vulgar buffoons,” who are not Members of the Club but who display actual respect, understanding and affection for the “common,” people.

              1. What’s that phrase (pardon me while I mutilate the French) “Aristo, Aristo, a la lantern!” ?

                  1. Isn’t that from the popular song Lili Marlene?

                    Underneath the lantern
                    by the barrack gate
                    darling i remember
                    the way you used to wait
                    ’twas there that you whispered tenderly
                    that you loved me
                    you’d always be
                    my Lili of the lamplight
                    my own Lili Marlene …

                    1. A la Lanterne means “to the lamppost” as in “hang them from the lamppost”. 😉

                    2. With RES, you can’t always be sure but of course somebody else might not know the actual meaning. 😉

                    3. Underneath the lantern, underneath the lamppost – what’s the difference? Lili Marlene was written after all (first world) street lamps were electrified.

                      Are you saying the song wasn’t about proper treatment of aristocrats?

                      Ich bin schockiert, schockiert!

      2. I’m a small “l” libertarian philosophically, but I would never vote for the Libertarian party, even if I thought they had a chance of winning. If the capital “L” Libertarians believe in any freedom other than the freedom to smoke pot, they’ve never demonstrated it around me.

        1. This is closer to where I’ve been for a long time, and if I hadn’t already been there the libertarians saying that Big Tech has the right to do whatever because they’re a private company, ignoring entirely the intermeshing of large, corporate interests with government, would have certainly driven me there.

          You can only do ‘live and let live’ if the other side isn’t actively seeking to destroy you and your beliefs.

        2. I wouldn’t vote for the Libertarian Party either; for me it’s the “no borders” policy. Intellectually I understand the argument: freedom of association and travel are human rights, not just an American rights, therefore non-Americans have the right to move wherever they want and associate with whomever they want, including Americans in America.

          I think this ignores the converse right to not associate with people you don’t want to associate with, therefore immigrants to a place need the consent of the existing occupants. (Which is what legal immigration amounts to.)

          In any case, to paraphrase Stalin qua socialism, I believe in “libertarianism in one country”. Given our unique set of premises and precedents, let’s have America get liberty and minimal government right amongst ourselves, and then we can think about extending it to others. (Corollary: GWB was wrong and not everybody pines for American-style freedom. Collectively a population might someday, and individuals in that population do now, but those individuals (legally) emigrate to America.)

          Does that make me a National Libertarian? 😀

          1. I think this ignores the converse right to not associate with people you don’t want to associate with, therefore immigrants to a place need the consent of the existing occupants. (Which is what legal immigration amounts to.)

            The problem with that argument is that if it were actually true everyone in the neighborhood gets to say if you are allowed to move in, regardless of whether someone is willing to sell you their house. HOAs for everyone, good and hard.

            Either property means something or it doesn’t. Confusing neighbors with freedom of association butchers all three concepts.

              1. A fact many property owners along our (putative) Southern Border have learned, to their regret.

            1. Yeah, there’s definitely a spectrum there, with regulated borders on one end and racist redlining on the other, and a balancing against property rights. I tend to fall into a “there is no moral principle that cannot be abused” camp, and in this case I’m willing to restrict its application to national borders. See: libertarianism in one country again.

            2. Property rights are exactly the problem– and while we all know of bad zoning laws, they do serve to protect the property rights of those who are already there, when someone comes in and wants to consume the local resources. For an easy example, laws against parking in front of other people’s houses, when there’s a house that has a very large population and is making it so nobody who was there before can park at all.

              They generally have to be made because the general understanding either got exploited, or became non-common. Much like any other rule. 😀

              1. What about laws against parking in front of your own house?

                I’ve had my car marked multiple times for being parked in front of my own house for more than 72 hours without being moved. According to the law, I have to drive my car at least 1/10 of a mile every three days or they can tow it away.

                Fortunately, that law is not enforced rigorously. Apparently some neighbor complained (anonymously, of course) that my car wasn’t being moved regularly. Probably because they or their guests couldn’t park in front of my house.
                The world is full of self-important, self-righteous, obsessed assholes, tormented by the conviction that Somebody, Somewhere is Doing Something they don’t approve of, and driven by a compulsion to Do Something About It at any cost.

                1. Ill-specified property is the usual reason given for why property doesn’t work and we should ignore it when convenient.

                  Well right up until the would be ignorer’s property is the one getting placed on the rack. Funny how the tune changes right about then….

                2. Depending on the area, this can be valid… I still think it’s STUPID, but it can be rationally argued for.

                  It’s complicated because *rights* are complicated– and interests don’t align perfectly. My right to use my property can and will conflict with your right to use your property, because they’re not utterly sealed off from each other.

                  So there are going to be tradeoffs.

                  …and the 90% of everything is crud law will apply FULLY.

                3. When I was an undergrad, the town parking near the dorm had one-way parking. Part of the week, you could park on the east side of the street, the rest of the week, the west. Certainly encouraged keeping cars in repair, at least enough to find a new parking spot.

                  1. I got two tickets in one second because my bumper was 1/4 inch over the end of the driveway at the B&B and into the sidewalk. When I asked about the double ticket, the clerk shrugged and said the meter-maid’s unit had double-fired, and I could go before the judge in a month and appeal. I paid both fines and have not done business with anything in that town since.

                4. I’ve mentioned the Blue Whale, a time or two. We had it parked along side the house. Short paved non-public right of way with two houses back behind the two corner houses (one ours). Our official property line was the edge of the asphalt. There was just enough room between there and our fence to park the Blue Whale, with chalks & blocks (since the breaks weren’t reliable). Pretty sure we know which of the two neighbors who turned us in, and why.

                  Why. We had a large dog and 4 cats by then. One of the cats was a huge, double the size of most Chihuahua’s, small Terriers, and miniature poodles. He a big boy. We also used to dog sit for the inlaws big dogs. They had a small undisciplined small dog that used to rush our fence. Our large dog, one of the inlaws large dogs, and the cats, as long as they were inside the fence, could care less. The other large dog, not so much (we also had to keep her away from our dog). She despised any female canines and any small dog, regardless of gender. We had a close call a couple of times with our female. She adored the cats. So anyway, we have the inlaws dogs, in our 8′ fenced locked yard, and this little dog starts running at the fence. We got the one dog put into the garage before we had a fence fight we couldn’t control (this dog, at 140, weighed more than I did back then). We then warned the owners of the small dog, that should their dog get inside the fence or close enough that T could get hold through the fence, their little dog was dead. Then a few weeks later (after the inlaws dogs had gone home), so they couldn’t blame it on T, the dog got beat up … by our big cat. The other neighbors witnessed it, they thought it was hilarious. Dog quit rushing the fence. Decided he could bark and carry on from HIS side of the right of way. (Not the only roaming neighborhood dog this cat convinced to stay on opposite side of the street from our house, him and his cat siblings. Most the other dogs were a lot bigger than him. But when you are a big 22# Tom, even neutered, and “mommy” is an 80# German Shepard, big dogs beware. Them claws be sharp, and he knew how to use them.)

                  So they retaliated, turned in the Blue Whale to the Washington State DMV for having Oregon Plates. We got a letter saying it had to be licensed for WA, even parked on private land, and not being driven, and not insured, or they’d confiscate it. I called and asked when could they come and pick it up? Dang it! They never came. Not the outcome the reporting neighbor wanted. They had to look at it for another 24 months (ish). Plus we let the neighborhood know what had happened. The other neighbors thought this was hilarious, again.

                  1958 Plymouth Power Wagon – The Blue Whale — This was in 1984 … Oh, it had already sat there for almost 5 years.

          2. I have a similar issue with the Libertarian party. A country with completely open borders is no longer a country. I do support immigration, as long as the immigrant does the paperwork and follows the laws. For that matter, I could even support making it easier to do that paperwork and, legally, immigrating to the US.

            However, in my opinion, entering the country illegally, should make it harder to gain citizenship. Not easier. Entering illegally and then committing (more) crimes should make it nearly impossible.

            I also don’t think the US owes welfare and other social services to adults who have entered illegally. Children, admittedly, is where I go soft. Kids don’t have a choice, they go where their parents make them go. However, entering the country illegally, dragging a child along, I would consider child endangerment. This morning I saw an article on 4? (can’t remember) little girls just dumped on the US side of the border, in the desert. If a local farmer (who’s land they were dumped on) didn’t find them, those kids would be dead. WHO DOES THAT?

            1. Most of those children are not being brought by their parents. They are bought by the cartels and used to get drugs and gang members across the border.

              Most of the parents aren’t evil, they’re just facing “Sell us your child or we’ll kill you and take her anyway.”

            2. Five. That is 5, little girls, ages 11 months (or so) to 7 (?), left in the desert, on a blanket, with no water. Baby was crawling around. One toddler was non-responsive from dehydration. They hadn’t had any water well before they were abandoned. They were abandoned to die. There is no other way to spin this. 100%.

              Regardless of the parents intent, by turning over these babies to the smugglers, they are guilty of endangerment. Immediate termination of parental rights due to endangerment and abandonment, and put up for adoption. The End.

              I might grant different thoughts should parents request their child be brought home because the child was abducted. Here is the problem. I don’t think that happened. It’s possible. But probability is almost nil. OTOH we are talking about cartels so it is possible the babies were taken and abandoned by a cartel as punishment for something a parent or relative did. But by claiming this, are they endangering the babies, again.

              1. If they were kidnapped, the parents are unable to protect them and sending them back is reckless endangerment.

                1. Sorry, I can’t agree with that. If that argument applies here, wouldn’t it have to apply elsewhere? What about cases where a non-custodial ex-husband runs off with the kids? She couldn’t protect them, so he gets custody! HAHA! sorry for ya!

                  I sure hope the world never works like that.

                  1. Doesn’t taking in kidnapped kids essentially benefit the kidnappers, rendering those taking in the children not only accessories but inciters of the crime?

              2. I’d take them to raise in a heartbeat. I wish our government would just start doing that. Severing the links with the parents, due to abuse, and letting people adopt.

                1. Won’t say “too old” because if they were our grandchildren, government would have to let us take and raise them. But by any other standard, “too old”.

                  Yes. Agree.

                  I’d take them to raise in a heartbeat. I wish our government would just start doing that. Severing the links with the parents, due to abuse, and letting people adopt.

          3. I’m a small l libertarian since I simply ask to be left alone and acknowledge that consistency requires I leave you alone.

            I admire the more doctrinaire libertarians in much the same way I admire the more doctrinaire leftists. Les extremes ce touchent. Both believe in a world that simply isn’t so and some form of “if only we reform the state it’ll all be unicorns and moonbeams.” At least the libertarians have remained libertines and seem to get some joy from life. The leftists are just prudish, priggish, shrewish scolds.

            I vote Republican because they don’t seem to want to kill me and the left does. Both are just corrupt grifters. I consider myself a member of the Mercutio Party: “a plague on both your houses.”

              1. What I love/hate about this site is that I don’t have to explain the references.

                For never was a story of more woe
                Than this of Juliette and her Romeo.

        3. I like some of the philosophical aspects of small L, but … well, we all know the Libertarians that *I* grew up around.

          I don’t give a lot of support to the guys who do exactly the same as the Dems, but insist they’re better Republicans than the Republicans! (Now with no icky traditional religion!)

          1. IIRC, that was basically before they opted to emulate the charismatic strategies and persuasive techniques of Vegans.

        4. I voted for Ron Paul in 1988. Don’t think I’ve seen a state or national level Libertarian Party candidate worth voting for since then.

          1. A big problem with the Libertarian Party is that they get all excited by getting 3.27% of the popular vote, zero electoral votes, as they did in 2016 (down again to just over 1% in 2020) while having effectively no LP elected members to Congress, state legislatures, or governorships.
            Their grassroots local game isn’t very good either.

    2. Buy the complete Yes, Minister & Yes, Prime Minister and watch them together.

      That ought cure her of excess trust in government.

      1. I simply note that governments killing their own people in the 20th century managed a body count 5 to one at a minimum over all the world’s murders by criminals (“private sector” anyway). And while some governments have been better about that than others, in the US the largest mass shooting in the US wasn’t the Las Vegas shooter at 61 dead. Wounded Knee, perpetrated by the US government, managed 90. And if you want to count a posse as “government action” (justifiable at that time and place) the Yontoket massacre killed 450 natives.

        On average people are significantly more at risk from their government than from criminals.

    3. Alas, even my father–born and raised an American, conservative his whole life–has this bizarre, almost childlike faith in the rule of law in particular. Specifically, that no, the politicians couldn’t POSSIBLY be up to evil shenanigans, because that’s against the law! Same with the COVIDIOT “healthcare experts” who are lying through their teeth about stuff. They can’t do that! That would be against the law in some way! Therefore, it isn’t happening. Or if it did, of course they would be stopped and prosecuted–and as no one is going to jail, therefore, no shenanigans are happening. I honestly do not know how he came by this particular delusion.

      My mother and I find it very frustrating.

      1. Because good people don’t really understand how bad people can be. One of the sadder parts of the WuFlu has been watching my wife make the walk toward reality. I had always tried to shield her from the worst of it but the stench is so overwhelmingly present that I couldn’t anymore.

        1. I hear that. A large proportion of the problems in my life came from people just… not believing what my family members were willing to do to people, even when they did it right in front of witnesses.

    4. I’m less of a libertarian than I used to be because I realized they will never leave us alone.

  8. The NHS operates very similarly to a massive insurance scheme: everyone pays into the pot through their taxes; the money in the pot is then used to fund medical care for those that need it. Those who don’t need much medical care and/or pay a lot in taxes get out less than they put in. Those who need a lot of medical care and/or pay very little in taxes get out more than they put in.

    The difference lies in who pays for what. In the NHS everything is paid for out of the peoples’ taxes, which has consequences. Firstly governments do not like to be seen to waste taxpayers’ money, secondly any increase in funding for the NHS either increases the government’s deficit for that year or must be paid for by a reduction in funding elsewhere. And governments tend not to want to increase taxes by too much (they’re more likely to reduce them in the good times in order to encourage the voters to vote them back into office).

    This means that there is a hard cap on what can be funded and what can’t be. And the cap doesn’t go up as fast as the demand. So the opposition is always able to argue that the government isn’t treating the NHS properly. And there are always going to be issues over costs being cut too much and expensive treatments not being available. Resultant limits on staffing cause waiting lists that are too long but can never be cut enough.

    But the sheer size of the NHS means that they can buy most drugs and equipment more cheaply than would be possible in a more fragmented healthcare system. And because everyone pays their taxes it’s a lot harder for anyone who needs healthcare to fall through the cracks and not be able to get anything.

    Swings and roundabouts. In some respects it’s better than the alternatives. In some respects it’s worse. Whether it’s better overall than the alternatives depends on what you consider to be the minimum standards that a healthcare system should reach. The NHS was built upon the minimum standard that no-one should be denied healthcare because they cannot afford it. The American healthcare system has been built upon a different minimum standard.

    1. “they can buy most drugs and equipment more cheaply than would be possible if the US wasn’t available to steal from.”

      FTFY. Because what socialists never realize is that those drugs and equipment simply won’t exist unless someone pays the research costs of the ones that work…. and the ones that don’t.

      1. Yeah.

        It is possible that the FDA’s standards are insane, but historically drug development costs for FDA standards were paid by charging a premium to US customers. The other nations used their leverage to negotiate reductions for their purchases.

        1. historically drug development costs for FDA standards were paid by charging a premium to US customers.

          Which is insane. Which is why I was very happy that President Trump (executive order? Already Reversed?) put in that US market can’t be charged any more than Canada or European. Essentially, everyone else in the World, cough it up for R&D, or don’t get whatever.

          1. I don’t remember hearing that this one was rescinded. Maybe even the Junta hesitates at the optics of that one…

          2. It is a little bit reasonable, foreigners have the wrong customs, and cannot be trusted to generate useful amounts of wealth in the first place. I think that extracting wealth from them is more a leftist fallacy than anything with good RoI.

            That said, I’m also willing to accept not spending on drug development.

      2. The underlying problem with new drugs is not just the costs of the research, but also the costs of the drug trials. The drug trials are expensive because they need to avoid the flaws that were noted in previous trials (e.g. double-blind trials because of the placebo effect arising from single-blind trials). If a drug passes then the company only has a set number of years to recoup its costs in profits before the patent runs out and other companies start selling copies for just above cost forcing the price down. And because not every drug passes the trials they need to make even more profit than that, or they go bust. Hence they need to sell the drugs for significantly above cost price, especially if the condition the drug has been developed for is rare.

        Buying in bulk might get the purchaser a discount, but that doesn’t negate the economic need for the drug company to make significant profits on each course of drugs. So theft – no, the companies are still making profits on selling the drugs to the NHS, just not as much as they would if it didn’t exist.

        1. It depends. There are countries that threaten to simply ignore patent if they don’t get at price they want.

          1. *cough*India *cough*

            The PRC is a bunch of scammers, and makes India look good.

            Being able to collect income to pay for the research behind your IP is not the same in every country, and depends on governments, rule of law, etc.

            1. Except there are various treaties that control it. But pharma and feds don’t want to push so let the consumer here foot the bill.

        2. Bandit 6 explains it very well in The Last Centurion. Developing a new drug costs around a billion dollars. Four out of five new drugs fail to get FDA approval and all their development costs are a dead loss. Most drugs don’t get very far down the billion-dollar road before they fail, but some do, and the few successful drugs have to pay for all of it.

          1. Does that include the trick where as a drug is reaching the end of its legal monopoly they tack on a couple atoms that — most likely — don’t change it, and then release a NEW AND IMPROVED! drug that is sooooo much better than the original, for minimal development cost beyond FDA approval?

          2. Then figure how long the patent will last allowing other companies that didn’t spend all that effort developing the drug to copy it, how many units you’ll be able to sell in that time and that has to pay for the development cost of that drug plus the four others that didn’t make it.

            If a lot of people are affected by whatever the treatment covers then the development costs get spread over a lot of units of the drug making the “per unit” cost relatively low. If there are three people with whatever condition the drug is to treat and the treatment is one pill a month, that’s going to be one expensive pill.

            Then consider “marginal cost” vs. “average cost.” Marginal cost being the added cost of making one more of something. So long as someone is paying at the “average cost” rate, enough to make back the high up-front costs, then one can make a bit more money selling additional doses at slightly more than marginal cost. And so various nations with their socialized medicine can insist on pricing which, so long as the cost is at least higher than marginal cost then it’s worthwhile for the company to agree, at least when the other option is not to sell there at all. At least, it’s worthwhile if someone is paying enough to cover those up front costs.

            And that someone is generally us. Basically, the prices we pay for new medicines in the US are essentially subsidizing medical development for the world. However, I’m not sure that there is a “fix” to that since somebody has to pay it or medical progress stops. I mean, how do you force others to pay if they are willing to violate IP instead?

            Sometimes there really are no good answers. Yes, as a matter of fact, I do believe in the no-win scenario.

    2. Thing is, the main expense in any medical system isn’t drugs and equipment, it’s the time and expertise of the medical staff. And unlike drugs and equipment, medical knowledge doesn’t have economies of scale – there’s a hard minimum time for diagnosing a patient or performing a medical procedure, and you can’t stamp out competent physicians and surgeons like widgets.

      (Note, too, that the NHS isn’t all that good at making medical equipment available to patients. The fragmented, chaotic US systems manage to buy a lot more of any given medical gadget per capita than the NHS does. You never hear of waiting lists for an MRI scan in America.)

      Because medicine lacks economies of scale, it’s about the last trade that one would expect to be run through a nationwide bureaucracy funded by the State. Outside of emergency care, which has to be paid for by insurance plans because it’s unpredictable, its natural form is a network of small independent clinics run on a fee-for-service basis.

      1. (Note, too, that the NHS isn’t all that good at making medical equipment available to patients. The fragmented, chaotic US systems manage to buy a lot more of any given medical gadget per capita than the NHS does. You never hear of waiting lists for an MRI scan in America.)

        Some years back, a lady in Calgary had, iirc, sextuplets, and they had to fly Momma to have the babies to, iirc Billings, MT because a Canukistan city of over 1,000,000 didn’t have enough natal care beds to handle 6 premies, but a U.S. city of 100,000 did.

        1. Similarly, I needed an MRI a few years ago for a knee problem. I lived between Austin and San Antonio, Texas, at the time. I called the local clinic (in a town between the two cities) and got an appointment two or three days out. Out of curiosity, I checked the official Canadian health website for the wait time for the same MRI in the Toronto area. It was about six to eight weeks, depending on where you lived near Toronto.

          1. having ridden there and thereabouts many times, you might have found a sooner time if needed by calling around. Just about everywhere along the I35 corridor there has multiple medical plazas and even some of the smaller outlying towns got more than one.

            1. Hell, thanks to a pissing contest (and semi-illegal shenanigans that led to the mayor and his secretary resigning) the nearest “proper” town to where I live (population: 1,377–my town has about 450 people) is getting not one but TWO medical centers. One of which will function as a small hopsital. Don’t know yet what kind of equipment it’ll get, but I expect fairly decent stuff. (No one wants to go to the ‘local’ hospital–an hour away–because it’s had such a crappy rep for so long.)

              That’s what for-profit drives will do, even for the tiniest, most rural bits of nowhere.

              1. The local one to where I grew up has a similar reputation, though it has gotten better (and is bigger now) most folks use it for stabilization and transfer to, usually Green Bay (now less of a travel as the highways are now far more 4 lanes, lopping off 30 to 40 minutes off the old 2:20 travel time) but some times Marquette, or even to The Mayo (depends a lot on what is wrong) but now some of the GB docs spend a few days a week up here at the new digs in Marinette so like My Uncle recently, the just travel to the halfway point.

                1. 1986, neighbor, a retired school nurse, and FIL, performed CPR on MIL, when she collapsed at their (then) home on the Little Descutes River, bordering the La Pine State park. Because at that time the nearest EMT station was in Sunriver complex. Then they transported her to Bend. NOW, there is a small hospital/clinic in La Pine. Still close to 15 to 20 minutes for EMTs to arrive to same location, only because driving the roads into the development complex after leaving the paved La Pine State Park road, isn’t something done at speed, even if the siren and lights are on. Given her condition, she likely even today be transferred to Bend, after being stabilizing. Stroke due to aneurysm of the brain. Or not, they could bring in what surgeon and staff in from Bend.

                  La Pine’s clinic/hospital setup is very, very, nice. It is the on call specialty surgeries they are missing.

                  1. Yeah, the specialties are an issue down here. Tends to explain the helipad just outside the ER entrance. A lot of trauma can be handled in house. Major trauma tends to go to St. Charles in Bend, while the really bad cases (head injuries, mostly) are stabilized then flown to Portland. Difficult eye issues go to Medford, while really bad cardiac cases will go there, too.

                    The hospital had a really poor reputation 15 years ago, but something happened, and it got cleaned up a lot.

                    1. They just didn’t have anything closer. In ’86, I don’t think La Pine had anything, not even a small clinic. The only reason there is an EMT ambulance in Sunriver is because, well it is Sunriver (Money for those not local). La PIne has a clinic/rural-hospital now. A big one. Plus multiple EMT. That has happened sometime since 2000.

                2. Truth be told, I’m not even sure the local hospital is THAT bad anymore. They’ve been really trying to improve their reputation–it’s just that when you’ve had a not-great reputation for 60+ years, and people prefer to go to the OTHER hospital (an hour and twenty minutes away from most towns out here, vs. an hour) if they have the choice, well…change comes slow. (The fact that one of their head doctors got busted for running a prescription drug ring a couple of years ago did NOT help. And on our family-level, finding out that they had been seriously overmedicating my grandmother also did not help. Though that was more the local-local doctor at the time, who sucked. He and his PAs had that all-too-common approach of “throw more pills at it rather than try and find out what’s actually wrong.”)

                  But if you’re involved in something that requires an ambulance, it’s the closest. And they do okay with trauma–for one thing, they know when they’re out of their league, and will put you on a flight-for-life to Colorado instead if it’s something they can’t handle. (Which is where everyone goes for major surgeries and/or cancer treatment, because Fort Collins is pretty good on that front.) I mean, that’s why I was prematurely-born in Denver instead of Rawlins 41 years ago 😀

                  1. When I broke my leg, by running a motorcycle into the side of a car, the local took 2 x-rays. one from the side, and a head on (with two thumbs as I had to hold the plate) that was useless. See when it broke, it was just above the joint, the lower dropped and the upper femur headed into the joint and the kneecap was the reason it didn’t become a compound fracture. Just me and a slight girl tech in the room. She took one look at the leg (knee tight in the pant leg as it was about as big as my bicycle racing thigh) and her instructions and said “Oh, hell no! No way am I straightening that out to get a front view.” so I offered to hold it in place for her. Far longer story of threats to medical licenses and whatnot skipped, I ended up being loaded into the family station wagon “Stabilise the leg, give him something for the pain, make him comfortable in the back of his dad’s car, toss in the x-rays, and get them on the road here!” and hauled to Green Bay, 2 hours and 20 minutes away. When we got there, the Doc (almost ‘retired’ i.e. “not dead yet”, but his son is just as good and both do Ortho for the Packers) was not amused to find someone who drove at speed into the side of a car had not had full body x-rays to see if anything was missed due to the obviously pranged leg/knee. “How stupid can you be?” he also had them anesthetize me so the twists and turn would not cause further pain (this is now about 6 hours after breaking the leg) or cause me to possibly cause other injury if there were injuries missed by not checking out head, neck, spine etc.
                    Also, his son is one of those who comes up here to Marinette a few times a week to see patients at the new hospital.

                    Also as an aside, where they really wanted me to go instead of GB when dad said “the butcher” wasn’t getting anywhere near me with a knife, was Marquette. They got a new Hospital a bit back because the one I would have went into was too contaminated with MRS and other resistant nasties so bad, they decided they could do nothing about it but tear the place down.
                    The Doc in GB just set the leg and put a cast on it.

          2. I once read someone assert that the reason that Windsor, Ontario had no MRI machines was its proximity to Detroit. Obviously, if you’re in a smallish city near a large city, the city you live in need not have much in the way of medical care because you can just go to the larger city, right? Well, it happens I live in a smallish city (Katy, Texas) near a larger city (Houston.) Houston also contains within it the Texas Medical Center, which is a world class accumulation of care and research and a major benefit for living in the general area. It’s also a place I’ve been to precisely once for my own care, although I’ve taken members of my family there on occasion.

            Anyway, as near as I could tell, there were more MRI machines in Katy than there were in Ontario.

            1. Once you’ve got an MRI, you find out that it’s got a lot of uses.

              And once you’ve got ten or twenty MRI machines, you can be using them for all those uses, all the time!

            2. I read somewhere, a while ago, that there were more MRI machines in Cleveland, OH, than in all of Canada. As of the 2010 census, Cleveland had a population of about 400,000. Could maybe double that for surrounding areas that use Cleveland for medical purposes? Canada has a population about 100 times larger – 38 million or so.

              1. Patients in the U.S. wait three hours for an MRI.

                Patients in Canada wait three months — if they can get one at all.

                If the patient dies waiting for treatment? Problem solved!

                Hey, it worked for the V.A.
                There are forms of stupidity that businesses can’t indulge in. There are no such limitations on the stupidity of government.

                1. Back in the days of the HillaryCare debates the single smartest thing I heard was an expert on NPR pointing out that the most “cost effective” course of treatment was to let the patient die.

                  The second smartest thing I heard was also on NPR, observing that the effect of almost all medical advances was to enable the survival of more, than ever before, people lived with previously deadly conditions/damage. We couldn’t cure many but we could enable them to survive. Folks with amputated limbs are rather rare now but were once quite commonplace.

        2. It’s probably a Rural Myth (that is, it really has happened, several times) but my daughter was born in the Spokane hospital that did the same thing. Multi-birth mother, their entire region didn’t have enough incubators, but the one hospital over in Spokane had more than enough that were empty, would’ve been either 2000 or the late 90s.

          1. I knew a lady in Calgary who said family had been transferred to Spokane for something. And Spokane is what, 200,000 people or so then?

              1. Heh, I live in “The 4th largest city in the Upper Peninsula” with about 8600 people. but the Biggest, Marquette, is a whopping 21,000. We used to have a Hospital here in town, but it is now just a V.A. clinic and assisted living home, and they expanded the Hospital across the river (which recently got expanded again in a new location), but the other three have rather large Hospital in them now (though with the WuFlu restrictions betting the Sault St Marie hospital is suffering from a lack of Canuk customers)

            1. 400,000. I went to college there, and it was about the same size as my hometown. Mind you, my hometown is just *one* part of a larger metro region, but numbers-wise, they match pretty well.

          2. A baby was airlifed to Buffalo from Canada and there was a todo because the parents didn’t have passports to follow.

            It was resolved by our getting them over the border without them, not by their bringing the baby back to Canada.

            1. I am trying to picture the result if a kid had to be air-lifted that far, and then somebody tried to tell the medical folks working on him to send him back…. they’d have sudden bomb threats called in from the nurse’s lounge.

                1. That is a different situation, of course.
                  But “parents can’t come over, got to send him back to the place that couldn’t handle it in the first case”? Whoof.

                2. A someone who works in Canadian healthcare, I can say that was never going to happen

        3. My primary care practice has an X-ray lab right there in the office facility. I used to get EEG’s whenever I had my annual exam (before one subparagraph or another of ObamaCare shifted its category from whatever it was to “diagnostic” which meant insurance could only cover it if there was suspicion of a specific problem, not just to check the health of my heart). Profit motive has made more of that medical equipment available to more people than all the socialized medicine ever has.

          1. as a kid, our family doc (originally two Docs shared the office, 3 rooms two offices reception and waiting but the one who was my first doc died in a motorcycle crash) in a town of 4,000 or so had an x-ray machine. When I broke my arm in 7th grade that was where it was x-rayed then set.

      2. Um. No. the primary expense for the NHS is non medical administrators, much as the main expense in education is not teachers but administrators. In the US, malpractice liability is a huge direct and indirect cost, think unnecessary tests but we ought to remember that cost is set by Medicare.

        In both cases, the cost is high because of government interference.

        Drug trial costs are a two edged sword, yes they’re expensive but the regulatory structure also protects big pharma against competition, which outweighs the cost of it from the firms point of view. Big firms like regulation and particularly like regulatory capture since in that case they get the protection from competition with limited interference in their business. In pharma, people die if you get it wrong so there’s a bit of a check and balance but regulatory capture explains banking, edification, much of farming, etc.,

      3. The wasting taxpayers’ money problem. If an expensive machine lies unused for too long a proportion of the time then the opposition argues that the government is overspending on machines. The resultant tendency is only to purchase what you know will get used, and this combined with the inevitable cap on budgets means that fewer than actually needed get bought.

        In other health systems a different system operates. As long as the machine can pay for itself it’s worth buying. Such systems will end up with more machines per capita. Depending on how much patients (or whoever pays on their behalf) can be charged per use, such a system may end up with more machines than is needed.

        1. “such a system may end up with more machines than is needed.”

          Until the levee breaks. Just In Time doesn’t work any better for health care than it does for keeping grocery stores stocked.

        2. Is it your contention, then, that a private individual, who chooses to endow a medical clinic will be less careful of the expenditures that he must make from money he himself earned than a government will of money that they collect from others on pain of imprisonment? If that is your contention, then it is contrary to all experience. People who own things tend to take care of them, and to take care in their choices, for that is how you get to own things. Governments tend to spend more money to get less, because mistakes in expenditure tend to have no personal consequences for those making the decisions.

        3. The requirement that MRI purchasers obtain a Certificate of Need from the appropriate authorities (usually the state) limits the number of devices in many areas. This is not much of a problem in large, urban areas, such as Raleigh, NC, but can be a serious obstruction in less densely populated areas, such as Boone, NC. The thought that such devices might prove useful in areas catering t, for instance, the snow skiing hobby, seems to often escape regulators’ minds.

          Are Certificate-of-Need Laws Barriers to Entry? How They Affect Access to MRI, CT, and PET Scans
          Many states require providers to seek government approval for new facilities. These certificate-of-need (CON) laws restrict healthcare institutions from expanding, offering a new service, or purchasing certain pieces of equipment without first gaining approval from regulators. Twenty-one states restrict acquisition of imaging equipment such as MRI, CT, and PET scans.

          A new study for the Mercatus Center at George Mason University compares how CON regulations affect imaging services provided by hospitals and imaging services offered by other providers. The results show that CON regulations adversely affect nonhospital providers, while hospitals largely remain unscathed. Residents of CON states are also more likely to travel out of state to obtain imaging services than residents of non-CON states. CON regulations can change the market for imaging services by setting up barriers to entry for providers that are not hospitals, consequently harming consumers of these services.

          STUDY DESIGN

          Twenty-one states have CON requirements for at least one of three regulated imaging services: MRI (magnetic resonance imaging) scanners, CT (computed tomography) scanners, and PET (positron emission tomography) scanners. Medicare claims provide an estimate of the utilization of these different services and allow their utilization and accessibility to be compared between CON and non-CON states.

          Utilization is measured as the number of claims filed in a state for the service in question divided by the number of Medicare beneficiaries who reside in the state. Hospital market share is defined as the number of times a relevant procedure takes place in a hospital divided by the number of times it takes place in all settings. …
          [END EXCERPT]

          1. Is there even a fig leaf of a rationale for this, or is it just open and explicit restraint of trade?

            1. I am sure the brilliant minds fixing our laws and regulations have excellent reasons for this. Probably something along the lines of not encouraging facilities to promiscuously use the device, simply because it is there, needlessly driving up people’s medical bills.

              On the internet nobody can prove you didn’t type something with a straight face.

              1. Pretty much that. Govt doesn’t want places overruling and then sticking patients with the capital costs for facility. Only they are allowed to do that.

      1. Those cases tend not to be reported over here. The press focus tends to be on the cases where the patients self-deny because they can’t afford to pay their share of the drugs that they have been prescribed, or need to be prescribed. I grant that that probably creates a biased view of the topic.

        1. See the comments above re: Charlie Gard, Alfie Evans, and the Liverpool care pathway.

          The NHS damn well does deny medical care to some people – for reasons far more arbitrary than “the patient won’t pay for the treatment”. In fact the NHS has been known to actively prevent patients getting medical care who wanted it and could afford it, something no US medical system ever had the gall to try. You are absolutely getting a biased view of the subject, if not outright mendacious.

          1. With regards to Charlie Gard and Alfie Evans the important point is that the final decision was not made by the NHS but by the courts.

            In both cases the parents, quite naturally, wanted their child to receive all possible treatments. In both cases the doctors came to the view that this wasn’t in the child’s best interests. In such cases there is no assumption that the doctors are right, nor one that the parents are right. Instead the courts are asked to determine what course of action is actually in the child’s best interests.

            Whether the doctors were right in their assessment in these cases is a matter of debate. Whether the courts were right in their assessment in these cases is also a matter of debate. In both these questions I’m not in a position to argue either way.

            The underlying principle is that sometimes in terminal conditions there comes a point where continuing treatment is counterproductive, that the benefits are outweighed by the disbenefits. If that point is reached (and it isn’t always clear if or when that is – hence its not unknown for experts to disagree) then sooner or later continued treatment is no longer in the patient’s best interests. Questions like this are sometimes so difficult that consensus between doctors and patient (or guardian if the patient is too young or otherwise incapable) is preferable. Where it isn’t a neutral arbiter is needed – and sometimes the arbitration process (the courts in the UK) takes too long, and only one option is left by the end of the process.

            1. And not one single word of that has any bearing on the scenario of taking the child to another country to pay for treatments.

              No; the British government murdered that child. As surely as it they had shot him in the hospital bed.

              1. They couldn’t RISK the child getting well in America, see? Because then all of the serfs would want cutting edge treatments for themselves and their children.

              2. I think this might be our first agreement. The British government murdered that child and Mr. Young seems to think that a fine idea because he knows what the child’s interests were. I’ll give him the benefit of the doubt that he believes utilitarianism, is coherent and somehow moral. Perhaps he could move to tiergartenstrasse 4 and join in the action after all the experts: doctors, lawyers, judges, bureaucrats know best.

                1. The boy’s best interests. Heh. For whatever reason that brought to mid this news clip I saw earlier today, about a one-armed kid (a wall fell on him when he was eight-years old in Guatemala and they had to amputate) who seems to have his own ideas about what his best interests might be:

                  Funy thing is, when I [searchengined] for “one-armed basketball player” Hansel Enmanuel is but ONE of the names who came up (there were 3 or 4 others), so I might be wrong about how this one lost the arm, it could be some other kid. Heck, there’s even some one-armed kid in China who’s dunking.

                2. needs a semicolon; as written there’s an issue parsing around “after all”.

                3. Sir, I am not employed in the medical profession. Consequently not only do I not know enough to be able to come to my own opinion as to what the child’s best interests were in either of those two cases, even if I were to read all the relevant information I wouldn’t understand enough to be able to do so. Therefore, as I stated above I am not in a position to argue either way.

                  My only position on this is that the doctors in such a case must put the interests of the patient first, not the wishes of the parents. If the doctors in these cases did not do so, then their actions were reprehensible, and the courts made a terrible error of judgement. If the doctors made a genuine attempt to do so, but came to the wrong conclusion, then their actions were understandable, but again the courts made a terrible error of judgement.

                  And as far as experts are concerned, in the simple cases, the common cases, the well-understood cases experts in the relevant subject are generally accurate as long as they restrict themselves to their areas of expertise. In the complicated cases, the rare cases, the cases where is limited understanding experts frequently make mistakes. Non-experts might be expected to make mistakes in those areas more frequently, especially if the solution turns out to be counter-intuitive, but in any given case the non-expert might be right and the expert wrong – and an expert should be willing to acknowledge that, an arrogant expert unable to admit the possibility of a mistake is not someone to trust anyone’s life to.

                  These cases were ones that were rare, complicated, and where there is limited understanding. The likelihood of the experts, i.e. the doctors, making a mistake is therefore high. And this should have been taken into account during the process.

                  1. ….if you think you have to be a medical doctor to say not being killed is a bad thing, you need to re-evaluate your priorities.

                    Especially when the person involved, or their parents, who love them, along with a wide selection of doctors, are all looking in in horror as the kid is slowly killed by exposure.

                    1. That is not what I am attempting, clearly badly, to argue. The cases referenced are both ones where the child will, irrespective of the treatment given, deteriorate and die. The question in both cases is at what point does treatment designed to extend life cease to be beneficial, at what point is it best to let the child die in peace. I do not believe that these questions are easy or simple. They should not be answered lightly.

                      My instincts are to attempt to answer such questions with ‘head’ not ‘heart’. (Many will believe that I am going about this the wrong way.) But this requires analysis of various matters that will not be easy for the non-medically trained to get their heads around – at the level I would want to carry out the analysis at least. And therefore I cannot solve the problem with ‘head’. (And yes, if I attempted to answer with ‘heart’ I would be able to take sides.)

                      In response to your specific accusation, I believe that doctors should not kill. Where they can reasonably prevent death they should do so. But sometimes the only way that the patient’s death can be avoided involves the doctors causing the patient to suffer – I am not sure that this is always reasonable. I am not sure that when it is my life on the line I would want to suffer beyond a certain level, but should such a time come I may change my mind.

                    2. Ah, yes, the gold old “kill them to put them out of my suffering” dance, wrapped in tenderness and appeal to the dead child’s best interest in preventing those who loved them from even attempting to help them.

                      Why? Because people whose strongest interest in the child was for him to die as they predicted said that it was best for him to never be allowed a chance.

                      Even if this wasn’t a system with a know issue with systematic murder via deliberate neglect of those whose financial cost/later income ratio wasn’t nice enough, that should make you think more closely about what you are asserting.

                      It’s good that you mentioned you are not a doctor, because that means you have some sort of an excuse for making claims anywhere close to “it’s impossible” with respect to recoveries, survivals, etc.

                    3. The question in both cases is at what point does treatment designed to extend life cease to be beneficial, at what point is it best to let the child die in peace.

                      That is not the question.

                      As Thomas Sowell said, “The question is not what is best, but who shall decide what is best.”

                      Not “what” but “who”.

                      Thus, the question is not when it is best to “let the child die in peace” but rather who shall make that decision. Shall it be the child’s parents, who presumably love the child and want what they believe is best for it? Or shall it be some bureaucrat to whom the child is nothing more than a resource sink and a cost item on the budget?

                    4. Not “what” but “who”.

                      As the Bolsheviks were wont to say, the question is “Who, whom?”

                    5. They say if you’re digging a hole the best thing to do is to stop digging.

                      It seems that every attempt to explain my position in this particular chain has left me needing to attempt to explain again in response to an interpretation my explanation admitted but I did not mean.

                      I could attempt to explain again in response to the commentary on my last. But given the calibre of my previous attempts I don’t think I will succeed any better this time. So I will stop digging.

                      I apologise for my failure to adequately think these things through before putting them on the screen.

            2. It’s irrelevant as to whether further treatment was warranted. It was available and the parents had the money to make the flight and everything else. The courts and docs had no business removing that decision from the parents.

                1. Uh… it’s Britain. The child belonged to the State. Though Brits get all defensive over exactly how much power the Crown has nowadays, that’s what “subject” means.

              1. By the time the courts got involved there were only two options in the Charlie Gard case. (1) That Charlie had deteriorated too much for the treatment to be worthwhile – and therefore the treatment would not have been available anywhere once Charlie had been examined on site. (2) That Charlie had not deteriorated too much.

                The doctors in the UK had withdrawn the treatment because they had come to believe (1) was true. So from their perspective the treatment would not have been available in the US. The parents believed otherwise.

                If the parents were right then your argument is valid. If the doctors were right then the question of whether a sick child should be flown to another country only to be denied the treatment the parents were seeking comes into play – and I have no good answer to this.

                Due to the circumstances of the case we will never know which of the two options was true. By the time the question was settled Charlie had deteriorated even further.

                1. If the parents were right then your argument is valid. If the doctors were right then the question of whether a sick child should be flown to another country only to be denied the treatment the parents were seeking comes into play – and I have no good answer to this.

                  So he had to be killed in the UK because he might either not get treated, or might not recover when treated?

                  Thus…he must be refused treatment?

                  That is not a valid argument. That is “because there is a possible bad outcome, the worst outcome must be enforced. For his own good.” Which is, obviously, nonsensical.

                  The only rational reason to deny him treatment was because he might live— which would both show that the doctors were wrong, and have the possibility that he would require further treatment when they’d decided he was a drain on resources.

                  If it had been my kid, the issue would have been solved long before because not a single one of those f*ckers would have been alive to have an opinion.
                  Do you have children?

                3. It. Doesn’t. Matter. The courts should never have been involved. The state had NO RIGHT to tell parents what they could and could not do for their child. You are suggesting that the child was the property of the state and the parents had no say. A doctor’s advice is not law.

                  1. Wasn’t there a similar instance here in the states? I recall a child being “held” in a Boston pediatric center whose parents had to go to court to get the hospital to transfer the child to another facility.

                    For that matter, “we” have decided that in America a girl to young to consent to sexual intercourse can be given birth control and, should that fail, abort her developing child without her parents (in their roll as guardians) informed, much less tasked for consent.

                    We are seeing a similar dynamic at work in the transgender debate.

                    I reckon we “know” whose kids they are.

                  2. A doctor’s advice is not law.

                    No, but a bureaucrat’s decree is.
                    There but one greater sin than to be right when those in power are wrong — proving it.

                4. Oh, and doctors in America had agreed to treat the child, so the argument that treatment was not available doesn’t fly.

            3. Your argument about Charlie Gard and Alfie Evans is disingenuous. Yes, the courts ultimately decided. But the reason why the courts were involved in the first place is because the British doctors involved were doing everything that they could to block the boys from traveling to the US for treatment.

              The costs of the treatment had been met through crowdfunding campaigns, and the treatment was scheduled to take place in another country. The British doctors had given up on the two boys. But when the parents attempted to take their respective baby boys to another country for treatment at no cost the the British taxpayer, they were denied the opportunity.

              If the doctors give up on treating a patient, then – so long as the patient doesn’t represent a risk to other people – it’s no business of the doctors if the patient in question chooses to try a self-financed method of treatment, even if that “treatment” is as absurd as “dancing naked in the light of the full moon”.

              1. That is not absurd. Works wonders it does. The Pure tastes even better when ye’ve got yer wan there runnin about in her birthday suit… 😀

              2. Having gone back and reviewed the cases, in Charlie Gard’s case the treatment had been agreed to. There was agreement amongst the medical experts that it was unlikely to help if there was sufficient brain damage. It was cancelled before it started after Charlie suffered seizures that led to brain damage. The doctors in the UK concluded that given this (unrelated to the treatment) change in his condition the treatment was unlikely to be of benefit. This was not a universal opinion amongst medical experts. But by the time that other experts evaluated Charlie he had deteriorated further, even they agreed that the treatment would now be futile.

                What we do not know, because Charlie was not evaluated by other experts at the time, is whether the doctors in the UK were correct in their assessment or not at the time that they made it. If they were correct then the doctors in the US would have been unlikely to proceed (all the doctors having already agreed that too much brain damage makes the treatment unlikely to be of benefit). From their perspective (and they may have been completely wrong) the parents’ plan would have involved Charlie flying to the US only to receive no treatment because he had now deteriorated too far for it to be worthwhile. Only if the doctors were wrong in their assessment would your construction have followed.

                The options were (1) the doctors in the UK were right in their assessment of how far Charlie had already deteriorated, and the doctors in the US would reach the same conclusion upon examining him, resulting in Charlie receiving no treatment in the US; or (2) the doctors in the UK were wrong, and Charlie would have been treated in the US.

                I’ve no idea which of the two options were correct in practice. If (1) then flying Charlie to the US would be futile. If (2) then Charlie should have been flown to the US as soon as possible.

                The doctors in the UK backed their judgement and argued (1) was true. The parents disagreed and argued (2) was true. We will never know who was right.

                1. Who is to decide is the question, experts or people with skin in the game. Who is to decide if a chance is worthwhile? Who is to decide if a life is worthwhile? Who is to decide if your life is worthwhile? The Nazi Aktion T4 euthanasia program wasn’t run by the deathshead SS, it was run by the experts: doctors, nurses, the lot. They decided, as many states are again, that certain lives are not worthwhile.

                  You might profit from reviewing the example of Peter Singer the “ethicist” who when asked why he was violating his principles said “it’s different when it’s your mother.” It’s interesting how the decision changes you have skin in it and it’s not an abstract decision affecting others. Killing other people’s children is easy, killing your own not so much.

                  I followed these cases and concluded that arrogance by the doctors and anger that the proles and peasants weren’t doing what they were told had more to do with it than anything else. The doctors said they should die and all the experts fell in line with the other experts and so they died. Your claims about the doctor’s and judge’s conclusions assume they are unbiased arbiters who weighed up all the factors and made the optimal decision. Sigh. They don’t exist.

                  You would have done better to argue that it was only that the money existed that made this an argument at all and had it not the children would have died without us knowing. You could have turned the argument against utilitarian calculation around and charge hypocrisy.. Incould still answer, but it would have been harder since there is an argument there. Arguing from expertise, nah brah.

                  1. Killing other people’s children is easy

                    While I get what you’re getting at, I just have to say that there’s a term for folk who find killing other people’s children easy. Actually, there are a great many terms but let’s just start with one: monster.

                    1. I said exactly what I meant. People who would never dream of killing in fact are perfectly willing to kill in abstract. It comes out in the BS about head versus heart because head is just the utilitarian calculus and the utilitarian calculus is monstrous.

                  2. Do not make the mistake of assuming “the experts” do not have skin in the game. If their prognosis is proven wrong, for one example, they suffer damage to their reputations.

                    As employees, for another example, they are subject to discipline if they recommend costly procedures to little benefit of the employer in this case, the NHS – in America physicians are increasingly becoming employees of rather than partners in medical practices, with long-term consequences ill-explained to patients.)

                2. In either case, 1 or 2, the decision should have been left up to the parents.
                  The idea that people who are not related to the child, e.g. doctors or judges, are more likely to want the best for the child than the child’s parents seem daft.

                3. The parents were right. Period. Even if they were wrong on the diagnostic, they were right.
                  The fact people in the UK can’t see that worries me beyond measure.

                4. And the motivation for *actively preventing* the attempt at treatment would be…

                5. What we do not know, because Charlie was not evaluated by other experts at the time, is whether the doctors in the UK were correct in their assessment or not at the time that they made it.

                  Charlie was not evaluated by other experts because the doctors originally treating him WOULD NOT ALLOW IT. That is not making sound medical decisions, that is simply exercising control over parents and destroying parental rights. It has nothing to do with proper treatment or evaluation for an ill child.

                  1. Just so. They said he should die and he died because they said so.

                    What is it Cartman in South Park says: “ you will respect my authoritah.”

                  2. Charlie was not evaluated by other experts because the doctors originally treating him WOULD NOT ALLOW IT.

                    I’d point out this has happened at least a few times in the US, because I’ve heard about it.

                    The most famous case, the (adult) son was declared brain-dead, and his mother and brother volunteered him for organ donation.

                    The father managed to beg his way into the room….and held the son hostage.

                    When the police SWAT team got their, their doctor put out an APB– because there was a disabled man in the room, with the father, but there was definitely nobody who matched “vegetative state” much less “brain dead.”


                    The mother was estranged from the father, had been for ages.
                    And the disabled son was disabled since before the divorce. And named for the dad. Mom took the not disabled son.

                    There are video interviews with the “brain dead” son, and his father, a year later.

                    Imagine how he’d be if he had gotten actual medical care, rather than being shoved into “support for organs we’re going to harvest.”

                    1. I’d argue that while clearly a bad situation, that is different that what the parents of Charlie and Alfie went through. In the case you described, family members who had the power to make decisions were the ones making the decision (whether you agree with it or not). The docs did not stop the mother and brother (and would they have if the opposite decision had been reached). The mother and brother decided not to include the father in the decision making process, that argument brought in the police. In the UK cases, the state intervened over and above *all* custodial guardians/parents. It’s not just the intervention of the state, it’s the timing of the interventions.

                    2. I didn’t explain it well enough, then– the mother and brother were estranged, and the father was the one that had been custodial.

                      The hospital just decided they’d listen to the ones who said it was OK to harvest the guy, instead.

                      Main point, though, was that there is a known pattern of “declare it’s hopeless, and then make dang sure nobody else gets a say in.”

                    3. Main point, though, was that there is a known pattern of ‘declare it’s hopeless, and then make dang sure nobody else gets a say in.

                      Obligatory mention of Terry Schiavo and her cheating desperate to be ex-husband.

                      I wish his inamorata joy of him.

                    4. Ah. Gotcha. Yeah, that’s different than what I was envisioning. When was this? Because I think due to Terry Schiavo and others hospitals are now really careful about PoAs, etc. for incommunicado patients. I know I had to prove several times that I held my father’s Health Proxy power. I carried those papers with me the last 2 weeks of his life as we went in and out of the hospital to see him.

                6. Your post is irrelevant in its entirety. The only two things that matter are this.

                  1.). The British medical service said it could not save Charlie Gard.
                  2.). The British medical service said that Charlie’s parents couldn’t seek help elsewhere.

                  Once again, it DOES NOT MATTER how likely it was in the opinion of the British medical professionals whether the treatment would work. The moment the British medical service announced that it could not save Charlie Gard, it should have let his parents do as they wished.

                  And that applies even if Charlie’s parents hadn’t been desperately trying to help him. A doctor should only be able to act as your doctor so long as he is working to save your life (and even then there will be exceptions). The moment a doctor announces that he’s given up trying to save you, you should be free to leave that doctor’s care.

            4. The general opinion seems to be that the courts paid undue deference to the opinions of the medical experts.

              We saw a similar dynamic in play with the treatment of Jahi McMath:

              Jahi McMath Was Not Brain Dead
              By Wesley J. Smith
              May 3, 2021
              Readers may recall the sad case of Jahi McMath out of Oakland, Calif. In 2013, Jahi experienced a severe bleeding event after throat surgery and a subsequent cardiac arrest. She was successfully resuscitated, but her brain was catastrophically injured from loss of oxygen. Doctors at Oakland Children’s Hospital declared her brain dead and announced plans to remove Jahi from life support.

              Not so fast. Jahi’s mother, Latasha “Nailah” Winkfield, did not believe her baby was dead. She sued to keep her daughter’s life support maintained. It made national headlines. Eventually, a deal was worked out in which California issued a death certificate and Jahi was transferred to her mother’s care still attached to life support. Nailah moved Jahi to New Jersey that permits a religious exemption from brain death, insisting that her daughter was severely disabled, but alive.

              I initially supported the brain-death declaration, but changed my mind over time when Jahi’s body did not begin to breakdown, as almost always happens in brain-death cases. Moreover and far more importantly, the noted neurologist Alan Shewmon reviewed the tapes of her seeming responsiveness and opined that while she met the criteria for brain death at the time, he believed she wasn’t any longer. He stated under penalty of perjury that she was not dead, but severely disabled. (Shewmon does not believe that brain death is a legitimate diagnosis.) I wrote about these twists in Jahi’s story repeatedly.

              Well, it now turns out that Nailah and Shewmon had it right. An article detailing the results of examination of Jahi’s brain by another neurologist, published in the respected Journal of Neurosurgical Sciences, explains precisely why she was not really brain dead. meaning, she was not dead at all. Rather, the doctor opines that she experience a severe cognitive disability of a kind not observed heretofore. From, “Jahi McMath: A New State of Disorder of Consciousness“:

              BD has been characterized by the loss of all HRV power. On the contrary, all HRV bands, BD were preserved in this patient, demonstrating preservation of autonomic function. Moreover, autonomic reactivity to “mother talks” stimulation demonstrated remaining function at different levels of the central autonomic system. These results support Dr. Shewmon’s analysis of Jahi McMath’s videos, who emphasized that her movements reflected responses to her mother. . . .

              Jahi McMath was a rare and argumentative case. The concept of BD is not denied with the discussion of this case but brings back the debate of using or not ancillary tests in BD confirmation.

              In conclusion, Jahi was in a new state of disorder of consciousness, non-previously described, that I have termed as a “responsive unawake syndrome”

              So much for the arrogance of, “The mother just can’t accept reality,” or, “She is in it for the money,” disdain that was thrown at Nailah constantly by people who loathed her for fighting for Jahi’s life. Perhaps one lesson in this tragedy is that doctors should be less dismissive of loved ones’ perspectives in cases like Jahi’s (and Terri Schiavo’s, among others).

              On a personal note: I had the great honor of visiting Nailah and Jahi in New Jersey, a visit arranged by Terri Schiavo’s brother, Bobby Schindler, who, almost alone in the world, stood courageously in solidarity with Nailah during the entire ordeal. For what it is worth, I found her to be a mother who was very aware of her circumstances and fighting fiercely for her beloved daughter’s life without ulterior motives.

              It was a day I shall never forget. Nailah asked Jahi to touch her right index finger and thumb together. Jahi appeared to be trying to comply — it was hard to say for sure, but her hand began to shake. A few minutes later, I saw her slowly move her thumb and forefinger together and touch them. I nearly jumped out of my shoes, as she complied precisely with what Nailah had asked of her. It is important to note that Jahi’s digits did not “jerk” or “twitch” during the movement, as one would expect from an involuntary action. Rather, it appeared entirely volitional and controlled.

              So, I am not surprised that Jahi was not really dead for all those years she lived in New Jersey. I wrote — and still believe — that scientists around the world should want to know more about her case and to further explore the brain-death diagnosis. Hopefully, this article will spark renewed interest. People need to have faith that when a loved one is declared dead, they are really dead.

              Post Script: Jahi really died in 2018.

              1. Another factor worthy of consideration in regard to “experimental” procedures: these are a big part of how medicine advances.

                While a particular patient, an Charlie Gard and Alfie Evans, might not derive much benefit from experimental therapies, the knowledge derived from the treatment may well take Medicine a step closer to being able to benefit other, subsequent patients. Louis Washkansky, recipient of the first human heart transplant, survived a meagre eighteen days after the surgery — quite possibly a shorter survival period than he’d have experienced without the transplant. Yet it would be hard to argue that the cost i reduced lifespan and added suffering of Mr. Washkansky was without purpose.

                Perhaps Charlie or Alfie’s experimental treatments would have prolonged their suffering and yielded no new knowledge – but we’ll never know that.

                1. My aunt was in a wheelchair for 50+ years as a ‘lucky quad’ (meaning her break was where she should have lost arm function as well as leg, but was incomplete enough to allow some movement in her upper limbs)

                  At that time, life expectancy was, max 10 years with only a hope of slowing the decline. 20 years later she regained a quarter inch of movement in her hands, was employed (programming, her last job involved converting bank computers from COBOL to something modern.)

                  She was one of the early ones to live past the 10 year mark. One of the ones to live long enough to prove that nerves DO heal, just very slowly. You never know what a little bit (or lot) of perseverance will unearth.

                  1. When my mom was a kid, someone with Down’s making it to teen was a really big deal that took a lot of fighting to reach (thank you, Robin Rogers; may you rest well)

                    Now, most of the cleaning staff at my husband’s office building have Downs, guessing off of appearances, and are older than he is.

                    Part of that is being able to fix the heart problems– but there’s also the “figuring out what the problems are because you are actually treating the person, instead of slowly killing them.”

                    1. Then there is the story of Sister Elizabeth Kenny,

                      a self-trained Australian bush nurse who developed a new approach for treating victims of poliomyelitis, which was controversial at the time. Her method, which she promoted internationally while working in Australia, Europe and the United States, differed from the then conventional medical practice which called for placing affected limbs in plaster casts. Instead Kenny applied hot compresses to affected parts of patients’ bodies followed by passive movement of those areas to reduce what she called “Spasm”. Kenny’s principles of muscle rehabilitation became the foundation of physical therapy, or physiotherapy.

                      Stupid ignorant bush nurse, ignoring expert medical opinion!

                  2. My oldest daughter had spina bifida, was paralyzed from belly button down. At the time of her birth, the first cohort of children with spina bifida were reaching young adult hood (previously, the expectation was to die during child hood, often from renal failure or sepsis). This gave us some hope.
                    In context, because of spina bifida as well as several other medical abnormalities, it was quite uncertain that she’d see her first birthday.
                    She passed this past fall, 28 years old, after living a life with a lot of happiness and a surprising amount of ‘normalcy’.
                    We focused one day at a time, and were grateful for each.

                    1. I am sorry for your loss.

                      The flat words aren’t enough– I’m a mom, I can just barely imagine, and I don’t WANT to.

                      You got…a few fewer years… than my folks got, from my little sister.

                      Perfectly normal, healthy– hell, healthier than me!– she just….died, one day. Didn’t feel good, then didn’t wake up.

                      My mom voiced the…feeling…that comes to mind: It is not right that a parent outlive their child.

                      I can’t help, I can just wish that I could.

                    2. My mom voiced the…feeling…that comes to mind: It is not right that a parent outlive their child.

                      Exact quote from my two aunts. Surprisingly the pioneer cemetery, where cousins are buried, has very few infant to young children, graves; which is unusual for mid-1800 pioneer cemeteries. A lot of young women, mid-20’s to mid-30’s, but few children. Family history antidotes state that most children survived to at least young adulthood, not that they were buried elsewhere.

                      We, as a family, had to watch a family close to my parents. Oldest son took sick, stage 4 colon cancer (age 24). They no more buried him than grandma found the second son dead in his bed, T1 diabetic (age 21). No more bury him, and mom is diagnosed with cancer, which went terminal very fast.

                    3. Cousin was born with spina bifida, 1967. Parents fought for her to be cleaned and treated. Told:

                      1) Wouldn’t survive.
                      2) If survived would be extremely physically and mentally disabled.

                      Later they fought to have her in mainstream classes with an aide (the poster child for the Act, do not get my Aunt started on how That has been *abused). Physically disabled, yes, which is why she needed an aide available (but not hovering). Mentally, very much NOT disabled.

                      Uncle, an engineer, built their daughter a slew of physical aids to allow her to be a child, and to try and strengthen her legs. One example of her toddler years … Crawl? Chase after the dog? Wide skate board for the win. She had a baby seat jumper seat before they were a thing.

                      She died in 1980 when the shunt to drain water from her brain, failed again. She is buried next to grandma in the Jesse Applegate Cemetery between Drain and Yoncolla Oregon. Our 12 year old cousin, killed in 1999, is buried next to her.

                      * Act was never intended to mainstream children who did not have ability to do the classroom work. Nor was it intended to mainstream children who were verbally or physically violent disruptive in class. Unintended consequences. Which was a hoot because after cousin died, Aunt continued in school system as an aide, until grandma (her mother) died. She took her inheritance from grandma (not a lot, but something) and got her teaching degrees. I understand when the issues with the Education Act came up the words “Do Not tell me what the intent of this Act is … !” Might have been uttered a time or two or hundred of thousands. Especially since she ended up teaching in California. Today? They’d more likely home school and forget fighting the system. But this was early ’70s, so …

                    4. I would like to point out the best medical science available when I was born informed my parents I would be severely retarded.
                      Also when I was going into eclamptic convulsions while pregnant with older son I was told he’d be severely mentally retarded or a vegetable, and I should abort “for his own good.”
                      Some of you have met him. Like h*ll he’s retarded. By testing (which I have doubts about, of course, but that’s ALL testing and it’s how they determine these things) his IQ classifies him as profoundly gifted with particular ability in math and music.

                    5. Hell, I was born premature in 1980 (and in the US, and they flew my mother to a hospital that a NICU) and they were STILL telling my parents that I was likely to be severely retarded, etc etc. One of my mother’s doctors when she became unexpectedly pregnant at 41 with youngest brother tried to pressure her into getting an abortion, because he might have Down’s. When she refused to do it on the chance, the dr tried to get her to do the test (which at the time–in 1996–was known to have not-small risks) and THEN get an abortion. Couldn’t grok it when my mother informed her (I think it was a her) that she didn’t CARE if baby had Down’s or not, she wasn’t going to get an abortion.

                    6. That was my reaction. So I never had the test. (Besides, I was 28.) I also informed them “if he’s retarded, I’ll TAKE HIM.” because we’d been trying for six years.

                    7. My doctor said “Given your age is over 30, I am obligated to offer the test to you?”.
                      Me: Glare
                      Doctor: “Okay, then. I’ll mark you refused.”

                      Yes. After 10 years of trying, I was taking what the lord decided we could handle.

                    8. Foxfier, thanks.
                      Our circumstance is different. We KNEW we would lose her, and could at most anytime from several risks, mostly infection, but also shunt failure as ‘D’ mentioned. The one certainty was renal failure (and she would not have been able to get a transplant or succeed with dialysis).
                      We’d been counting down for several years, and frankly were anticipating later this year… but her single kidney took a hard hit from infection and just quit. Hospice is a wonderful service (one which we’d decided upon several years ago — another key, we had the time to reflect, pray, and plan).

                      BUT, this also provided a special blessing. We prepared, braced ourselves. We also choose to focus on every.single.day! We found the joy that the simple everyday things bring, and we never let go of that happiness and the peace it often provided.

                      I am grateful that Kayleigh was in our life. She taught me so much, and provided loads of love, joy and pride. Her sister and brother continue to be the largest joy I have.

                      (And, there’s always someone else whose circumstances prompt the observation — how do you do it? I mean, I can handle X, but I couldn’t handle what you have! Funny, that feeling is usually mutual between the 2 parties)

                    9. I’m happy you had Kayleigh in your life. It is still hard. Aunt and Uncle knew they’d lose Lisa eventually, just there had already been so many miracles, they were hoping for one more.

                      A couple of years later they started fostering and ended up adopting a hard to place toddler, who has severe seizures due to brain lesions. Cousin is now married with two children.

              2. Cases like that are when the “brain death is real death” folks started switching into the life unworthy of life zone.

                And yes, when people are actively defending killing people for being disabled, I am going to point out we’re not even a the century mark for the last time a famous country got themselves all wound up into thinking that was a great idea.

        2. What’s reported over there is usually wrong. I still read the UK papers every day and they would have it that poor Americans have no healthcare and the rich pay no taxes. In fact, we have superb healthcare even for the poor and the rich in the US pay a much higher proportion of the total tax than just about any country in the world.

          There was an old Boomtown Rats tune called Don’t Beleive what you Read. Good message. of course, you won’t find the truth in the US papers either.

        3. Oh. There is a way to deal with that too. My friend was put on a drug that cost 10k a pop. He needed a pill a DAY.
          He wrote to the company that made the tablet and explained.
          He took that for 3 years, for free.
          Yes, there are people who die because they’re “embarrassed” about going in. Only I’m not sure I buy it. That’s how it gets spun, but I’ve also had friends die because they keep putting off going in until it’s too late.
          If that’s the case, it’s easier to say to family “well, he was embarrassed.” Than (and btw, I’m one of the people who does this) “Well, he never got around to getting that pain checked out.”
          For the record, I KNOW what gets reported there. Portugal and Canada actually make up these wholesale stories of people turned away from hospitals in the US. It’s bullshit. No one is EVER turned away for inability to pay.
          Now, mistakes happen (DUH) and if you’re a frequent flyer who is there every night with a drug overdose, they might miss that tonight you’re having a stroke.
          Also our system is about to become so strained that errors will happen more.
          Most of our bed occupancy and hospital costs? Illegal immigrants. Because we’re suckers, that’s why.

          1. Yes, there are people who die because they’re “embarrassed” about going in. Only I’m not sure I buy it. That’s how it gets spun, but I’ve also had friends die because they keep putting off going in until it’s too late.

            Eh, I can see someone doing that. Not least because I’ve been there. Which is part of why I spent 8 days in the hospital for double-pneumonia + mono instead of nipping it in the bud.

            Ok there were other factors, like not even being aware it had reached that stage because the signs I was looking for weren’t there. But still, trouble getting air happened long before someone else noticed that it was serious.

            It is still a small matter of shame that I never saw most of the costs from that. (small because I also know how completely whacked out medical pricing is and why)

            1. Heck, we had insurance, and I spent 11 days in ICU for pneumonia at 33.
              Why? I had small kids, and it was “just a cold.”
              Oh, and THANK THE LORD we had insurance. Because the alternative ws to be completely destitute to get that treatment for that long.

              1. I was in college working at seasonal job. Fall. Working outside. So hot but cold crisp air. Which breathing in dried out nasal passages and upper throat, so sore throat the next morning. This went on for days, before suddenly I was miserable. We worked a canyon that day when it was about 101 F at the upper road, and around 110 F in the canyon. By the time I got off work and drove myself straight to the emergency room (40 miles away), almost straight, had to stop and check on, and feed, my dog and leave a note with my roommate, I was running a 104 F fever. Called my parents, called the district office, because I was in the hospital. Mom was there with sis to bail me out of the hospital, pack me and the dog, and pack us off to grandparents, for the week, where I spent it in bed. Another week before I was allowed to go back to work at all. A third week before I was allowed out in the field. Hospital wanted to keep me, mom pointed out while there should be *insurance, maybe the insurance might not pay, I didn’t have any money. They pumped me full of antibiotics and released me to mom. Strep Throat and Tonsillitis. I’d already had Strep Throat as a child that went into Scarlet and Rheumatic Fever because the antibiotics hadn’t work. When I was sick, I was too sick to realize how sick I was. When I went to our regular doctor for followup after the first week, he wouldn’t release me to go back to work because my white count due the infection was still super high. I begged him to release me to go back to work. His response scared me a tad. The response “You go back to work you’ll be back in the hospital in a week, or two at most. No.” Okay then. I was sick.

                * Dad’s work insurance covered me as long as I was in school. Which I was, but couldn’t prove because no credit classes fall term. Degree I was getting required no school credit 6 months work before issuing degree, 100% true. I was working 6 months, June through December, to fill that requirement (my story, I’m sticking to it). Insurance paid, but there was a lot of proving the requirement was real. By the time I graduated I had 15 months toward the requirement, just a coincidence, I’m sure (not counting the time I had working for the school in the same field, but part time, during the school year).

            2. *derp* forgot at the end of the first paragraph:

              If I had been on my own at the time there is a very real chance that I would have died a few days later. Because it never would have even entered my head to get help that I couldn’t pay for.

              1. Dan threw me in the back of the car, after I collapsed in the hallways, and drove like heck to the hospital, while I bitched I didn’t need it. 🙂

              2. It took a few minutes for us to realize that I really needed an ambulance ride after I ruptured that tendon. The occasional screams might have convinced both of us.

                And, FYI, nobody on the ‘bus crew asked if we could pay. It might still be working through the Medicare gubbage, but the standard is care first, then worry about the administrivia later. (Said ambulance is part of the fire department of a neighboring town, only 25 miles away.)

          2. And Canadians (even those who really should know better) believe it.

          3. There are also various programs that base what you pay off your income and necessary expenses, which might mean you need to discontinue your drinking/smoking/drug/cable tv habit to buy your meds. This frequently is treated by the media as unable to pay copays when it’s more unwilling to pay copays.

          4. My brother is an invalid (self-inflicted, he’s six years younger and looks 15 years older). He blew his share of our inheritance in less than a year. But he goes into the hospital whenever he needs to.

    3. Economies of scale argument may not hold water.

      In certain types of market, buying more units means that you are in a position to negotiate more favorably, if you want to negotiate more favorably. Is this an absolute rule?

      There are three things this model isn’t considering, that can result in different behavior from predicted.

      One, vendors deciding that the pressure is so great, that it makes sense not to do business. My grandfather decided federal contracts weren’t for him, and stuck to doing business on state, local, and private contracts.

      Two, vendors deciding that the pressure is so great, staying in business requires doing troublesome things to arrange very favorable contracts. US defense contracting is an area where questions are raised about procurement officers retiring to work for defense companies. Pick six flag officers, and follow their post active duty careers. Is there really no means by which a government monopoly can effectively require vendors to provide bribes in place of more goods at a lower price? Now, defense research or procurement spending is not a perfect example. Someone chasing airplane research contracts can, in principle, choose to only pursue those from a less abusive service’s research organization. In practice, things may not be so positive.

      Three, how does the government organization select, reward, and motivate bureaucrats? Does this necessarily compare with what vendors can be incentivized to offer? Bureaucracies by nature are bad at looking at specific individuals within an organization, and judging what extraordinary incentives would change behavior, or prevent a change in behavior. They do not necessarily out-compete individuals representing vendors, when those individuals have incentive to find the specific bureaucrats who can be convinced to change behavior by extraordinary incentives.

      1. “Economy of scale” isn’t a thing that just happens when demand for some thing gets large. Economies of scale happen for reasons that can be well understood. It seems to me that economies of scale happen most often because of expertise that can be encapsulated.

        What I mean by “encapsulating expertise” can be illustrated by a story. Suppose you’re a craftsman that makes some thing that people value, and therefore buy. Your expertise allows you to make the thing, and other people value it so it has value. Now, suppose you create a mechanism that allows a machine or even other, less skilled, people to make a similar thing that people will still value enough to purchase. The machine or process encapsulates your expertise so that you can make make more of that item without having more people with the expertise.

        This works if and only if there is enough demand for those items that you can sell enough of them at a price people are willing to pay to pay what it cost to invent the machine or the process, and if that cost can be spread out over a much larger market, it will be much lower. For most manufactured goods, that’s what happens. The fact that some people will buy a thing at a high price generally implies that many more people will buy almost the same thing at a much lower price. That’s an economy of scale.

        Other times, an economy of scale happens because of network effects. It can be cheaper for a vendor to stay in business if they locate near other similar businesses because then it’s easier to reach new customers, as an example. Shipping companies accumulating near where the roads are good and better roads being built near where all the shipping companies accumulate would be another. I’m sure you can think of others.

        Anything that involves diagnosing a problem (health care, small electronics repair, gardening, etc.) is going to be unable to achieve much, if any, encapsulation of that expertise at least with the current state of our technology. That means they are largely going to not apply to those professions. Sometimes, like with small electronics repair, that means that the manufacture of repairable items is disincentivized. With health care in the US, it has meant the rise of the “doc in a box”, where I understand that the “doc” is usually a Physician’s Assistant operating under the “supervision” of some MD that you won’t actually ever see. The PA’s job can be viewed mostly as being able to tell the difference between most patients and those that genuinely need to see an actual doctor.

        1. There’s also the notion that economies of scale have no upper limit. There’s an optimal span of control and once you get past it the organization becomes bloated. of course in the case of the NHS you have a variation on Parkinson’s law in that the number of administrators continues to grow faster than the growth in healthcare capacity.

          Were economy of scale so decisive, the USSR would still be around since that’s all they had.

          1. There are also diseconomies of scale. Their interaction with economies of scale is how you get optimum sizes rather than bigger-is-better-without-limit.

            But most people haven’t heard about diseconomies of scale, and the concept isn’t intuitive the way the concept of economies of scale is. Also, economies of scale has been terribly useful for arguing the superiority of the USSR and socialism in general, because the smaller multiple producers in a capitalist system are “inefficient.”

            1. We have a massive example of diseconomy of scale which confronts us every day — the government. The bigger it gets, the more money it wastes and the less work it gets done.

              And the Leftroids keep wanting to make it bigger.

            2. “There are also diseconomies of scale.” Very true. Such diseconomies often show up when somebody tries to create ‘synergy’ by combining two activities that *sound* alike, but are actually different in important ways.

              A classic example is when Company A acquires Company B and decides: “Hey, we already have a great sales force. We can combine the Company B force into it, and save some money on redundant geographical and account coverage.” But it turns out that the Company B sales process, and maybe even the kind of people needed, are different.

              Same phenomenon with the consolidation of engineering groups.

              As a business friend used to say, ‘Synergy costs money.’

    4. Governments tend not to want to (get caught) increasing taxes by too much.

      Fixed that for you.

      Of course, as we are seeing, they’ve no problem being perceived as raising taxes too much on those not “paying their fair share.” Can’t raise taxes fast enough nor high enough on those unpatriotic tax shirkers.

      Never you mind that every tax increase on them is directly charged back to the general public in one way or another.

    5. The British Socialist Party did a meme where they showed a glittering piece of machinery and labeled “Socialism, where health care waits for you,” and a line outside a building labeled “Capitalism, where you wait for health care.”

      Problem: the first one was a private American hospital, and the second one was the NHS.

      1. “Capitalism, where you wait for health care.”

        And it is worth waiting for, too. Because in free market society you don’t have to go to the assigned medical facility. And if you don’t like the care you receive can transfer elsewhere.

        I bet they don’t have any memes comparing the typical waiting periods for a variety of standard services ad specialists.

  9. Here in east Tennessee (outside of places like Knoxville), government is generally viewed as a necessary irritant, tolerated so long as it doesn’t start interfering with life more than the absolute minimum necessary. Once it passes that minimum level, the “redneck” starts to kick in. As I say, the three basic philosophical/political tenets are:

    1) I’m not hurting anybody.
    2) It’s none of your business what I do.
    3) Leave me alone!

  10. *raises paw* Mild disagreement on a detail. If you look at some of the individual Imperial Free Cities in the Hanseatic League, between 1000-1400 or so, you see a LOT more self-government and a limited meritocracy. Society was run by the businessmen and the guilds, along with the Church (confraternities of saints that acted as mutual-aid but also public charities). Yes, you had a strong class structure, based on employment and municipal citizenship, and it fossilized after around 1400 or so, but the idea that it was the city vs. the nobles (including princes of the Church) with the possibility of a neutral outside mediator (the Emperor or various imperial councils that heard claims and sought solutions) remained strong. Not perfect, and the sense that “someone will take care of me/my guild will support my widow and kids” didn’t completely encourage US-style independence of thought, but for a while there were some exceptions. By the end of the Thirty-Years War and the wars that followed (sooo, by 1700) the exceptions had mostly been quashed, either by local rulers, or the Fickle Finger of Fate. The 1800s finished the job.

  11. Alas Prof O’Dragon’s talking about the America that was, freedom wise;
    “Temperature check?”
    “Social distance?”
    “Are you now, or have you ever been, within 3 statute miles of anyone with the Bad China Cold?”
    “OK, now can I buy a loaf of bread?”
    “No, wait 48 hours for the result of your nose or anus swabbing to come back and then we’ll see.”

  12. rant was about how the insurance company reneged on paying after they received a settlement

    Haven’t read all the post, nor the comments, yet, so forgive me if this has already been mentioned.

    Depending on the reason for the settlement, their medical insurance isn’t required to pay. If the settlement was received directly to relation for the reason of the child’s death, then the hospital is to be paid out of those funds. One of the reasons when filling out medical forms one of the questions asked is “Is this due to an accident or work injury?”, or words to that effect. Translation, which type of insurance is paying for this; “settlement” for the cause would be considered a direct insurance payment to be used to pay the medical expenses. Which is why never accept a flat settlement when medical is coming into play. Should be settlement + legal + any and all medical, depending. Harder to do with class action. Although when I’ve read these situations generally the insurance paid the medical providers, then they went after the settlement for repayment. The insurance never comes out as the good guy, either.

    1. If it’s the case I’m thinking of, it was a car vs. pedestrian accident that hit the husband and kid in a crosswalk. Kid died, husband injured, driver sued. Further deponent knoweth not.

      1. Not saying this is morally right but … in the case you cite then the family medical insurance would expect the driver’s insurance to cover. The driver’s insurance would expect the medical to be paid out of any settlement reached. Especially since in all indications the settlement doesn’t appear to have covered all the medical expenses. Or that is the impression the brief description the blog account news reference hints (again with the sensationalism).

        My 12 year old cousin was killed by a hit an run driver on a rural road, in front of the farm (they hadn’t reached the driveway), in front of her older brother (19) and two friends (two friends were also clipped). (See Oregon *Katie’s Law.) The settlement Aunt and Uncle received was $X And all expenses related to her death (she was killed on impact), including legal fees, from the liability insurance of the company the driver was working for. I know why they were able to deal with this in their grief … they didn’t. Another Aunt and Uncle, much older, very business savvy, and rich, tasked their lawyers with dealing with this.

        * Google Foo failing or I’d link it (buried under all of Kate Brown, spit, links). Katie’s Law is a law that in the case of vehicular hit and run, someone is majorly injured or killed, the driver is to be prosecuted as driving DUI.

  13. Professor Ornery Dragon?

    Not the Professor Ornery Dragon? That would be Ornery the 8th, would it?

        1. “I should demand you slay the beast,
          But he stirs in me such ardor!”

      1. Thinking of this:

        She wouldn’t have a wyvern or a smaug
        I’m her 8th dragon named Ornery,
        Ornery the 8th I am:

          1. Ah, my day is complete. 🙂

            Random thought: If a Dragon was an anti-tank missile, what would an anti-dragon missile be called?

  14. Just a thought – I was forced on Medicare (by the State and the insurance company) because no one else would handle my kidney care. The prices for kidney care (dialysis) is astronomical. My freedom in this situation is I can have freedom to die or I can have freedom to choose Medicare. Sometimes the choices are Hobson’s choice. I would hate to be in the UK right now. I talk to others there with my autoimmune disease with other problems (kidney, lungs, etc). They deal with the stress of finding out someday that they are not worthy of treatment due to inability to work or age. It is not a good place to be. At least here Medicare will pay for my treatment. I have more choices here… although my choices have gotten smaller the longer I’ve been in the medical system.

  15. Without freedom, there is no growth. All our individual journeys are arrested. If you can’t choose a bad path, then the path you’re on is meaningless. If you force people to do something, they learn nothing; they are not enlightened; their potential is never realized. You might do that to a child, to teach them and prepare them for adulthood, but they never reach maturation if you don’t set them loose to see the effects of their decisions, and learn from them what they want out of their lives.

    I never fail to be shocked at how the people who say they are so committed to consent can fail to understand that consent applies to all parts of life.

    1. I never fail to be shocked at how the people who say they are so committed to consent can fail to understand that consent applies to all parts of life.

      How odd! I never fail to be shocked when such people demonstrate intellectual consistency in support of a principle when it might inconvenience them.

      1. What can I say, I like people and tend to expect the best of them, even when it is imprudent. -_-

  16. “No health care. No job protection. No state support. Americans are free to starve, free to lose their homes, free to die in debt and penury.”

    Ah yes, that one. I hear this one a lot in Canada. “Free healthcare!” they bray. “And worth every penny you paid!” say I, and get dirty looks every time.

    Because everybody knows that if there’s anything interesting wrong with you, you better get on a plane to Rochester Minnesota and let the Mayo Clinic have a go at you.

    I have worked in the Canadian healthcare system in Ontario (the Crown Jewel of Cdn healthcare by the way), and in the American healthcare system, in three states. New York, Arizona and Minnesota.

    I can tell you right now that the Canadian hospitals in and around Toronto, the Gooooooolden Horseshoe, comapare roughly with the shitty county hospitals in New York and Arizona, and the VA. They’re about the same.

    The -nice- hospitals in NY, AZ and MN are amazingly better than Ontario. So much better. We really don’t have anything like that here at all. Seriously, we don’t.

    Also, it isn’t free. It is very far from free. Quite apart from the fiscal nightmare that awaits you if you get really sick, the TAXES Canadians pay for their “free” healthcare are breathtaking. Like, you read your paycheck and it sucks the air out of your lungs. Newfoundland is literally going bankrupt this year because of medicare costs wildly outstripping taxes. Like by billions in a population of 520,000 people. Okay? It’s not f-ing well free, boys and girls.

    My personal history is that after beating my head against the wall in Canada to get a Physical Therapy degree (or any decent job of any kind for that matter) I gave the hell up and MOVED TO AMERICA. Where I got my PT degree, and a job, and IT WAS EASY! I wish I could make the font size bigger, to emphasize how appallingly EASY!!!!!!! it was compared to Canada. Seriously, I felt very angry looking back on all the horseshit and jumping through the flaming hoop I did back in Canada.

    You see, Americans, in America if you have some money, only a little mind you, maybe $50k, you can BUY an education. A good one! You’ll know what’s up in your field. In Canada, it does not matter how much money you have. You will be stopped by gatekeepers at every step of the way.

    Because it’s socialism. THEY decide if you’re going to be clever enough to go to their school, not you. If they’re only taking girls this year, you boys don’t get a chance. If they’re only taking black girls this year, white girls don’t get a chance. In fact the University of Toronto was successfully sued back in the 1990s because they wouldn’t take men in the PT program no matter what their marks were. And it didn’t make a lick of difference, they still don’t take men.

    So all the socialists and Europeans whinging about America being Healthcare Hell can pretty well suck it. It’s a -lie-. You can tell them I said so.

    1. “If you think health care is expensive now, wait until you see what it costs when it’s free.” ― P.J. O’Rourke

      1. No one really knows how much. It’s a black box. They’re willing to admit to about a third.

        But the underlying problem is they spend about double to what they take in, except for 2020 and 2021 which is so far about 10X what they take in. I’m probably on the low side at 10X. Trudeau has amassed more debt in the last year than all previous prime ministers taken together. That’s more debt than ALL previous governments taken together. Every single man, woman and child in Canada owes about $200 grand in unsecured government debt, if you take all the layers of government together.

        Inflation, anyone?

  17. America, May 2021.
    Got my monthly investment report today.
    Currently earning 18%
    Will require 6 more years at that rate to achieve an annual income from investments only that will equal what I currently earn.
    Will require the U.S. government to: (A) not seize those investments, (B) not screw up the economy so I lose my current job, (C) not enact European-style taxation, (D) not dump us into a runaway inflationary period (see B).

  18. I have to laugh at Americans who always go on about freedom. He then went on about how Americans pay about the same in taxes but get nothing for it.

    Get nothing for it.

    I started to pull the stats for the USN v RN for headcount and equipment, USAF vs RAF, and so on, but day job calls so I’ll just note that the reason said friend is not speaking Russian at work even though his little country abdicated a real navy and air force back in the day is because the US viewed, and still views, his little historical backwater island as Airstrip One, so we all just absorbed the cost of defending his little socialist nightmare along with that of the Franco-German Imperial “European Union” as preservation of necessary forward bases.

    Should the “All y’all are on your own” sentiment, a significant fraction in US politics, ever gain power, or if the fever dreams of a second US civil war actually manifest fully, said friend might learn what they failed to “get” in return for their taxes and BBC licenses when they chose to buy the NHS instead.

    1. Lessee … after Hurricane Katrina there were the carrier USS Harry S. Truman, amphibious assault ships USS Bataan & USS Iwo Jima, amphibious transport dock USS Shreveport, dock landing ships USS Tortuga & USS Whidbey Island, hospital ship USNS Comfort and a number of other ships, aircraft, and aid troops. After the tsunami that swamped Indonesia we sent a carrier task force but I guess we, as Americans, got squat for that and all the other international aid we provide.

      Although if ever a hurricane or similar storm hits Britain I don’t advise holding your breath awaiting arrival of succor from Russia, China, Iran or the EU.

      But you know what – you’re right, we don’t get nothin’ so don’t move here. We’ve got enough like you already.

      1. A carrier group full of guys heading back to Japan from Iraq, which was on the longest deployment on record. After doing the emergency help, we then split up and did shore leave to get money into the area; I was designated walker for some of my geek buddies, and we all went drinking in the last standing Irish pub in the port we hit.

        (We didn’t get recognized for the deployment because the records are set by which fleet you’re in, and we swapped fleets during the deployment. MUCH saltiness.)

  19. Oh, jeez yes, that whole “freedumb” thing. You’ll get these entire whinging diatribes about how Americans SAY they’re all about freedom, but never seem to care about if this freedom is just the ability to go hungry, be homeless, to not see a doctor or die in a ditch–if it’s “freedumb”. Whereas sophisticates like the writer value REAL freedom, which is concerned with how much MORE people can do if they’re not oppressed by the possibility of starving or anything else.

    It’s such a fantastic load of hooey–a self-important screed to redefine basic terms to their exact opposite, and the explicit statement that anyone who holds the actual original definition is the rankest idiot. I–well, I’ll let Hayek say it, though I apologize that the quote is long (and I suspect I’ve quoted it at this blog before):

    The most effective way of making people accept the validity of the values they are to serve is to persuaed them that they are really the same as those which they, or at least the best among them, have always held, but which were not properly understood or recognized before. The people are made to transfer their allegiance from the old gods to the new under the pretense that the new gods really are what their sound instinct had always told them but what before they had only dimly seen. And the most efficient technique to this end is to use the old words but change their meaning. Few traits of totalitarian regimes are at the same time so confusing to the superficial observer and yet so characteristic of teh whole intellectual climate as the complete perversion of language, the change of meaning of the words by which the ideals of the new regimese are expressed.

    The worst sufferer in this respect is, of course, the word ‘liberty.’ It is a word used as freely in totalitarian states as elsewhere. Indeed, it could almost be said–and it should serve as a warning to us to be on our guard against all the tempters who promise us New Liberties for Old[5]–that wherever liberty as we understand it has been destroyed, this has almost always been done in the name of some new freedom promised to the people. Even among us we have “planners for freedom” who promise us a “Collective freedom for the group,” the nature of which may be gathered from the fact that its advocate finds it necessary to assure us that “naturally the advent of planned freedom does not mean that all [sic] earlier forms of freedom must be abolished.” Dr. Karl Mannheim, from whose work[6] these sentences are taken, at least warns us that “a conception of freedom modelled on the preceding age is an obstacle to any real understanding of the problem.” But his use of the word “freedom” is as misleading as it is in the mouth of the totalitarian politicians. Like their freedom, the “collective freedom” he offers us is not the freedom of the members of society but the unlimited freedom of the planner to do with society what he pleases.[7] It is the confusion of freedom with power carried to the extreme.

    A very wordy fellow, but very on point. I frequently recommend that everyone read the book (The Road to Serfdom). And in fact, though not quite as relevant, there’s a passage about a page later I like to quote that I feel wouldn’t be unappreciated here, either…

    If one has not one’s self experienced this process, it is difficult to appreciate the magnitude of this change of the meaning of words, the confusion which it causes, and the barriers to any rational discussion which it creates. It has to be seen to be understood how, if one of two brothers embraces the new faith, after a short while he appears to speak a different language which makes any real communication between them impossible. And the confusion becomes worse because this change of meaning of the words describing political ideals is not a single event but a continuous process, a technique employed consciously or unconsciously to direct the people. Gradually, as this process continues, the whole language becomes despoiled, and words become empty shells deprived of any definite meaning, as capable of denoting one thing as its opposite and used solely for the emotional associations which still adhere to them.

    1. The most effective way of making people accept the validity of the values they are to serve is to persuaed them that they are really the same as those which they, or at least the best among them, have always held, but which were not properly understood or recognized before.

      See, “if you like children you won’t have any because everyone will die if you do”.

      See, “if you love your children you will beat the shit out of them for the smallest infraction”.

      See, “if you care about animals you will make sure any animal that has contact with humans dies”.

      1. I will just note that Americans had to borrow the word “whinging” from our English cousins. We invented words like “bunkum” and “moonshine” but whinging we had to import.

    2. a self-important screed to redefine basic terms to their exact opposite

      “You think freedom is doing what you want? You’re wrong. True freedom is doing what I tell you.” The Ape from “The Last Battle” by C. S. Lewis.

      Just to be clear, the ape was the bad guy (at least until the Tash worshippers from the nation to the south of Narnia showed up and we saw just how petty the ape actually was).

      1. I have such a feeling that many are now worshipping Tashlan, and will be astonished when Tash shows up for real.

        Remembering Emmanual Cleaver praying to Brahma, amen and awomen.

      2. Freedom from “self” is the only actual freedom I have ever experienced.

        I am crucified with Christ: nevertheless I live; yet not I, but Christ liveth in me: and the life which I now live in the flesh I live by the faith of the Son of God, who loved me, and gave himself for me.

        But there is also “freedom” in just doing what you’re told; what is expected of you — freedom from the need of self. Downside — big brother becomes the mega-self of the masses.

  20. Freedom has to include the freedom to fail, because otherwise it’s meaningless.

    The (Christian) answer to “Why do bad things happen?” and “Why does Hell exist?” is that God loves us enough to give us the free will to choose our own damnation.

  21. “If ye love wealth better than liberty,
    the tranquility of servitude
    better than the animating contest of freedom,
    go home from us in peace.
    We ask not your counsels or your arms.
    Crouch down and lick the hands which feed you.
    May your chains set lightly upon you,
    and may posterity forget that you were our countrymen.”

    -Sam Adams (yes, the guy the beer was named after)

    After putting that up I point out that peasants don’t really understand freedom, which is why free men don’t particularly care about their opinions.

  22. From the Department of Governmental Lies, Damned Lies & Statistics (credit due to the soon to be former New York Times reporter whose work forms the basis of this):

    CDC Misleads: Calls .01 Percent Chance of Infection, ‘Less Than 10 Percent’
    The CDC has published a technically true — but profoundly misleading — statistic about the chance of outdoor infection. The story is brought to us by New York Times journalist David Leonhardt in his daily, “The Morning Newsletter”:

    When the Centers for Disease Control and Prevention released new guidelines last month for mask wearing, it announced that “less than 10 percent” of Covid-19 transmission was occurring outdoors. Media organizations repeated the statistic, and it quickly became a standard description of the frequency of outdoor transmission.

    So, what’s the actual number?

    The number is almost certainly misleading. It appears to be based partly on a misclassification of some Covid transmission that actually took place in enclosed spaces (as I explain below). An even bigger issue is the extreme caution of C.D.C. officials, who picked a benchmark — 10 percent — so high that nobody could reasonably dispute it.

    That benchmark “seems to be a huge exaggeration,” as Dr. Muge Cevik, a virologist at the University of St. Andrews, said. In truth, the share of transmission that has occurred outdoors seems to be below 1 percent and may be below 0.1 percent, multiple epidemiologists told me.

    That is not merely an exaggeration. It’s what is known as a whopper.

    Leonhardt makes an apt point:

    Saying that less than 10 percent of Covid transmission occurs outdoors is akin to saying that sharks attack fewer than 20,000 swimmers a year. (The actual worldwide number is around 150.) It’s both true and deceiving.

    “Follow the science” requires that the people can safely trust that “the scientists” will communicate facts accurately. The CDC has failed in this basic task abysmally.

    Thanks to David Leonhardt for setting the record straight. The CDC should revise its communication accordingly.

  23. But without Government Safety Theatre they’d have to actually produce meaningful results! They’ve got t protect their phony-baloney jobs!

    Shock Study: Voluntary Gun Buybacks Are Pointless
    From a new working paper put out through the National Bureau of Economic Research:

    Gun buyback programs (GBPs), which use public funds to purchase civilians’ privately-owned firearms, aim to reduce gun violence. However, little is known about their effects on firearm-related crime or deaths. Using data from the National Incident Based Reporting System, we find no evidence that GBPs reduce gun crime. Given our estimated null findings, with 95 percent confidence, we can rule out decreases in firearm-related crime of greater than 1.3 percent during the year following a buyback. Using data from the National Vital Statistics System, we also find no evidence that GBPs reduce suicides or homicides where a firearm was involved.

    Of course, this won’t surprise anyone who’s paid attention to these programs. They collect very few guns — typically 1,000 or fewer — and by definition they collect only unwanted guns, which tend to be old or even broken. The U.S. has about as many guns as it has people, so destroying 1,000 unwanted guns isn’t going to make any meaningful difference, even in a pretty small city.

    1. They got one thing wrong — the U.S. has between two and three times as many guns as people. We have more guns than CARS for Pete’s sake! There have been more than 600 million documented gun sales since they started keeping track in 1968. Americans are on track to buy more than 60 million guns this year alone. Hey, we can’t count on those defunded police any more.

  24. Sore subject.
    Let me start with the story as described. First if all, there are many people who think that nothing bad should ever happen, and if someone, especially a child, dies, it’s the medical system’s fault. Now, part of the story is that there is a settlement involved, so the grieving parents had contacted a lawyer to sue. The settlement is in legal terms, to “make you whole” so the PICU (expensive real estate in the hospital) should be paid from there. If they had to put a lien on the house, I’m going to assume the parents weren’t paying, even minimally because the system will take payment plans, or any attempt to pay. Nothing is going to make whole a family that lost a child and I’m not minimizing grief, but they had enough time to get a lawyer for a settlement…
    I’m not trying to say the system is perfect, or even good, but it’s better than the detractors say. I’ve had patients show up in the country with no resources at all, or immigration status, enter the ER, and receive EXACTLY the same care my child would have gotten. Don’t give me people refused care here.

  25. Stockholm syndrome.

    When held in the power of brutal monsters, some people decide that the only path to survival is to convince the monsters to hurt them last. So they do various things to suck up to their captors, trying to humanize themselves in the eyes of their captors. At times, they end up convincing themselves that their captors are correct.

    The thing is, this is pointless where there is no path where the captor can see you as human, no path where the captor does not torture, kill, dismember, and eat you. Yet people make the mistake of trying anyway.

    There’s a numerical exercise that one can use to evaluate any national scale bureaucracy. Take the number of people administered/overseen by the agency, and divide by the number of bureaucrats in the agency. For a public health agency, the first number is everyone in the country. For a hypothetical agency, one can vary the number of bureaucrats, looking at the trade off between too many people administered for a bureaucrat to see as human, and too many bureaucrats for a distressed citizen to get problems addressed by holding officials accountable. It is not hard to see that for a large country, bureaucracies administering the whole population are either unable to see those administered as human, or impossibly intractable. The US military services are pretty dysfunctional, with their people administered (active servicemen) numbering only in the millions.

    Anyway, anyone who overlooks this issue, and insists that Federal health bureaucrats would care, is obviously mentally retarded. Which means that they are unable to live a fulfilling life, cost too much, and need to be euthanized. 🙂 (Note: I very much do not believe that the genuinely retarded should be euthanized.)

    Another long argument can demonstrate the soft proof that government health bureaucracies inevitably get into meddling with euthanasia and similar forms of health cost savings.

    Anyway, these NHS apologists have been abused by monsters, and are damaged. Sometimes killing the hostages is the correct path towards preventing the hostage takers from escaping.

  26. There can be no ‘rights’ which must be provided by other people. Such is the nature of every one of the ‘rights’ demanded by Leftroids. ‘Rights’ to ‘free’ health care, education, housing, food, job security (or to be paid for not having a job). A ‘right’ to prevent you from saying anything they decide ‘offends’ them.

    Of course, pointing out the nature of their ‘rights’ is highly offensive to them.

    They can’t exercise their ‘rights’ on their own. You will be compelled to provide them, at gunpoint. At least a mugger doesn’t pretend to not be robbing you.

    As for the glories of socialized medicine — last year the Italian government decided their health care system was overloaded by the ‘pandemic’ so nobody over 70 was allowed to receive their ‘free’ health care. Sure, you paid into the system for 50 years but right now you’re an inconvenience to the government, so just go away and die. There was zero righteous outrage from the left-wing media.
    Nobody has so little that some asshole doesn’t want to take it. And the government is full of assholes.

    1. The correct formulation of a “right” is not that it is something to be demanded, but a line which others are not to cross on pain of, well, pain, and possibly death.

  27. There is a word for that British friend’s ideology; it’s called Ingsoc, and Freedom is Slavery is one of its core tenets.

  28. I never fail to be shocked at how the people who say they are so committed to consent can fail to understand that consent applies to all parts of life.

    I think part of it is that they don’t see consent as (*is waving hands in real life, like someone trying to grab smoke*) as part of a weave of principles and conflicting interests and protections to inherent things, it’s just a specific individual thing.

    Sort of like the contrast between those who go “I want to rule the world!” and those who go “oh, good heavens, I DO NOT want to rule the world, I’d have to DO A GOOD JOB OF IT! Cleaning alone would take forever!”

    I don’t know if they just never thought about the “but why is this important?” (well, outside of high stress situations, which do not promote solid conclusions) or if they’ve been trained to actively avoid it, or if the tendency to try to figure out how stuff fits is just not universal.

    1. a) The thinking that comes naturally to you is definitely not universal to humanity. Humans have a /lot/ of variation.
      b) Consent, for them, is an aspect of dogma, and a flag they fly for fear of being ostracized for not flying it. They make a public show of ‘supporting’ precisely the issues the inner party currently says to support, and no others. Any sort of independent analytical process is /counterproductive/, and works against the comfort in their social circles that motivates them.

  29. *sigh*

    You hear stories sometimes. Where a “leader of the community” is found out to be a monster, say a pastor that is proven to have been raping little kids. Inevitably in such stories there is the contingent of people who attack the kids because “how dare they make such an accusation of a Man of God!”.

    With those stories even if you recognize that humans would totally do that, there is still a certain element of disbelief.

    And then I read discussion threads about the NRA’s death, filled with NRA simps.

    1. a) NRA had a few good programs.
      b) Far too much in bed with the gun controllers.
      c) Leadership was much too stupid to hold a position of trust and responsibility.
      c) ii. Very much too idiotic. Colossally moronic. Dan. Boren. They hired a law firm that employed Dan Boren.
      d) Has to be understood in the context of the will to power of the PRC satraps.
      e) I understand that NY is releasing the criminals that they have with firearms violations. NY Gun Control efforts are thus merely and obviously an effort to disarm those who are not chronic felons, so that the felons have free reign.
      f) Technically, it is still possible that the judge in question is acting innocently and fairly. From my limited information.
      g) James is clearly a conspirator in the corrupt organization that seeks the murder of law abiding New Yorkers. She is a legitimate target for vigilante justice.

      1. It’s like antifa breaking into the capitol: they are doing it for every possible wrong reason, but the right thing nonetheless.

    2. Well, there is the little thing like — there was a case that went to court of a man saying that a priest had molested him on an overnight trip to NYC.

      It was a day trip, and it was before the priest had been at the parish.

      Indeed, I’ve heard of a support group consisting of the now-grown children at the center of a big child molestation trial, and they were trying to come to grips with how they had told such ghastly lies.

      1. There’s a lot of stuff like that in the much-decried groups who actually look if the accusations are possible, much less true.

        There have been some very lurid ones that were supposedly happening after a priest had died….

  30. I find myself reminded of a clip I saw from The Mandalorian. (Don’t have access to Disney+ and with their crap lately I’ve no intent on trying. Which is a pity since what I’ve seen of The Mandalorian is pretty good.) I think the attitude of the average prog can be boiled down to the Imp officer’s gloating remarks. Why no, I’m a (mostly) peaceful person and would never advocate what happens near the end. Poor Shoretrooper was just having lunch…

    1. I’m not even going to ask why that officer had a Southern twang and not the sinister British accent that all proper Imperials have.

      1. As I understand it, the US “southern accent” is pretty much straight out of upper-crust London circa 1770 or so – Southerners didn’t invent it, they kept it intact when the home country accent shifted radically after the Napoleonic Wars.

        So that Galactic Impie Officer was just an old-school Imperial.

    1. For you young’ns:

      James G. Watt was Reagan’s first interior secretary, notorious in the MSM for his pro-development views

      The (then) head of the PLO was named Yassir Arafat

      The “Y” refers to the YMCA, a once popular venue for swimming, basketball and other idoor sports.

  31. Heh.

    MIT Researchers Shocked to Find Anti-Mask Proponents Seek Data, Do Their Own Homework, and See Science As a Process

    0 “For these anti-mask users, their approach to the pandemic is grounded in more scientific rigor, not less.”

    0 “In fact, the explicit motivation for many of these followers is to find information so that they can make the best decisions for their families—and by extension, for the communities around them.”

    0 “While these groups highly value scientific expertise, they also see collective analysis of data as a way to bring communities together within a time of crisis, and being able to transparently and dispassionately analyze the data is crucial for democratic governance.”

    0 “In other words, anti-maskers value unmediated access to information and privilege personal research and direct reading over ‘expert’ interpretations.”

    0 “Arguing anti-maskers need more scientific literacy is to characterize their approach as uninformed & inexplicably extreme. This study shows the opposite: they are deeply invested in forms of critique & knowledge production they recognize as markers of scientific expertise.”


    “As a subculture, anti-masking amplifies anti-establishment currents pervasive in U.S. political culture. Data literacy, for antimaskers, exemplifies distinctly American ideals of intellectual self-reliance, which historically takes the form of rejecting experts and other elites. The counter-visualizations that they produce and circulate not only challenge scientific consensus, but they also assert the value of independence in a society that they believe promotes an overall de-skilling and dumbing-down of the population for the sake of more effective social control. As they see it, to counter-visualize is to engage in an act of resistance against the stifling influence of central government, big business, and liberal academia. …”


    As the researchers noted, “Most fundamentally, the groups we studied believe that science is a process, and not an institution.” The problem with that statement is they think it is something the anti-mask network believes. Science is a process. The fact that these young academics do not think so demonstrates the corruption and failure of the education system. If these are the future “experts” at MIT, the idea that they find skepticism troubling is terrifying for the future of science and the nation.

      1. I am shocked, shocked, to learn that Brahamandarins agree that the peasants of the world should unite in doing what their betters instruct them to do.

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