If they’re giving tax breaks to employers, does that mean insurance is still tied up with jobs in California? I think that’s a mistake in the design of their system if it is. It puts a brake on wage negotiations and labour market dynamics, advantages big companies over small ones, and reduces wages overall. Although perhaps anything else was too big a change for people to cope with all at once.

I wish California well. With the demise of Republicans as a political force in CA and its stewardship under Jerry Brown, gridlock has been vanquished and political functioning revived on a spectacular scale. This has happened in multiple areas from economy to environment. The comparison of California (where Republicans went extinct) to Kansas/and or Texas (where democrats have suffered a similar fate) has been addressed by the most eminent minds, (Paul Krugman, Robert Reich etc). Heck, even Bill Maher has a monologue on the “Real live experiment”. Not that I believe in Maher’s eminence but it takes a mere comedian to make the point… In contrast, Texas is in the toilet. New Yorker piece “America’s future is Texas”, details a mindset where Texan politicians poop in their pants about the Californication of America while their own state gets taken over by right wing crackpots. To capture in a nutshell where Texas is headed their child mortality rate now exceeds that of many third world countries, where the uninsured rate is sky high, where if you are a public servant to whom integrity and evidence are sacrosanct your job is imperiled, and where Jesus juice gets shoved down everyone’s throats day in day out. Yes, Texas is the densest turd at the bottom of a septic tank. I wish CA well. In the end a single payer system is vastly superior both in terms of health outcomes and cost to society. But it involves higher taxes in place of the prohibitively expensive health premium contributions by employee and employers, tax subsidies to employers and a multitude of other costs. The citizen will be better off in the end but we all know the sort of fear mongering CA law makers will face.

We can agree on that definitely – the litigious nature of US medicine makes things very difficult for your doctors. I can understand why some of them do unnecessary tests because of that. But I vaguely remember work done on bill-padding by US hospitals when I was still working, which is why I mentioned it.

I agree that many US hospitals are run by organisations that are officially charities and therefore are not required to make a profit. However, they can and do make a profit. In countries like NZ, churches are not involved in hospitals, tertiary education etc because there is no money in it. In the US, there is the potential to make a profit for their church. They don’t have to, but they do, and they certainly don’t run at a loss. Our hospitals can run at a loss if they’re required to in order to get the job done because they can get extra funds from the government. This is especially important in natural disasters, unexpected severity of the flu season etc.

I doubt Mr. Whale Oil received any votes in the US presidential election, so he has nothing on Homilies.

Unrelated to the previous exchange, may I point out that the primary reason that doctors and hospitals practice so-called defensive medicine (unnecessary tests and procedures) is to mitigate the risk of exorbitant malpractice claims. That’s an area where your yen to criticize our system would find warrant. (Also, while profits are not a dirty word, it happens that less than one in five US hospitals operate on a for-profit basis.)

That said, I believe Coel’s point had more to do with innovative and unproven therapies rather than unnecessary testing.

With most of these arguments we’re just going around in circles, so I won’t go into them again. Also, the abortion issue is really a bit outside the scope of this post and I shouldn’t have gone there. However, it’s a topic we’ll have the chance to discuss again in the future.

NZ’s preeminent blogger, Whale Oil, is male btw, and I’m sure you would like his opinions much better than you like mine. However, even the politically conservative are largely socially liberal in NZ.

I am not acquiescing to the government. This is not a government decision, and it is only your beliefs that are making it one. The doctors and the parents have a different opinion as to what is best for the child. Therefore the court is deciding what is in the best interests of the child. They happened to agree with the doctors. Exactly the same thing happens in the US in these situations.

Just as you don’t get my pov, I don’t get yours. Where is it written that being a parent is a right? For example, you don’t think same-sex married couples should be able to be parents even though there is absolutely no evidence a child suffers in that situation.

1. I agreed with your proposition that children have rights. When somebody is agreeing with you, isn’t it bad form to quibble over their reasons for doing so?

2. I don’t even want to know where you’re going with this weird tangent. Perhaps you can address and defend your claim that there is no right to be a parent, and cite some mainstream support for that view? I can’t imagine there is any.

3. Do I really need to go over the immunization red herring again? No one can be forcibly vaccinated (indeed that would constitute assault). Requiring immunization records as a condition of government school attendance is not the same as actually compelling vaccinations. (Just another reason to avoid government schools, albeit a bad reason when there are so many good ones.) More importantly, the rationale for requiring immunization is the *public’s* interest in controlling communicable diseases (which actually does not require that *every* person be immunized). There would be far less public support if, as you suggest, the justification had to do with imposing the state’s view of the *child’s* best interest.

4. “If you are making a bad choice when it comes to medical care, it is surely the responsibility of professionals to step in.” No. I am presumed to be competent to make my own reasoned medical decisions unless and until it can be demonstrated otherwise. Additionally, I am presumed to be competent to make reasoned medical decisions on behalf of another as long as my actions are not neglectful or abusive.

Your acquiescence to authority and state power, and discomfort with individual liberty, would seem to be at odds with your professed devotion to the Enlightenment.

On the other hand… whereas protecting the right to life is the most basic legitimate duty of the state, and it therefore has a duty to intervene to protect anyone who is threatened with direct and intentional killing, when it comes to abortion you change the rules, and the child’s best interests go right out the window.

Your belief that an embryo is not a person is just that — a matter of belief, not fact or reason. Once upon a time an embryo grew up to be New Zealand’s preeminent blogger. Do bloggers have a right to life? If so, when do they acquire it? By what occult ceremony or magical incantation do they acquire it? And here’s the real mystery: If that embryo was not the same person as the blogger, then who was she, and where is she now?

Sorry Coel, but even though this isn’t directed at me I want to say something on this:

The reason for a lot of the unnecessary interventions in the US is PROFIT.

i.e. Making money by taking advantage of sick people.

There is no incentive to change that either, and there will be even less if the GOP health bill goes through because medical professionals will want to continue to increase how much they earn with 23 million less people paying the bills. That’s a lot of unnecessary tests to pad the hospital bill with.

1. An embryo is not a person. That people are created in God’s image is a belief, not a fact. Besides, I thought you disapproved of those who tried to depict God as an actual being. I guess, as always with religion, it depends on the circumstances. How do you know anything was endowed by your God. No one has ever proven He even exists.

2. The right to form a family is NOT the same thing as the right to be a parent. It’s not what this means. Also it creates the widest possible definition of family, and does not specifically mean nuclear family, though that is, of course, a possible version.

3. Parents are responsible for their children. That doesn’t mean their wishes should automatically be pre-eminent. Do I really need to go over the immunisation example again? Of course disapproval is not just cause – I never said it was.

4. In NZ and Britain, as I’m sure is the case in the US, doctors are required to act in the best interests of their patients. That is what they are doing here. I’m sure Charlie’s parents are doing the same. As they have come to different conclusions, both cannot be correct. The courts have decided that the doctors are correct.

This is not some conspiracy to undermine parental authority in general. It is a case of doctors who are caring for a patient wanting what is best for that patient. Loving your child and wanting the best for them does not mean you’ll always make the right choices. If you are making a bad choice when it comes to medical care, it is surely the responsibility of professionals to step in.

When you advocate that all embryos should be brought to term, don’t you say that you are speaking for the future child in those cases? Here we have an actual child, and the rules have changed.

@Coel: Vive la différence, but I have to say this sad case has done nothing to increase our esteem for the UK medical and legal establishments.

>”The American ethos on health care seems to be to always try any intervention, regardless of whether it is likely to work, so long as someone will pay for it. The decision of whether to try the intervention thus comes down to whether someone is stumping up the cash. In the UK the decision is instead about whether the intervention will benefit the patient.”

I’m curious for what purpose OTHER than benefiting the patient you think that someone would be willing to “stump up the cash”?

Follow-up question: Which approach would you say is likely to produce greater and faster innovation: the stingy conservative one, or the roll-the-dice, reap-the-rewards one? (You don’t have to answer — but you’re welcome.)

Happy Independence Day.

@HH:
>”Children have rights as individuals.”

True. Every person is created in God’s image and is endowed by God with inalienable rights, including the right to life, at all stages of development from conception through natural death.

>”Being a parent is not a right.”

Not so. Everyone has the right to form a family, and the state must respect the family unit. See the Universal Declaration of Human Rights, Article 16.

>”A parent should not automatically, just because they are a parent, be able to make decisions that are not in the best interests of the child.”

Nobody is infallible. But the parents are responsible for the child they brought into the world. The judgement is theirs alone to make, absent a just cause to take away their natural rights. Disapproval does not constitute a just cause.

>”The doctors know Charlie Gard’s condition better than the parents and are making the best decision on his behalf.”

The government doctors may mean well, and they may know all about Charlie’s “condition”. But it is his parents who know and love the *person*, and the decision properly belongs with them.