The Dream Café

Steven Brust: “A masterful storyteller of contagious glee and self-deprecating badassery” —Skyler White

Though this be method, yet there is madness in't

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It fascinates me, in reading over the discussion of “a fundamental human right,” how often various people make arguments of the form, “If there is a fundamental right to freedom from pain, that means that any doctor has to stop whatever he’s doing and treat this person’s pain, right now.” Or, “That means every individual has the right to treatment from the best specialist there is, no matter where he is or what he’s doing.”

I’m having a lot of trouble wrapping my head around this way of thinking. One of the rights few would deny is the right to life, yet no one claims this means Joe Supercop of Sydney, Australia, has to fly to Hamtramck, Mi, because Vicki Victim is having a knife pointed at her. Hell, next time you’re in the hosptial, look at the “patient’s bill of rights” they have posted. You might read something like this: “If you have severe pain, an injury, or sudden illness that makes you believe that your health is in serious danger, you have the right to be screened and stabilized using emergency services. These services should be provided whenever and wherever you need them, without the need to wait for authorization and without any financial penalty.” Does this mean that the hospital is obliged to fly in Dr. Flash Gordon from San Fransisco because he is especially skilled in ER work?

I’m not, here, concerned so much with the particulars of medical rights as I am with the bizarre method these people are using: to claim that one has a right to certain services is to claim one can demand those services from some particular individual?

The scary possibility is that these people, following the logic of their argument, believe no one has any right to anything ever. The more likely possibility is that they don’t agree that pain relief is or ought to be a fundamental right, and have run out of arguments supporting their position. I really hope it’s the latter.

corwin

Author: corwin

Site administrative account, so probably Corwin, Felix or DD-B.

0 Comments

  1. What if there’s only one individual capable of providing that service?

    What if there are 50, and none of them wants to? Do you force one to do it anyway? Which one?

    skzb wrote: “Should freedom from pain be a right? I believe it should be, to exactly the extent that medicine is able to make it so. ” That implies that, if necessary, the best anti-pain practitioner in the world must provide his services, if those of the second-best don’t suffice.

    In general, I don’t believe in *rights* that force other people to do things. I believe in rights that require other people to leave me alone; things like Freedom of Speech (you don’t have to help me speak, you don’t have to listen, but you can’t stop me from speaking), or the right to travel (You don’t have to give me a ride or buy me an airplane ticket, but you can’t imprison me).

  2. That isn’t even difficult. Under those conditions, one does not have the right, even if one SHOULD have the right. During the depression, people didn’t have the right to wear shoes, because it wasn’t profitable to make them, so even many who could afford shoes didn’t have them. They should have had the right to shoes, but they didn’t.

    If a given society cannot, for economic, cultural, political, social, or technological reasons provide everyone with something, then everyone does not have that right to it, even if everyone should.

    For heaven’s sake, if humanity didn’t make the distinction between “things are like this” and “things should be like this,” we’d never have come out of the trees. Hell, wouldn’t be human, would we?

  3. So who bells the cat? Should people be forced to provide goods and services when required? The shoe analogy is incomplete. If people could afford them, then it would be profitable to make them. If it was profitable to make them, someone would. Maybe not on a large scale, but it would be done. Shoot, if you really wanted shoes, you could learn to fashion them yourself. I guess I am missing the point, you say they lacked the right to have shoes, and I say that is incorrect. They lacked easy access to shoes. Is it someones job to ensure that people have easy access to all wants, needs, and desires? Cause right now I really want some showarma from Sharief’s in Belgium. Are you going to fly him over to make me some?

  4. “If people could afford them, then it would be profitable to make them. ” Check out some history of the Depression. That isn’t how it worked. I know this is unpleasant news for those who worship the Almighty Market.

    As for the rest, yes, I would say that “missing the point” describes it fairly well. If we, as a society, reach the point where we feel something is a right, then we, as a society, do or should arrange for it to exist. Clean water. Education. People to come and put out fires in our homes. Seems to me that, generally, we find people to fill those needs as they come up; sometimes easily, sometimes less so. And when it begins to fail, as for example when the public education system begins to decay and the right of all children to a decent education is threatened, then complaints arise socially, and with good reason. The ability to deal with such problems as they come up is one important measure of the health of a society.

    When you get major sections of the intelligencia saying, “Well, if there’s such a problem supplying these things, then there shouldn’t be any right to them,” that’s a pretty good indication of that society’s fundamental sickness.

  5. I get the sense that there’s a problem with fundamental premises here.

    It seems to me (corrections welcome, of course) that Steve is arguing from the position that many of us collective comprise this thing called “society.” One of the defining characteristics of said “society” is that its members share some common interests. It is therefore in the collective interest of (many of) said society’s members to see those interests fulfilled. Ergo, we have the notion that education, for example, is a public good, and that society as a collective should make some amount of education available to its individual members.

    On the other hand, Seth and Jeff’s arguments suggest (again, corrections welcome) that they’re arguing from the standpoint of a kind of radical, forty-acres-and-a-mule individualism. Society, per se, doesn’t really exist. The world instead consists of self-sustaining individuals possessed of individual desires. They may occasionally make ad hoc arrangements among themselves to meet their individual needs, but they spending most of their time plowing their own plot of land.

    If that’s the case, misunderstanding seems inevitable. If that’s not the case, well, let the flaming begin.

  6. Ah. Then the discussion is not so much rights themselves, as what our society should provide. I still say, who bells the cat? You stated:
    ““If you have severe pain, an injury, or sudden illness that makes you believe that your health is in serious danger, you have the right to be screened and stabilized using emergency services. These services should be provided whenever and wherever you need them, without the need to wait for authorization and without any financial penalty.” Who pays for it? The guberment? At some point, someone is sacrificing their time/work/money for you. How does one decide the measure of worth? In my humble opinion, the original Bill of Rights said “You can do these things if you wish. We won’t stop you, but we won’t necessarily help you either” That is as far as I go in my view of rights: what I choose to pursue and achieve without interfering with others. I still want that showarma, I can’t get it in the US. I don’t rationally expect society to get it for me, nor should I. But I can learn to make it myself, and no one is stopping me from making it for others.

    Now this is a more easily agreeable statement.

    “The ability to deal with such problems as they come up is one important measure of the health of a society.”

    I agree completely. And our society is sick to the core. Again, who bells the cat? Who is going to fix it? You could argue that as the majority of the society has allowed it to happen, then that is what it wants. So, just because we see a better way, is it within our rights to try to “improve” the lives of others even if they don’t see the same vision?

  7. scott @ 5

    To a point, you are correct. At the moment, I am an automotive technician. By SKZB’s argument, say his car breaks down near me and he is rushing home due to an emergency. By his stated view, I should repair his car, or give him mine, without necessarily expecting compensation. Now, as I am a decent human being, I would probably do so. But to what point? How long until my generosity has bankrupted myself? What should I be reasonably expected to sacrifice of my rights for his? In order for this view of society providing for your rights instead of allowing you to pursue them, there would have to be a drastic shift in the operation of society (which my be what he is getting at in a roundabout way).

  8. Jeff #7: “By his stated view, I should repair his car, or give him mine, without necessarily expecting compensation.” That is either disingenuous or insane. It requires a misreading and ignoring of what I’ve said to the point where further efforts at communication are pointless.

  9. There is no such thing as a fundamental human right. Quit confusing the issue.

    What you are discussing is the minimal share of a goods and services delivered by a society that every member of a society should get. That share is very much dependent on the particular society under discussion and has nothing to do with any inherent human worth.

    And its not only a matter of the type of economic model, either. Era, political system, available resources, whether the society is under external threat, whether the society is expanding or not, etc, all will determine what each society can deliver as a minimum set of good and services. All that and the value system of the society all define what everyone is due as a minimum.

    When people start talking about “fundamental human rights” they are in essence saying there is some cosmic unambiguous rule. There may be, but then you wander into religion.

    If religion is kept out of it, then all human worth is temporal.

  10. If it helps clarify the issue. I don’t believe in any kind of innate human rights. Man claws what he can from the world.

    I think it would help to clarify and define first of all, what kind of rights you’re debating. Are you talking about a quasi religious fundamental right, the US Bill of rights, or rights in some Utopian society that you’ve yet to define?

    I’ve noticed that nearly every web forum is full of people with differing debating skills, logical reasoning abilities, and willingness to understand others. I often feel like I’m viewing a bad high school debate where the participants aren’t listening to each other and just hammer away at each other trying to score some sort of cosmic debating points.

    I recommend that everyone learn some basic debating techniques, as well as taking a course in logic. Often times the people that consider themselves logical, aren’t. These are really some helpful life skills and it’s not really mean to suggest that certain people learn them. It’s good to learn.

  11. I’m going to be out of my depths here I imagine… but…

    I don’t seem to remember reading Kit saying that he expected treatment with no recourse. Only that treatment should be made available and not dismissed because what the treatment is treating is somewhat mysterious.

    Why is that complicated for people?

    Where do people keep coming up with forcing someone to do something? It’s creating an argument to justify a point. I hate when people do that.

    Taking something that should be pretty simple morally and socially to accept. “I have pain, treatment exists. I would like that treatment.” And turning it into something else totally. “I have pain, treatment exists. But only 1 dose. And 50 people have pain. Who gets it? And why does your pain make you more important than the rest?”

    This shouldn’t be a philosophical debate to me, or a political one between warring factions of socialists, communists, humanists and everyone else on every other side… it should be simple for us as human beings.

    Someone is in pain. A commercially available relief for that pain exists. Why deny them relief? We’re not talking about if they can afford it or not. Or if it’s right or wrong that there is even a price involved in the relief from pain in the first place.

    Just if they should be denied relief from pain because people don’t understand the pain.

    Perhaps the reality is less fun for people to discuss. Which is why people fall back on to grand arguments and sweeping statements. But it seems like when that happens we stop seeing the minutia, and the little things are in cases like this are so very important.

  12. Thank you, GWW. You said it better than I could have.

  13. GWW #11: ::sustained applause::

  14. That does seem like a simple way of phrasing it, however, that’s not at all what Kit’s original post was about.

    It invited debate as to if there is a right to pain relief. General exploration ensued as to what did he mean by a right in this case. Several people asked in a rather hyperbolic manner if he had certain expectations.

    Warning: Hyberbole alert below.

    I rather think that asking for pain management as a right from society is akin to asking for cold fusion as a right. It’s just not something that is entirely feasible in every circumstance.

    It’s not that I don’t empathize with Kit for the pain that he’s in, but I still don’t know what he specifically expects or from who.

  15. Although I do believe that properly managed socialized health care is something that would be a boon to this country, I believe what I am asking is:

    If I am in pain and go to a doctor, that they take me seriously, give me adequate pain medication for MY condition and my level of pain, do not accuse me of being a junkie without evidence because I have a chronic pain condition, and do not accuse me of being a drug abuser simply because my condition is not as easily defined using today’s knowledge as, say, Rheumatoid Arthritis.

    Given the oath that doctor’s swear to care for their patients, I do think I have a right to this level of care.

  16. Oh, I understand WHY it turned into what it was. But almost without fail, once a single person turns to hyperbole the discussion will fall into the trap that almost all philosophical, religious, moral, or political debates fall into… endless mazes of hyperbole that totally overshadow the simple truths of the question.

    It’s easy for us to use hyperbole to skip the simple truths. Truths that we may not want to look at because they may not agree with a grander belief or philosophy.

    But it doesn’t make those simple truths go away. And the simple truth in this case is that there are people out there that live with pain. And that some people wish to deny them relief from pain simply because they do not understand the pain. And since they don’t understand it, they deny it.

    That’s ignorance at it’s worst. And no amount of hyperbole should detract us, as humans, from the simple truths that people are in pain, that a relief exists, and that it would be wrong to deny them that relief out of ignorance.

    I know. Hyperbole is more fun. Because it’s the act of debate which is attracting many people to the discussion. But we should not let that allow us to overlook the simple things.

    I’m no scholar, I’m not an intellectual, I’m not a student of sociology or philosophy. But… I can see the minutia. And I’m damn happy for that.

  17. Gww #16: My only disagreement is where you say you’re not an intellectual. The working definition of “intellectual” I use is someone who tends to seek the general rule that applies to specific situation, like, for example, “almost without fail, once a single person turns to hyperbole the discussion will fall into the trap that almost all philosophical, religious, moral, or political debates fall into… endless mazes of hyperbole that totally overshadow the simple truths of the question.”

    So, by my lights, you’re an intellectual. Learn to live with it. 🙂

  18. GWW: Yes, I do see how this debate has gotten here — I knew this was a possibility when I threw around words like ‘fundamental rights’, and in some ways I did intend to raise that debate. Debating IS fun. But it’s also important not to lose sight of where we started from.

  19. Kit: Well, that’s a much simpler premise and something that’s probably much easier to address than the whole societal right concept.

    I fully agree with you. You have the right to expect that level of care from your individual doctor. My advice would be to first tell your doctor these exact concerns. Failing that, shop doctors until you find one that meets your standards.

    Back when I was in the depth of my depression and the height of my weight, a doctor asked me if I wanted a cholesterol test. He told me that it would be a waste of time and money if I had no intention of acting upon the results of that test. It really pissed me off at the time, which was impressive considering my general lack of emotion back then. I felt he shouldn’t have assumed the worst in advance.

    Later I confronted him about it, and we had a discussion about whether or not it was wise to tell a depressed person “not to bother.” While he was 100% accurate, he didn’t know me well enough to determine which things I was coping with and which things I wasn’t coping with.

    General rule, don’t put up with the 5 minute doctors visit. You’re paying for a full appointment, it’s not your fault he/she over-scheduled. Tell them that you want to know on a cellular level how the medication they’re prescribing will help you out and what the side effects are of long term use. Consider it a test of their doctoring skills. Are they prescribing something just because the Merk salesmen took them out to golf last week, or do they know what the medicine does. Ask about rotating different medicines to avoid certain side effects/addiction. Ask what they recommend for non medicinal treatment as well. Write down your list of questions in advance and don’t leave the office until each question is addressed specific to your situation. It’s not uncommon for the patient to know far more about a specific disease than the doctor, so be reasonable and give the doctors the web references that you’re discussing and ask him/her to call you and discuss whether a certain course of treatment might be applicable to you.

    If you can make the doctor your partner, you’re more likely to like the treatment plan.

  20. Yes I agree, one does have to stick up for oneself at the doctor’s office, insist on fair treatment, and educate oneself if we hope to receive proper care for our conditions. Your experience is one I am sure many can echo.

    BTW I also responded to you on the original thread, in case you missed it.

  21. At skzb in 17: Alright, I guess by your definition I can wear the mantle of an intellectual. I may be able to live with it. But… I have read your novels… and wasn’t that also what you used as your definition of a philosopher? In your daily life do you consider them intrinsically tied together? Or interchangeable? Or simply defined in a similar manner? Consider me curious.

    At kit in 18: Oh, I enjoy debate as much as the next I guess. But on some level I find it difficult to branch off into hyperbole. I can do it of course. But I find it difficult. I’m the worst kind of debater. The one that keeps bringing up the original context of the discussion. Heh.

    It drives my wife insane.

    At ker_thwap in 19: Wow… that doctor sounds like a tool. He really isn’t in the position to make psychological or moral judgments like that. Thats why you go to a therapist.

  22. Hmm…I might have written a character who used that definition of philosopher, but I can’t remember doing so, and that isn’t at all what I mean by it. I use “philosopher” to mean one who studies epistemology, ontology, or both.

  23. Hm. I may be mistaken. It just sounded very familiar to me when I read it. I do apoligise for dragging your novels into the thread.

  24. Steve @ 2,

    People had the right to wear shoes. They didn’t have the ability. Nobody got arrested for wearing shoes.

    Do I have the right to run a 4-minute mile? I say that I do; there’s a running track in a park nearby. The ability is another issue; I don’t have the right to force them to redefine the minute or the mile (the only way I would be able to do it).

    Suppose there’s an acquired taste that only 1% of people have (so 99% don’t want it). Society has the ability to produce enough for 5% of the people, and actually produces about enough for the 1% who want it. I’d say that the right of people to have it isn’t affected by the fact that they can’t all do so.

    Do people have the right to live in [a particular City]? There’s no city large enough for everybody to live there (nor any city that everybody wants to live in); but does that mean that people don’t have the right to live there?

    Rights have little to do with “should be”. There are lots of things that should be, that aren’t rights. Helping people who need it is a “should”, and I often do; but it’s my choice to help them, not their right to get my help.

    Gary @ 9, there are fundamental human rights; they are of the form “the right to be allowed to (try to) do something”. Freedom of speech, for instance, is such a right.

    GWW @ 11, there seem to be two different issues you’re conflating. If someone chooses to offer treatment, he should have the right to do so (on terms he chooses). If someone offers treatment, and someone else wishes to avail himself of it, he should have the right to do so.

    If I can gives massages that ameliorate pain (and sometimes I can), that doesn’t provide me with any obligation to offer a massage; it’s my choice whether or not, and when, and to whom, to do so. If I were a professional masseur, offering my services to the public, then anyone who wanted ought to be able to purchase them. But I’m not, and don’t.

    “Someone is in pain. A commercially available relief for that pain exists. Why deny them relief?” I don’t think anybody here agrees with the government’s stance that they should not be able to get relief. But if the store that sells the relief is closed, they have to wait until it opens (and pay for it). No third party should be able to interfere with that voluntary transaction.

    kit @ 15: I don’t think that doctors (or anyone else) should be able to get away with being incompetent oath-violating oafs.

    GWW @ 16: The difference is between having an active right to something, and having the passive right that no third party can interfere with getting something. You have the right to send a message to my brother, and I have the right not to deliver it for you. But I don’t have the right to stop you from talking to him directly; to do so would violate your rights.

  25. I really enjoyed GWW responses on this thread and the whole discussion illustrates why I always preferred working in direct care, as opposed to policy setting or the like.

    I am not articulate and eloquent and have trouble expressing what I think but I do know that the problem Kit expressed is a common one and I believe that there are ways for “us” to make sure he and his cohorts get the care they need (and, I believe, deserve).

    I’m very lucky in that I have excellent health care and live a fairly comfortable life. Even so, several years ago our son was in the hospital (age 4) with a platelet count of 27. He was very sick. When he was well enough to come home the doctor wrote us a ‘script for medication in case he should have a bleeding episode at home. Please remember we have great health and prescription plans…but not for this drug which no plan covered. The single dose would cost us $2000. I didn’t have 2K sitting around. Oh sure, I made it happen, but it really brought home the reality of medical care and choices that others (without family to front them the money) make every day. I don’t know from “rights”. I do know that it’s a crime for a solution to exist but no access given to a medical condition.

  26. I may be totally off-base here, but I wonder if the fact that doctors can face criminal prosecution for over-prescribing pain medication has anything to do with certain doctors’ reluctance to write kit a prescription.

    On the topic of rights, I would just like to point out that, here in the US, children have the right to an education. This policy has led to exactly zero teachers being forced to educate against their will.

    There is a distinction to be made between saying “we should consider access to ‘x’ a fundamental right”, and deciding how to provide ‘x’ to everyone. In this country, we provide public education through schools that are funded directly by tax money, but this is not the only way to provide public education. We could, for example, give some out some sort of vouchers that would allow parents to send their children to the private school of their choice. We could also try to force teachers to work for free, at gun point, but the inherent problems with this method are so obvious that even the most clueless of politicians would be unlikely to propose it.

  27. This policy has led to exactly zero teachers being forced to educate against their will.

    Not exactly what you mean, I know, but I would like to point out that at least in some places in the US, it is illegal for public school teachers to strike (I know it is in Florida, where I went to school; I don’t know about anywhere else). I would argue that the teachers are being legally compelled to work when they do not want to.

  28. Hmmm – I’m all for “fundamental rights” in various areas – healthcare, education, shoes. This defines society’s responsibility to care for its own. Where does responsibility of the individual back to that same society fit in though?

    Healthcare for example – an individual has the right to be cared for and we can agree that society should provide it. But does that same individual retain that right when he/she does not care for himself/herself? I drink too much, I fry my liver, I receive my “entitled” transplant, I fry it again. If society has the responsibility to provide a right, shouldn’t those benefitting from them have some accountability as well?

    Yes, everyone should have fundamental rights but until everyone is trustworthy (loyal, helpful, friendly, courteous, kind, etc – sorry, went all boy-scout there for a sec) how do you create and manage a system to provide and guarantee those rights?

  29. As i said in a previous comment, im from sweden.
    Some of the things you talk about here is quite far from swedish healthcare and i can’t really relate to them, but it gives me an insight into how your medical system works and for that i am grateful.

    Thank you for giving me something really interesting to read at the office when the computersystem i work with is down for maintenance

    (if you are interested in how swedish healthcare works, there is a good article on wikipedia.
    http://en.wikipedia.org/wiki/Healthcare_in_Sweden )

  30. Hm, not insane, and not particularly disingenuous. Seth articulated my argument better than I did though. My main points of contention were the use of “society”, “rights”, and “without any financial penalty”

  31. Mab wrote:”Healthcare for example – an individual has the right to be cared for and we can agree that society should provide it. But does that same individual retain that right when he/she does not care for himself/herself? I drink too much, I fry my liver, I receive my “entitled” transplant, I fry it again. If society has the responsibility to provide a right, shouldn’t those benefitting from them have some accountability as well?”

    It’s significant that many people are able to do exactly what you describe because they have the money, insurance and hence the ability to and that others without those resources, and without any intention to trash liver #2 can’t get one. Several years ago I was unable to get a heart transplant for a severely disabled adult who needed one. She was deemed too “low functioning” by the transplant team. She died less than 2 years later. She was a delightful woman and it pissed me off that because she wasn’t an intellectual powerhouse she was deemed worthless.

    On the other hand, how exactly would we police the intentions of health care recipients. I’m a type 1 diabetic with an A1c of 5.8% but what if I had a bad month or year? Should we cut me off? Pregnancy is a voluntary condition (for most) so why should “we” pay for it.

    Ultimately I believe that in order for our society to survive we need to radically change our economy. I’m not educated in the terminology, but as long as we have executives making 20X the lowest paid employee, as long as we allow a free market and all that brings with it, as long as we exist to just grab what we need for us and not think about the long term effect on the rest of humanity situations like the one that started this thread will continue.

  32. corwin

    Welll said, amysue.

  33. Ok, now this is the part that really gets me;

    “If you have severe pain, an injury, or sudden illness that makes you believe that your health is in serious danger, you have the right to be screened and stabilized using emergency services. These services should be provided whenever and wherever you need them, without the need to wait for authorization and

    without any financial penalty.”

    Well, that is a bunch of bull, my wife was in and out of the hospital several times in one year due to kidney stones and gee, they still want a ton of money from us! As for the pain, well she had to sit in the waiting room for over an hour a couple of times, in severe pain waiting for her “turn”.

    Some things just aren’t as they seem and unless and until society or the powers that be decide to make some noise to get things changed, they will remain just words on a piece of paper hanging on a wall.

    Ronnie

  34. Those were interesting thoughts amysue, but the original question of Mab wasn’t answered. AmySue addressed rich people going outside of the society provided services (eg. Mickey Mantle) but no one has addressed the responsibilities of the individual within the society.

    I’m of the opinion that with greater rights comes greater responsibility to the society. I also thought it was scummy that Mickey Mantle got two livers from a “socially maintained” organ donor system. As far as I’m concerned anyone that drinks their way through a liver should be at the bottom of the list, whether rich or poor.

    Empowering Success @ 33:
    They can want the money. It’s never been advertised as free emergency room treatment. It just means that they must provide such service in advance of wanting the money.

    I had some chest pains last year, went to the emergency room, went straight to the head of the line, got hooked up to the neat beeping machines, and got some $3,000 worth of treatment before they ever asked how I was going to pay for it. That was one expensive pulled muscle in my chest cavity.

    I don’t have insurance by the way, it’s a stupid concept that’s akin to gambling against house odds. I put my “insurance premiums” into my savings account.

    One of the illegal immigrant debate concerns that does concern me is the massive backlog in emergency rooms. I don’t particularly care if they work here and earn money, I do care when my kid has to wait four hours in the emergency room while in pain with a broken hand.

    What do you folks think about the rights of those “outside the society?”

  35. I don’t have insurance by the way, it’s a stupid concept that’s akin to gambling against house odds. I put my “insurance premiums” into my savings account.

    Says a person whose health is basically good, and can afford $3,000 health care bills.

    One of the illegal immigrant debate concerns that does concern me is the massive backlog in emergency rooms. I don’t particularly care if they work here and earn money, I do care when my kid has to wait four hours in the emergency room while in pain with a broken hand.

    Are you arguing that a patient’s immigration papers overrule the doctor’s Hippocratic Oath? I don’t recall the clause within any modern or classical version of this oath which allows for such things. Exactly at what times would you justify withholding medical care from illegal immigrants?

  36. 1.
    No, seriously, I’ve deposited hard earned money every month into a separate account ever since I began working, over 20 years ago. Unlike my brother in law, I don’t have $150,000 worth of cars, snowmobiles, motorcycles and a boat; he still has the balls to whine about the lack of affordable insurance.

    I live in an average apartment, and drive an average car, don’t smoke, don’t drink and generally don’t have expensive habits. This is not because of any kind of outstanding moral specialness on my part, I’d love to be able to live the high life, I just can’t afford to. I avoid debt and actually live within my means because it’s cheaper in the long run. I’m not a slave to fashion, trends or any other form of materialism.

    Insurance companies pay actuaries to damned well be certain that they’re going to turn a profit on the average. Mathematically the average person is going to lose money on health insurance because they don’t have the discipline to save.

    If you look at the statistics for amount spent on medical care, I’d suspect a large amount of the U.S. medical budget is the overhead of insurance costs versus the actual cost of procedures and infrastructure. I don’t blame insurance companies, they just offer a relatively expensive service. I just recognize insurance as being a step above casino gambling on the financial decision scale.

    Yes, I would have been screwed had I gotten sick when I was young and hadn’t accumulated enough funds yet. I probably could have turned to family.

    2.
    I’m not advocating any specific position regarding the withholding of medical treatment. Just because I’m annoyed that the emergency room is overflowing with people seeking treatment for colds, doesn’t mean they should be turned away.

    I’ll answer my own question however. I’m concerned about the trend of illegal aliens utilizing services they never intend to pay for. I rather like McCain’s plan to allow the illegal aliens already here to become contributing citizens, with a future eye towards making certain all aliens come here legally.

    My question about the rights of non members of society was more of a question for the socialist types that frequent this forum. It’s been many years since I actually read any large amounts of socialist doctrine, but I vaguely recall that part of what made the society work was that those outside the society would see how wonderful things worked and desire to join the society.

    That said, it seems a large number of people are clamoring to get into the U.S. capitalist society vs. those leaving it to move to say, Sweden. So, I’m wondering what the current position is on providing non society members with services? For that matter, is there a current socialist position on state sponsored charity for general world poverty for example?

  37. If you’re asking me, Ker-Thwap, I have trouble seeing anyone who lives and works in a given society as not being a member of that society.

  38. I hate to pester you on your own journal, but that’s not really saying much.

    Two people work equal hours at equal jobs. Both raise families, contribute to the general economy, utilize all the benefits of the society. Bob pays his taxes and donates to charity. Bill doesn’t pay his taxes and makes origami figurines out of his spare cash then promptly lights them on fire.

    Do Bob and Bill have equal value to the society at large?

    Maybe you’re just far far more generous than I am, but do you see any value to individuals who contribute funds to society?

  39. In that particular case, yes: the government prints more money in the amount Bill burned, so in effect Bill paid taxes.

    Now try the case where Bill worked half the hours, and didn’t pay taxes so had the same final income as Bob.

  40. I’ve worked in quite a few hospitals in the past and while I have seen ERs become primary care centers and the reasons for that are many, I have yet to see uninsured undocumented workers waiting for cold relief bumped ahead of sicker individuals.

    Triage, is the reason you wait forever. Whenever a more emergent case comes in it gets bumped higher up or goes in right then. Your son’s broken hand is certainly not trivial and the pain is horrible to watch in one’s child but with triage it’s not up there. Most of the running noses you may see going ahead of you, whether they are documented workers or not (and I am curious how you know whether or not they are insured or documented) are going to some version of “fast track”, which a broken hand cannot. I will tell you that the last time I needed emergent care, with a ruptured gall bladder I was seen without waiting and hooked up to morphine pretty quick. The kid in the bed next to me, who was uninsured and homeless? He got bumped to the head of the line too. His PIC line was clogged and he had hemophilia and he was in serious trouble. Triage trumps all, but to the patients in the waiting room the waits seem unfair and arbitrary. The system isn’t perfect but the triage team isn’t checking out your insurance status.

  41. Seth: I believe I covered that in my example, both have the same effect on the general economy. Printing more money creates inflation.

    amysue: Yes, I fully understand the concept of triage and accounted for such. My concern is with the effect of 20 million illegal immigrants utilizing the nation’s services. I’m all for free care of our own citizens that are unable to pay, that’s a sound social concept. I’m not suggesting that we not treat illegal aliens, since they’re already here, but we need to do something to ensure the continued standard of medical care for our own citizens.

    Overall:
    I’m beginning to think that folks are dodging the underlying question of does the individual have a responsibility to the society.

    It’s all well and fine to discuss idealistic concepts such as being nice to every person on earth, but at some point pragmatic issues need to be addressed as far as taking care of the burden on people who contribute to the society.

  42. Ker-Thwap: What’s the difference between printing some dollar bills and burning them, printing a newspaper and burning it, and burning some dollar bills and printing new ones, in terms of economic effect?

    amysue: If I’m in pain for an extra hour because other people get treated first, it doesn’t affect my pain at all whether they’re treated first because they were triaged to the front of the line, or because they got there before me.

    Ker-Thwap: Individuals have a responsibility to other individuals, not to “the society” (whatever that is). The issue is how much responsibility, and how that amount is determined.

  43. Seth: I understand how the paper monetary system is essentially a faith based system. That wasn’t the point of the question. Continuing to bring up the paper monetary system is about as relevant to this conversation as asking, “What if an elephant fell on Bob’s head.”

    Some dead Greek guy said something to the effect of that the greatest good was an act on behalf of the society. I tend to agree. I think it’s the worst kind of selfishness to have otherwise capable people leeching off of a community that’s worked together for a common cause.

    I think the “Individuals have a responsibility to other individuals” theory is wonderful. When applied to living in the actual world however, it breaks down. Let’s say you feel a responsibility to help your neighbor put out a fire in his burning house. Without responsibility to the community, now you’re responsible, but not capable.

    Really, if you choose not to understand what “society” is in the context of this conversation, or in general, them I see no point in continuing this. I shall bow out of this conversation and let you have the last word if you so choose.

  44. No, I want it.

    Word.

  45. Ker-Thwap: It was your message (#38) that introduced the concept: “Bill doesn’t pay his taxes and makes origami figurines out of his spare cash then promptly lights them on fire.” For some reason, I didn’t think you were writing about gold coins.

    If somebody does nothing: taking nothing, giving nothing, then he isn’t “leeching off of a community”. If, instead, he engages in some voluntary transactions (where he provides sufficient value to the other participant that both are happy with the transaction), how is that “leeching”?

    How is “feeling responsible to the community” supposed to make me more able to help put out a fire in my neighbor’s house? Equipment and training increase my ability.

  46. Ker-Thwap pointed out in 41 “that folks are dodging the the underlying question of does the individual have a responsibility to the society”. I agree but I don’t think it is intentional. The feeling may be the belief that people abuse the system exists only because the system isn’t doing what it should, and if it were that still no excuse to deny everyone else.

    The thread started with amazement at what people expect out of the “system” or “society”, which led to discussion on the responsibility (or lack thereof) that society has for its members, demonstrated daily by the various medical horror stories detailed throughout.

    So I take away from this that people in this world have crazy demands based on perceived rights which should be fundamental but aren’t because society doesn’t do its job but that it (society) should provide these rights without having to be told to do so through legislation.

    The thing I find odd here is that the bottom line is that *we* are “society” – the buck stops here. The bad guy in this isn’t some ambiguous “they”, it is *US* and if it is that bad and the system sucks and society isn’t doing what it should be doing fundamentally, that is a reflection on the individuals of that society and what the heck are *we* doing about it? Other than pandering about with words that is.

    We ask for the benefits of a socialist approach to these basic rights, a society where everything is taken care of for us and everyone is equal, but we greedy, capitalistic bastards still want some people to be more equal than others (thanks Mr. Orwell).

    We’re looking for that socio-economic utopia akin to that demonstrated in Rodenberry’s Federation of Planets from Star Trek, and it might be possible. Not, however, until we give up the baggage we carry as humans that everyone must work equally, must contribute equally, can only take equal portions of whatever. That may seem counterintuitive – the assumption is always “equality”, but until everyone is happy pursing what they are skilled at or want to do, can take what they need and no one is keeping score, we can never really get to a place where society can provide those fundamental rights both in concept or in means.

  47. Gosh, I didn’t mean to kill the discussion. If I was either too mean or annoying I apologize. I think the discussion was just starting to get interesting and didn’t mean to offend anyone.

    I will drop it now but leave you with a link to a story which is in line with the topic. As a member of our society I was embarrassed, and as a member of this race I was deeply saddened. Embarrassed and saddened that we tune out the needs of those around us to the point that something so basic has become a problem;

    http://www.worldchanging.com/archives/007783.html

  48. Thank you for linking to this. I have often heard, when traveling in Asia or Africa in the past, the exact argument mentioned near the end of the article. “In an ideal world”. Yes, indeed. In an ideal world we could do a lot of great things, but denying available solutions because we don’t want to violate some “prime directive” when it applies to third world populations is the ultimate hypocrisy.

  49. mab: I think the conversation may have been petering out on its own, so I doubt you killed it. On the other hand, I think that most change begins with people talking about making a change.

    I also think it’s extremely difficult for one person to effect change at this time in history, and people can be excused for feeling powerless — for one thing, the media has done a lot to drive home the message of a person’s ineffectuality.

  50. Kit #49: I agree: no one can blame an individual who feels powerless in a world as complex as this one. It is also worth noting that adventure fiction is wish fulfillment in which an individual is not powerless, or an investigation into the role of the individual in a complex world, or some combination of these.

  51. Kit 49: Interesting – that may be in at the core. People feel the problem is too vast, that they cannot possibly change the world. Being told something often enough, by the media or anything else may indeed reinforce that.

    I think it all boils down to desire though. If we want to change things bad enough, as a society or individual then we figure out a way. Individuals impact the world every day, sometimes in ways they never imagined. It is possible, just not easy.

    SKZB 50: Good point concerning adventure fiction. I think those I enjoy the most pull me in by established plausible characters, those whom I believe their actions to given situations to be realistic. This starts by having them react to simple, believable stimuli in simple, realistic ways and then going down the reality meter from there. The character(s) are not powerless , they make a difference and you cheer for them.

    Enacting change in the world I think is much the same. We start little, work in methodical manner up the reality scale and then eventually we’re doing the impossible. The level to which the impossible is achieved depends on the focus, drive and enthusiasm of the individual though. Toss in luck and timing and you have those who have changed things drastically or on a broad scale.

    The adventure fiction at some level empowers us to believe in other possibilities.

    Maybe good writing is the key to helping people overcome that programming, helping them realize the possibilities and enabling some to actually make a difference.

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