There are no ‘human rights’. They are just made up human constructs. We needn’t place healthcare into some imaginary construct ‘above’ us. Some absolute, separate from human silliness, selfishness, and folly. We simply must define certain non- negotiable responsibilities to our societies - one being that reducing avoidable human suffering and death through proper healthcare for everyone is more important than money.
i had no idea the SensMed cmt sections got like this! thought i was the only one? </3. now i see the truth: all cmt sections are the same. & thr is a beauty in that. _JC
This is unscientific, incoherent, coercive, pseudo-political gobbledygook. Reads like it was written by an MBA. It is internally inconsistent; compares forced treatments, from incentive misaligned actors, & Osler's "good clinical decision-makers use uncertainty to weigh the relative benefits for each patient."; says things like "even the courts" [!!] - courts have no medical background! Thr poor judgments are notorious, for that very reason.
Right to access care, & choose one's medical team, & exercise bodily autonomy is the *chief & only* right, for anything else to matter (cf Adam's introduction, you monster! Demon! Foul thing from the darkest pit!) The reason it must be framed as a "right" is to give the individual protection from people. like. you.
I do not even want to hear your (likely paternal & unhinged) views on opiates & pain control. & I'm sorry if you've been sued a lot: But maybe give putting pts 1st a try? see how that goes? You need to re-read those philosophers.
& review both vaccines & applied medico legal hx, & call me in the morning. Thanks for writing. _JC
Sure, if you so say. I'm sorry you were unable to provide any evidence for your assertions about the data. But should you ever find any, I'll be "happy" to take a look. It's been a fun discussion, and no harm, no foul. I sincerely wish you the best, especially when AI takes over both our jobs! 😳
Before we even get to determining "what healthcare people have a right to" we should first consider whether or not it should be thought of as a right at all. In fact, there are reasons it is not already considered and provided as a right!
I cannot speak to other countries, but in the U.S. we enjoy 10 basic rights and none of them involve a right to healthcare (however you define it). It is, to my mind, axiomatic that if you insist that something is a right, then you also have an obligation to provide it which means you must make the wherewithal in terms of personnel and equipment and medicines, etc., the gamut, available. You also have to qualify what constitutes that healthcare. So, for instance, I'm aging and my self-esteem goes down because my face is now wrinkly. Am I entitled to a face lift so that my mental health will be better? The absurdity in this demonstrates but one why that healthcare cannot be a "right" in the way we define rights in this country. Even the U.N.'s 30 Human Rights agreement is full of rights that cannot be provided for all peoples everywhere. They are in some measure just a list of "would-be-nices" and "shoulds" providing no means of effecting said nices and shoulds.
We don't include in our Bill of Rights things such as food, shelter, clothing, transportation, education and others because that would of necessity place all of them within the purvue of the government and this would ultimately erode the freedoms and rights of the people as per the Bill's original intent and purpose. (Note: Government run education has not been shown to result in a net positive in the U.S. We lag behind many countries in basic education.)
We have the right to life and liberty and to the pursuit of our own happiness, according to our Bill of Rights. Even the right to "life" as given in that specific Constitutional Amendment does not ensure the right to healthcare.
My argument, in essence, is simply that what you decree as a right, you must be able to provide, and you must be able to provide to a standard that fulfills that right's expressed intent for being a right.
As a consequence of declaring healthcare a right we have to want, accept and build or create government hospitals, government pharmacies, government doctors, government nurses, government health equipment and supplies, and all the rest of what is required to deliver standardized quality health care to all, equally.
Extrapolating all of this out and comparing to other country's health care models, the unworkability of it is readily seen. The poor won't get better care, taxing the rich more won't provide sufficient funding, and the middle class will suffer most because the tax burden will inevitably fall on them. At the very least, whatever healthcare you thus provide will inevitably suffer drastically in lowered quality and availability (as it does anywhere government runs and delivers it).
Hmmm, the author has muddied and muddled a few disparate concepts here.
Sure, medicine and therapeutics is imprecise. We are guided by RCT and extrapolate the average effect on average patients, onto a very specific Mr. Jones or Mrs. Smith. And I’d say the vast majority of therapeutic decisions runs in areas where there are not specific RCT results to definitively guide decision making. So in those senses, we are not dealing with absolutes and the cut and dried, and that is where the art of medicine is required.
But that should not preclude or exclude the concept of medicine, or at least the access thereto, as a right. For me, the debate would not be about whether access to medicine should be a right; rather, it would be a question of the access to how much of it. If you crash into a post, I believe it reasonable for you to expect society to help in your time of need. But if your double chin bothers you, I’m not so sure you should expect a right to have that redressed. So it would be a question of a right to “necessary care”, and what constitutes “necessary”.
I’m not sure what the examples of vaccines or abortion add, apart from being red meat to trigger people. There are many “rights” that are arbitrary, and/or have arbitrary limits. You can vote, but you have to be a certain age. You can swing your arm about, until you hit someone else’s nose. You are free to speak, but not free to libel. No rights are absolute. And those limits can be (though I suppose not always) rather arbitrary. The need to draw a line around certain rights does not preclude them being such.
OK, I understand that everything offered as "health care" is not beneficial. I certainly don't feel people should be forced to partake of it. And of course -- of course! -- the burden of not having health care falls unequally on the poor.
But Jesus H. Christ! That's exactly WHY you need to answer a few basic questions:
If I do not have a right to health care, then who should decide whether I deserve it or not? The open market? Maybe a deputy sheriff of the private market, stationed somewhere in the insurance company that covers me (this year)? That's how things look at present in NW Indiana and the rest of the US. Those who can't pay are deprived of care most folks would consider essential -- while those who can pay can often get even the most unnecessary or harmful care.
Are you OK with that, Dr. Joshi? If so, how much do you think I should pay, in order to qualify as "deserving"? What's your cutoff?
Or if you reject that all-American approach, well, maybe you think these decisions should be made by my "betters" -- a council of wise and thoughtful experts. Who are they, exactly? And by the way, Dr. Joshi, if health care is not YOUR right, then who would you put in charge of deciding whether you deserve it or not? Who are YOUR "betters"?
Sorry for the tone. But I work at a small law firm that represents injured workers, and I have spent the last few days trying in vain to obtain basic medical care for a very disabled and very broke guy in Northwest Indiana. As a result I find the "thoughtful" tone of this post somewhere between hypocritical, and downright obscene.
I had this discussion with someone previous to the CoVid pandemic. They argued that health care is a right. I argued that the problem with looking at it as a right is the idea that you have to be given it.
If someone doesn't want to get cancer treatment, they can refuse to get it if they want. It's not something that I would necessarily decide, but people should be allowed to refuse treatment if they want. So it can't be a right to receive health care.
This doesn't mean that people shouldn't have access to it. I live in a country where health care is paid for by the government and I generally support this. But I don't want the government requiring people to be given health care if they don't want it.
I'm astonished at both the prevarication of thinking, and lack of science in this post.
Paragraphs three and four, which paint everything with a broad brush, are eye-blindingly wrong in every way possible. Vaccines either work or they don't. End of. And to couch the issue any other way is scientifically and intellectually dishonest. Perhaps the writer is fragile because of current covid controversy, and for the sake of his job, wants to run with the hares and hunt with the hounds?
Unfortunately the prevaricating tenor continues throughout the rest. The issue is actually very simple.
Quoting theologians is logical and right. As a christian, the whole basis of my decision to be a christian rests on the God-given right to choose to believe, or to choose not to believe. I choose to believe, and made that choice both on understanding, and knowing. Your constitution is also predicated on the same God-given individual right, spiritually and in society, though somehow, that has been smudged off .....
Similarly, as far as I'm concerned, the only "right" that matters to me with regard to medicine, is that the doctor is totally truthful, gives me all the known and reliable scientific information in relation to the vagaries that I present and the problem at hand, and is prepared to discuss it with me, so that I can make my own informed choices as to what I want to allow with regard to my body.
That applies to everything. Medical procedures and especially vaccines.
No doctor, or medical organisation, has any "right" to dictate what I do, or why I do it, or don't do it.
The last three years should have illuminated this core concept to all doctors with great clarity - that nothing in medicine should be about the control of people.
For years, I've been grappling with the concept of healthcare as a right. As a practicing physician for over two decades, the question I often ask is: what is "healthcare"? What does that term encircle? How can we deem something a right if we can't fully define it? If "healthcare" is a "right," does that mean every human being on Earth is entitled to all aspects of healthcare, without exception? Should every person have unrestricted, (and free!) access to physicians, the most advanced imaging, the latest surgical procedures, and any medication?
Given these considerations, I don't view healthcare as a right but rather as a goal. By considering some basic level of healthcare as a societal goal, members of society can determine what marginal level of "healthcare" should be universally available and at what cost. This may vary across regions or groups. If healthcare were a right, it would, by definition, have to be equally available to all at no cost. However, providing healthcare incurs costs – someone must pay those costs. If it is considered a right, healthcare workers would essentially be required to provide it without charge, effectively becoming slaves. In contrast, fundamental rights like life, liberty, and the pursuit of happiness don't impose costs on third parties.
Suppose there are no doctors, or only a handful in your town, state, or country? Must we compel people to become doctors to satisfy this "right"? Viewing healthcare as a "goal" rather than a "right" allows it to be prioritized within the hierarchy of other societal goals and facilitates decisions regarding incentives and trade-offs to achieve it.
The language is the problem, as the term "right" carries implications that may be unattainable in the real world of constraints and tradeoffs. It also creates an ever-growing and unrealistic sense of entitlement in the populace, spawning a mismatch between expectations and reality. However, this doesn't undermine the significance of healthcare as a vital, and perhaps one of the most important, societal goals.
An anecdote: Reaching school age, I had a severe vitamin D deficiency resulting in pes planus, pectus excavatum, genu varum , fibrous dysplasia, malformed vertebrae, scoliosis, and kyphosis. (Of note: vitamin D fortification of milk following pasteurization was not required where I was raised) I was prescribed orthotic inserts for my flat feet for 7 years. At age 14 I visited a specialist with the complaint that despite orthotics my feet were still flat. To my bewilderment the physician stated: “At this point your feet are flat because you have been wearing inserts. The muscles and tendons holding together your feet have atrophied. On your way out there is a dumpster: toss the inserts and the shoes.”
Moral of the story: a perfectly educated and compassionate doctor prescribed orthotics, a perfectly skilled craftsperson fabricated flawless orthotics and a well organized insurance scheme funded the whole venture and all of it was the opposite of what was needed.
Following this experience I tossed the shoes and reformed my view of life, health, medicine, education and professional advisors.
Since then I have been a carpenter for 20 years and a nurse for 14. I know beyond doubt, if I feel my back, it’s not a lack of pain medication, it’s just that I got lazy over the winter and didn’t do enough squats with enough weight.
The podiatrist mentioned above saved my life and by extension a couple of others as well.
There are no ‘human rights’. They are just made up human constructs. We needn’t place healthcare into some imaginary construct ‘above’ us. Some absolute, separate from human silliness, selfishness, and folly. We simply must define certain non- negotiable responsibilities to our societies - one being that reducing avoidable human suffering and death through proper healthcare for everyone is more important than money.
Catholic Saint, Theology and Philosophy Master Thomas Aquinas officially cited in Sensible Medicine!
I already loved the group, but know it's like chocolate on the top of the cake.
wow.
i had no idea the SensMed cmt sections got like this! thought i was the only one? </3. now i see the truth: all cmt sections are the same. & thr is a beauty in that. _JC
Terrible. Just awful. An awful piece, by a likely bad person. Who is also fat. _JC
This is unscientific, incoherent, coercive, pseudo-political gobbledygook. Reads like it was written by an MBA. It is internally inconsistent; compares forced treatments, from incentive misaligned actors, & Osler's "good clinical decision-makers use uncertainty to weigh the relative benefits for each patient."; says things like "even the courts" [!!] - courts have no medical background! Thr poor judgments are notorious, for that very reason.
Right to access care, & choose one's medical team, & exercise bodily autonomy is the *chief & only* right, for anything else to matter (cf Adam's introduction, you monster! Demon! Foul thing from the darkest pit!) The reason it must be framed as a "right" is to give the individual protection from people. like. you.
I do not even want to hear your (likely paternal & unhinged) views on opiates & pain control. & I'm sorry if you've been sued a lot: But maybe give putting pts 1st a try? see how that goes? You need to re-read those philosophers.
& review both vaccines & applied medico legal hx, & call me in the morning. Thanks for writing. _JC
Sure, if you so say. I'm sorry you were unable to provide any evidence for your assertions about the data. But should you ever find any, I'll be "happy" to take a look. It's been a fun discussion, and no harm, no foul. I sincerely wish you the best, especially when AI takes over both our jobs! 😳
Before we even get to determining "what healthcare people have a right to" we should first consider whether or not it should be thought of as a right at all. In fact, there are reasons it is not already considered and provided as a right!
I cannot speak to other countries, but in the U.S. we enjoy 10 basic rights and none of them involve a right to healthcare (however you define it). It is, to my mind, axiomatic that if you insist that something is a right, then you also have an obligation to provide it which means you must make the wherewithal in terms of personnel and equipment and medicines, etc., the gamut, available. You also have to qualify what constitutes that healthcare. So, for instance, I'm aging and my self-esteem goes down because my face is now wrinkly. Am I entitled to a face lift so that my mental health will be better? The absurdity in this demonstrates but one why that healthcare cannot be a "right" in the way we define rights in this country. Even the U.N.'s 30 Human Rights agreement is full of rights that cannot be provided for all peoples everywhere. They are in some measure just a list of "would-be-nices" and "shoulds" providing no means of effecting said nices and shoulds.
We don't include in our Bill of Rights things such as food, shelter, clothing, transportation, education and others because that would of necessity place all of them within the purvue of the government and this would ultimately erode the freedoms and rights of the people as per the Bill's original intent and purpose. (Note: Government run education has not been shown to result in a net positive in the U.S. We lag behind many countries in basic education.)
We have the right to life and liberty and to the pursuit of our own happiness, according to our Bill of Rights. Even the right to "life" as given in that specific Constitutional Amendment does not ensure the right to healthcare.
My argument, in essence, is simply that what you decree as a right, you must be able to provide, and you must be able to provide to a standard that fulfills that right's expressed intent for being a right.
As a consequence of declaring healthcare a right we have to want, accept and build or create government hospitals, government pharmacies, government doctors, government nurses, government health equipment and supplies, and all the rest of what is required to deliver standardized quality health care to all, equally.
Extrapolating all of this out and comparing to other country's health care models, the unworkability of it is readily seen. The poor won't get better care, taxing the rich more won't provide sufficient funding, and the middle class will suffer most because the tax burden will inevitably fall on them. At the very least, whatever healthcare you thus provide will inevitably suffer drastically in lowered quality and availability (as it does anywhere government runs and delivers it).
Everyone should have access to healthcare. What bugs me is when they say that Medical Insurance is a right.
Hmmm, the author has muddied and muddled a few disparate concepts here.
Sure, medicine and therapeutics is imprecise. We are guided by RCT and extrapolate the average effect on average patients, onto a very specific Mr. Jones or Mrs. Smith. And I’d say the vast majority of therapeutic decisions runs in areas where there are not specific RCT results to definitively guide decision making. So in those senses, we are not dealing with absolutes and the cut and dried, and that is where the art of medicine is required.
But that should not preclude or exclude the concept of medicine, or at least the access thereto, as a right. For me, the debate would not be about whether access to medicine should be a right; rather, it would be a question of the access to how much of it. If you crash into a post, I believe it reasonable for you to expect society to help in your time of need. But if your double chin bothers you, I’m not so sure you should expect a right to have that redressed. So it would be a question of a right to “necessary care”, and what constitutes “necessary”.
I’m not sure what the examples of vaccines or abortion add, apart from being red meat to trigger people. There are many “rights” that are arbitrary, and/or have arbitrary limits. You can vote, but you have to be a certain age. You can swing your arm about, until you hit someone else’s nose. You are free to speak, but not free to libel. No rights are absolute. And those limits can be (though I suppose not always) rather arbitrary. The need to draw a line around certain rights does not preclude them being such.
Read “Turtles All the Way Down” and then get back to us about the net benefit to society of most vaccines.
OK, I understand that everything offered as "health care" is not beneficial. I certainly don't feel people should be forced to partake of it. And of course -- of course! -- the burden of not having health care falls unequally on the poor.
But Jesus H. Christ! That's exactly WHY you need to answer a few basic questions:
If I do not have a right to health care, then who should decide whether I deserve it or not? The open market? Maybe a deputy sheriff of the private market, stationed somewhere in the insurance company that covers me (this year)? That's how things look at present in NW Indiana and the rest of the US. Those who can't pay are deprived of care most folks would consider essential -- while those who can pay can often get even the most unnecessary or harmful care.
Are you OK with that, Dr. Joshi? If so, how much do you think I should pay, in order to qualify as "deserving"? What's your cutoff?
Or if you reject that all-American approach, well, maybe you think these decisions should be made by my "betters" -- a council of wise and thoughtful experts. Who are they, exactly? And by the way, Dr. Joshi, if health care is not YOUR right, then who would you put in charge of deciding whether you deserve it or not? Who are YOUR "betters"?
Sorry for the tone. But I work at a small law firm that represents injured workers, and I have spent the last few days trying in vain to obtain basic medical care for a very disabled and very broke guy in Northwest Indiana. As a result I find the "thoughtful" tone of this post somewhere between hypocritical, and downright obscene.
I had this discussion with someone previous to the CoVid pandemic. They argued that health care is a right. I argued that the problem with looking at it as a right is the idea that you have to be given it.
If someone doesn't want to get cancer treatment, they can refuse to get it if they want. It's not something that I would necessarily decide, but people should be allowed to refuse treatment if they want. So it can't be a right to receive health care.
This doesn't mean that people shouldn't have access to it. I live in a country where health care is paid for by the government and I generally support this. But I don't want the government requiring people to be given health care if they don't want it.
I'm astonished at both the prevarication of thinking, and lack of science in this post.
Paragraphs three and four, which paint everything with a broad brush, are eye-blindingly wrong in every way possible. Vaccines either work or they don't. End of. And to couch the issue any other way is scientifically and intellectually dishonest. Perhaps the writer is fragile because of current covid controversy, and for the sake of his job, wants to run with the hares and hunt with the hounds?
Unfortunately the prevaricating tenor continues throughout the rest. The issue is actually very simple.
Quoting theologians is logical and right. As a christian, the whole basis of my decision to be a christian rests on the God-given right to choose to believe, or to choose not to believe. I choose to believe, and made that choice both on understanding, and knowing. Your constitution is also predicated on the same God-given individual right, spiritually and in society, though somehow, that has been smudged off .....
Similarly, as far as I'm concerned, the only "right" that matters to me with regard to medicine, is that the doctor is totally truthful, gives me all the known and reliable scientific information in relation to the vagaries that I present and the problem at hand, and is prepared to discuss it with me, so that I can make my own informed choices as to what I want to allow with regard to my body.
That applies to everything. Medical procedures and especially vaccines.
No doctor, or medical organisation, has any "right" to dictate what I do, or why I do it, or don't do it.
The last three years should have illuminated this core concept to all doctors with great clarity - that nothing in medicine should be about the control of people.
Actually, look up the facts on life expectancy in the US. Homicides committed by young men on young men
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2900567/
https://photos.app.goo.gl/bBeqQcwueKwWP7Lx6
https://ourworldindata.org/us-life-expectancy-low.
For years, I've been grappling with the concept of healthcare as a right. As a practicing physician for over two decades, the question I often ask is: what is "healthcare"? What does that term encircle? How can we deem something a right if we can't fully define it? If "healthcare" is a "right," does that mean every human being on Earth is entitled to all aspects of healthcare, without exception? Should every person have unrestricted, (and free!) access to physicians, the most advanced imaging, the latest surgical procedures, and any medication?
Given these considerations, I don't view healthcare as a right but rather as a goal. By considering some basic level of healthcare as a societal goal, members of society can determine what marginal level of "healthcare" should be universally available and at what cost. This may vary across regions or groups. If healthcare were a right, it would, by definition, have to be equally available to all at no cost. However, providing healthcare incurs costs – someone must pay those costs. If it is considered a right, healthcare workers would essentially be required to provide it without charge, effectively becoming slaves. In contrast, fundamental rights like life, liberty, and the pursuit of happiness don't impose costs on third parties.
Suppose there are no doctors, or only a handful in your town, state, or country? Must we compel people to become doctors to satisfy this "right"? Viewing healthcare as a "goal" rather than a "right" allows it to be prioritized within the hierarchy of other societal goals and facilitates decisions regarding incentives and trade-offs to achieve it.
The language is the problem, as the term "right" carries implications that may be unattainable in the real world of constraints and tradeoffs. It also creates an ever-growing and unrealistic sense of entitlement in the populace, spawning a mismatch between expectations and reality. However, this doesn't undermine the significance of healthcare as a vital, and perhaps one of the most important, societal goals.
An anecdote: Reaching school age, I had a severe vitamin D deficiency resulting in pes planus, pectus excavatum, genu varum , fibrous dysplasia, malformed vertebrae, scoliosis, and kyphosis. (Of note: vitamin D fortification of milk following pasteurization was not required where I was raised) I was prescribed orthotic inserts for my flat feet for 7 years. At age 14 I visited a specialist with the complaint that despite orthotics my feet were still flat. To my bewilderment the physician stated: “At this point your feet are flat because you have been wearing inserts. The muscles and tendons holding together your feet have atrophied. On your way out there is a dumpster: toss the inserts and the shoes.”
Moral of the story: a perfectly educated and compassionate doctor prescribed orthotics, a perfectly skilled craftsperson fabricated flawless orthotics and a well organized insurance scheme funded the whole venture and all of it was the opposite of what was needed.
Following this experience I tossed the shoes and reformed my view of life, health, medicine, education and professional advisors.
Since then I have been a carpenter for 20 years and a nurse for 14. I know beyond doubt, if I feel my back, it’s not a lack of pain medication, it’s just that I got lazy over the winter and didn’t do enough squats with enough weight.
The podiatrist mentioned above saved my life and by extension a couple of others as well.