Philosophical Productive Discussion

[Eric Cartman]

Well, while I think the law is probably best evaluated in the content-neutral paradigm, one of the burdens on the gov't is they have to show that their law is narrowly tailored to fit the issue. Relevant to that is defining "social media." I think that's an extremely difficult task, especially since I have a hard time believing they're including Youtube in that restriction. Can you imagine telling your 15-year-old she's not old enough yet to watch makeup tutorials on Youtube? So if Youtube doesn't count, as I'm assuming it wouldn't, I don't know how you meaningfully differentiate it from basically any other social media website up to the standard of review the court would implement.

YouTube is just too big and useful to do much of anything about - its as fundamental to the useful part of the internet as wikipedia tbh.

[Uncle]

well, but that's the issue, isn't it? there isn't an exception for "this is just too useful." somebody could argue "twitter is just too useful and ubiquitous." this is why there have to be concrete definitions applied equally across all sites and media

[benji]

Now that I know what this says I have to rewrite this.

[Eric Cartman]

Well if they didn't let creators remove / edit comments, I'd suggest it would fall under the 'community' branch of social media, but they do.

Letting you drop something out there and not permit rebuttal would fall under the 'didactic' category, but then I guess you could argue the fact you can do "(Other YTer) is FULL OF SHIT and HERES WHY" reaction videos still keeps it in the 'community managed' side of things.

It already has a split between kid friendly and general purpose YT, I just don't want to get into the other can of worms on what age is arbitrarily decided as okay for some content but not others.

[Uncle]

Now that I know what this says I have to rewrite this.

[PogiJones]

It really latched onto the Michigan aspect

[Eric Cartman]

Moving my semi-carepost reply to this thread where it belongs?

I think you're wrong on this one; Firstly, I don't believe that use of force is acceptable where alternative methods of change exist, and where use of force is required it should be both measured and proportional, and executing a dude in the street in a democratic nation is neither of those things.

But the scarcity argument is flawed. It creates inefficiency, not solves it.
There already exists mechanisms in healthcare to distribute limited resources to those that most need it - its called triage.
For-profit health insurance changes the criteria for triage from those in most need to care, to those best able to afford it, specifically those with the best insurance.
It removes the treatment assessment criteria away from the doctors performing the care to the actuaries looking at a spreadsheet, and, worse, it creates perverse disincentives; the trust fund kid who broke his arm snowboarding and has super double platinum insurance will get a barrage of tests they don't even need (utilising those self same scarce resources) while the guy whose insurance company decided his best treatment is experimental and won't pay for it gets to bankrupt himself before his long painful death from cancer.
That shit ain't right.

Except this isn't how triage or insurance works in any system anywhere. Every single system would, with no other information than what you provided, deny this hypothetical rather than fund it blindly for "triage" reasons. There are gobs of non-profit and state healthcare providers in the United States and every single one denies things. Every single "universal" system denies things. You're making the same mistake Hap did in thinking that insurance doesn't direct resources exactly the same as any funding system does. "For-profit" is an entirely irrelevant saying because all systems are for-profit, especially states. "Non-profit" doesn't mean they don't make profits, it means they do accounting tricks to hide the profits. Accounting methods don't change that systems always have limited resources, and funding, money, is a resource because it simply is the representative of all other resources.

Okay, so perhaps I should have clarified as 'actively profit seeking behaviours' rather than just 'can make money'.
Insurance as an industry is inherently a profitable endeavour, because in much the same way the house always wins when it comes to gambling, the insurance company always makes money longterm, because insurance rates are always calculated based on the probability of payout.
Like... most people with insurance are always putting in more than they take out, right?
Sure, in the event something happens that you need to make a claim, in the very short term the insurance company will take the hit, but in the longer term they are going to make that back and then some.

What seems particularly egregious about US healthcare insurance providers is the combination of;

1. reduced risks of casual fraud - average joe might be tempted to buy a load of expensive stuff, put it in storage, burn their place down, then claim everything on insurance and double dip by reselling everything they didn't actually lose in a fire. You can't really do that with healthcare?
   
2. Denying payouts on things people have already paid for, and often on fairly spurious loopholes, or by changing the terms after the fact and only disclosing that at the point that the money is needed. And they get away with it (and rely on) protracted legal action having the wronged parties just fucking die before wrongdoing is proven and a payment is forced.
   

A healthcare underwriter is still gonna make plenty of money from every month someone is paying them and not getting sick, right?
Even the crazy big unforeseen payouts are just going to come out of someone elses pool until they can top it back up.

We can look at an extremely important example in your country right now, where life saving care for trans people is going to be denied thanks to Joanne's massive spending rather than life-long "triage" taking priority. 

I snipped the stuff about justifiable homicides because I don't believe in justifiable homicide, so its irrelevant to my point that the way healthcare is run as an agressively for profit business generates bad feelings (avoiding the bad blood metaphor / pun) because of how those businesses conduct themselves and actively prevent alternative solutions.

Lets take for granted Kyunujis understanding of waiting lists as accurate; they can go get themselves their elective, non-essential, self-diagnosed treatments right now if they want; sure they might have to spend a bit of time diagnosis shopping to find the private doctor who will just sign off on a scrip no problem, but I am somewhat sure such physicians contact details are already widely circulated online amongst that community.
They'd have to pay for it themself though.
Or wait to get it free on the taxpayer.

I don't consider that as an aspect of denial, I consider that perfectly logical allocation of resources. I also don't deny the concept of resource scarcity.

I also reject your proposition that UHC represents a monopoly interest; if anything it represens a baseline standard to encourgae competition.
If the NHS hits the levels of shittiness certain political leanings would like, people can always get private insurance instead.
Conversely, if the levels of shitiness I'm sure private providers would like to be able to achieve if left unchecked gets reached, they lose business because that baseline level of care for free for all still exists.

If your belief is that healthcare is not a thing a government should pay for, I would ask what should a government pay for with taxes?
Keeping its own citizens alive by removing avoidable threats would seem to me pretty much the most important function of a government.

universal healthcare still involves someone picking and choosing who lives or dies

it might ultimately be a better system for many, but in the moment that doesn't mean much to the person who dies as a result of the bureaucracy, as a result of being forced to wait to get examined for something that needed immediate treatment, or any number of other silly reasons people continue to suffer under universal healthcare

all healthcare everywhere ultimately involves someone picking and choosing who lives or dies, the difference being whether its someone in the hospital making the judgement call at 'point of sale' based on medical grounds, or someone looking at a spreadsheet making that decision on profitability grounds.

I'm also not sure you understand how, well, most every other country in the first world actually operates, because waiting lists are generally for non essential treatment, not diagnoses.

You also can't really point to universal health care being worse than the US system on economic or efficacy grounds, because the US spends fairly significantly more than most other comparable countries on healthcare as a percentage of GDP, but also generally has a lower life expectancy than those same comparable countries.

I don't know what your specific criteria for success are, but 'costs the country less and has better results' seem like fairly good ones, no?

[benji]

all healthcare everywhere ultimately involves someone picking and choosing who lives or dies, the difference being whether its someone in the hospital making the judgement call at 'point of sale' based on medical grounds, or someone looking at a spreadsheet making that decision on profitability grounds.

This is the only thing actually relevant to any of the argument I was making: your assertion is that the NHS funds anything any doctor of any kind asks of it without question? I've never heard such a thing about it, nor remotely your claim that this is true for any other country.

Because then how can this be true?

I also reject your proposition that UHC represents a monopoly interest; if anything it represens a baseline standard to encourgae competition.
If the NHS hits the levels of shittiness certain political leanings would like, people can always get private insurance instead.

Also, wait...

I'm also not sure you understand how, well, most every other country in the first world actually operates, because waiting lists are generally for non essential treatment, not diagnoses.

Diagnoses?

So you agree that "every other country in the first world" denies treatments the patients or even doctors might want? It's just declared "non-essential" and money is saved, profit for the "baseline standard to encourage competition" corporation through "perfectly logical allocation of resources"!

Because if I'm being ignorant of something obvious I would like to know why these immediately Googled type of stories don't match my general impression:
https://www.theguardian.com/society/article/2024/aug/22/uk-health-regulator-rejects-lecanemab-as-treatment-for-alzheimers
https://www.theguardian.com/society/2024/oct/23/alzheimers-drug-donanemab-rejected-widespread-nhs-use-england
https://www.bloomberg.com/news/articles/2024-11-14/nhs-drug-pricing-standoff-denies-cancer-patients-treatmen

[Besticus Maximus]

The NHS is the best thing that's happened to the west since Hiroshima.

Benjamin's americentricasm cannot fathom how class it is to nearly die and not have to pay for it or indeed have a job. It is the reason I'm here posting too much while making bolognese today.

[benji]

So the NHS doesn't deny anything? Those articles/Kyuuji/etc. are wrong? Then why is there private insurance?

[Besticus Maximus]

So the NHS doesn't deny anything? Those articles/Kyuuji/etc. are wrong? Then why is there private insurance?

Private insurance means jumping the queue and it's a status symbol.

Without divulging too much, since I was a little boy I've had world expert surgeons and consultants operating on me. Neither of my parents worked since I turned 13. I work in a real big boy job with private healthcare and I've never even activated it. I've got 3 consultants at 3 different hospitals for 3 different very complex and intertwined problems and I wouldn't swap those motherfuckers for the biggest texan in the land.

Kyuuji's issue is he's a fucking whopper who wants tits grafted on for free. If he wasn't an insufferable cunt and joined the queue like a real Englishman he'd have them by now. Alas.

Unlike my more mental comrades I'm pretty comfortable with a bit of private in the mix, because ultimately what matters is the universal service provision and only an idiot would imagine they can't co-exist and complement each other if the universal element covers the non-drama llama stuff.

Another way of putting it. My stroke victim dad has an ulcerated leg. District nurses come twice a week to treat it and change the dressings. He hasn't worked since 2003.

[benji]

I feel like I'm going crazy with people not reading what I write and responding to something they've imagined instead.

[Besticus Maximus]

I feel like I'm going crazy with people not reading what I write and responding to something they've imagined instead.

you're setting up a straw man though.

The argument is not 'well the NHS doesn't deny ANYTHING'

It's that there's an integrated healthcare provider with regulation that stops people dying because buck hannigan didn't sign off their forms.

You're smart enough to understand the economic consequences of at least half of the semi-terminal americans being able to go back to work if they have time out to recover from a health crisis.

[benji]

No, I am not setting up any kind of strawman, you're all arguing with someone you're imagining. You're still doing it. Completely ignoring the entire argument I was making to argue about some other shit you want to argue about.

None of this has been some deep esoteric point or argument over superiority of specific versions of the same system. I'll try another time to make the entire thing clear in idiotic desperation.

Health insurance CEO: "We're not fucking paying for that shit." -> Justified murder.

NHS official: "We're not bloody paying for that shit, gov'nor; spot of tea?" -> Justified murder? I say yes.

[Besticus Maximus]

No, I am not setting up any kind of strawman, you're all arguing with someone you're imagining. You're still doing it. Completely ignoring the entire argument to argue about some other shit you want to argue about.

None of this has been some deep esoteric point or argument over superiority of specific versions of the same system. I'll try another time to make the entire thing clear in idiotic desperation.

Health insurance CEO: "We're not fucking paying for that shit." -> Justified murder.

NHS official: "We're not bloody paying for that shit, gov'nor; spot of tea?" -> Justified murder?

If something passes NICE and is regulated and available you will get it. There's no one sitting in an office doing sums working out whether or not it's financially viable. If the doctor decides you need the treatment and it's providable, you will eventually get it if you live long enough.

The problem that Kyuuji has is that he wants cosmetic surgery, which is non-essential, so yeah he probably does need to pay a quack to get it done quicker if he turns up to the clinic and it looks like there's nothing wrong. He's not getting turned down cos it's too expensive, it's because it's medically unnecessary according to the experts (who are actual experts).

[benji]

Then your argument isn't with me, it's with the version of how health insurance in the United State works in your imagination.

[Besticus Maximus]

Then your argument isn't with me, it's with the version of how health insurance in the United State works in your imagination.

I wouldn't argue with you personally, I think you're lovely (even if you are a yankee doodle serious business no holidays bugger)

I do think however that you don't understand it because you haven't experienced it. I know lots of american expats in the UK through work and all of them think the NHS is the tits.

[benji]

No, I think the problem is that you guys have this fantasy version of the US system in your head so you think it's dramatically different when it's totally not.

The fact that you think a health insurer can just deny essential care to save a few bucks and makes these decisions on every single case is a perfect example. They're literally all regulated in the exact same way you describe the NHS/NICE except that our largest states are the size of your whole country, they're essentially state monopolies in most states. All these examples you keep throwing out would be pretty much the same in the United States. Your parents would have been on Medicaid until they got Medicare, etc.

That's why I think there's literally no difference in justifying the murder of the CEO vs. justifying the murder of whatever state officials made the regulatory decisions of what and how to fund this or that along with the immediate availability of resources. Private insurance or state insurance denying payment for an experimental drug in terminal cases should justify murder in both cases in my opinion. In the United States it probably justifies murdering the existing regulatory officials too, along with all the other politicians.

[Besticus Maximus]

No, I think the problem is that you guys have this fantasy version of the US system in your head so you think it's dramatically different when it's totally not.

The fact that you think a health insurer can just deny essential care to save a few bucks and makes these decisions on every single case is a perfect example. They're literally all regulated in the exact same way you describe the NHS/NICE except that our largest states are the size of your whole country, they're essentially state monopolies in most states. All these examples you keep throwing out would be pretty much the same in the United States. Your parents would have been on Medicaid until they got Medicare, etc.

That's why I think there's literally no difference in justifying the murder of the CEO vs. justifying the murder of whatever state officials made the regulatory decisions of what and how to fund this or that along with the immediate availability of resources. Private insurance or state insurance denying payment for an experimental drug in terminal cases should justify murder in both cases in my opinion. In the United States it probably justifies murdering the existing regulatory officials too, along with all the other politicians.

NHS isn't insurance though. It's a right.

Tbf I don't think anyone should be going around shooting CEOs in broad daylight either, because I'm not a mentalist.

[benji]

Whatever, that was my entire point, someone decides the allocation of resources so it's justified to murder them if they make decisions you don't like. Others were objecting that it doesn't count because they're the King's Men.

[Potato]

Our learned friend Benjamin is correct in that he's arguing something completely different. 

His simple point (I think) is that no matter the circumstances, murdering a CEO in cold blood is not justified as he is making decisions about allocating scarce resources (health care) based on need and resource availability.

These decisions are exactly the same as those made in public health systems all around the world. So, if denial of service based on scarce resources occurs in the UK (which it does), then assassinating the head of the NHS Midlands for their service classifying someone as non-urgent who subsequently dies before care can be provided does not justify murdering them in cold blood. 

Have I got your point esteemed Benjamin?

[benji]

Right, and from the point of view of the murderer.

Some guy denies me to pocket a bonus, or NHS or whatever denies me because the budget wasn't enough or whatever reason. To me, I'm getting denied either way, right? I don't see the second one as convincing me, oh well, they tried I guess at least it was for a good reason.

I don't see why any systemic change in any direction would alter this moral framework.

[Besticus Maximus]

Whatever, that was my entire point, someone decides the allocation of resources so it's justified to murder them if they make decisions you don't like. Others were objecting that it doesn't count because they're the King's Men.

There's no justified murder in social democracy  

which is why the party that made the NHS also got rid of the death penalty 

And also why our british (american) progressive liberal ideologues of the purple place have no idea what they're arguing for half the time.

with regards to budgets, it's just not a thing unless it's experimental pioneering treatment in extreme cases (like mad cancers where americans have crazy shit that costs a fortune and the risk analysis is underdeveloped and it's not been regulated to shit and back).

[benji]

Another example of why we need to eliminate the social fascists first so they can't betray the Revolution later.

[Besticus Maximus]

Another example of why we need to eliminate the social fascists first so they can't betray the Revolution later.

Genuinely, it's extremely interesting to get a libertarian view on these things because I think they're more of my enemy than you are and you like Ron Paul

Nepenthe, Kyuuji, plagiarise, excelsior etc are further to the right and centre than you are they just don't understand it.

[Potato]

with regards to budgets, it's just not a thing unless it's experimental pioneering treatment in extreme cases (like mad cancers where americans have crazy shit that costs a fortune and the risk analysis is underdeveloped and it's not been regulated to shit and back).

But it is a thing because capacity is finite in a socialised health system. It's why we have different categories for patients so that the most urgent cases are seen first. 

There are many cases where someone is assessed as a less urgent category when they shouldn't have been and budget is the cause of this. If we had unlimited budgets, we'd have every patient treated as a cat 1, but we simply don't and some of those cat 2 and 3 patients will actually be miscategorised or will develop more serious symptoms while waiting for treatment.

The experimental treatment thing is an interesting case too because every few months the shitty tabloid TV news shows will have some sob story where people are begging for money to send their child to the US for one of these treatments and the story always has a "blame the government" angle for not paying for it. There is a prediction here that if we keep expanding the health budget at its current rate, then it will consume all government spending on its own within a few decades.

At the end of the day we can all sit back and argue about what is the best way to provide health care to people and no one has a perfect answer, but I think we all agree that shooting people in the face for running a business is not acceptable in a civilised society and anyone who celebrates those actions should probably be sent to the gulags for re-education given a stern talking to.

[Eric Cartman]

No, I think the problem is that you guys have this fantasy version of the US system in your head so you think it's dramatically different when it's totally not.

I mean... US has global cultural domination, so unless you're saying that most medical related dramas are entirely horse shit, rather than a believable starting point for the drama to unfold from, outsiders do have a general sense that, well, US health insurance kinda fucking sucks?

European / Canadian Breaking Bad ends at Episode 1, where Walter White gets diagnosed with cancer and referred to an oncologist for immediate treatment the following week. Most every US hospital drama routinely has "Yeah, we could have treated this, but your insurance company pulled some bullshit sooooo.... seeya!" type plot point, usually with the doctors pulling some kind of borderline fraud fast one on that self same insurance company so people get the treatment they need on the down low.

Regardless, my overall point isn't that CEOs getting murdered in the streets is defensible (its not) - its that needless deaths due to egregious corporate greed will generally elicit more of a negative response in the general public than other types, hence widespread ambivalence to the guys murder, even outside the grave dancing from the regular sociopaths and morons.

[Uncle]

European / Canadian Breaking Bad ends at Episode 1, where Walter White gets diagnosed with cancer and referred to an oncologist for immediate treatment the following week. Most every US hospital drama routinely has "Yeah, we could have treated this, but your insurance company pulled some bullshit sooooo.... seeya!" type plot point, usually with the doctors pulling some kind of borderline fraud fast one on that self same insurance company so people get the treatment they need on the down low.

in the Incredibles Bob Parr happily continues working for Wally Shawn approving every claim that comes across his desk, and the lack of drama or desire for change means he ignores the mysterious invitation to the island and never stops Syndrome who successfully kills off all the supers

[Cauliflower Of Love]

I feel like I'm going crazy with people not reading what I write and responding to something they've imagined instead.

I'm gonna be honest, and you haven't been clear on whether your expressing your arguments or an argument someone else is making in regards to this whole thing.

Preface it.

[benji]

its that needless deaths due to egregious corporate greed will generally elicit more of a negative response in the general public than other types, hence widespread ambivalence to the guys murder, even outside the grave dancing from the regular sociopaths and morons.

This is the entire non-sequitur that has been frustrating. That I have only been rejecting reasoning because I don't understand why the ignorant are reasoning the way they are. It's possible to entirely understand some reasoning and reject the reasoning nonetheless. Reiterating that reasoning over and over at me is not going to convince me it's not wrong.

At no point have I been "baffled" or "confused" at the response, it is exactly as I would have predicted had you asked it hypothetically before hand.