Hacker News Reader

Comment by ziddoap | Hacker News Reader

>"I suppose we'd better open the borders and prisons just to prevent disease, right?"

That's one way to take something that no one is arguing for and turn it up to 11. At least try to argue in good faith.

Edit: Found a source for you regarding trust in healthcare, for what it's worth.

>A 2015 Pew study [...] We as a country have less faith in the medical system than we once did — trust was at 80 percent in 1973, and in 2016 it is 39 percent."[1]

[1]https://fivethirtyeight.com/features/americans-dont-trust-th...

View on HN

I tried to find the actual poll to find out what questions were being asked, but link 1 says the 39% figure is from a 2016 study, while link 2 is a 2015 study and doesn't mention 39% anywhere relating to the medical system.

"Less faith in the medical system" could mean just about anything, from people not believing they have the right coverage, to people being afraid that doctors in lab coats are doing voodoo rituals behind closed doors and giving people diseases.

I don't think it means what you're insinuating: that people with serious flu (or initial ebola symptoms) would avoid going to a doctor in the US when they would have a few decades ago.

You are correct, my 2nd link doesn't seem to have that figure. That was my mistake in sourcing, I will remove it.

I wasn't trying to insinuate anything, honestly. I was just trying to provide a source that trust in healthcare is falling to the person who said "Goodness. Citations needed" to the person who said trust in healthcare is falling.

Al was responding to someone who was insinuating that distrust of medicine (doctors, generally) was the result of aggressive law enforcement. The strong implication was we should do something about the reluctance of people to seek medical care because of their immigration status or outstanding warrants. That means reducing enforcement of various laws. That's what Al was responding to.

The possible variations are:

1. Stop enforcing immigration laws and checking immigration status except in very narrow cases.

2. Stop trying to apprehend people with open warrants.

3. Decriminalize some stuff that's criminal so that fewer people have warrants.

Maybe I've got blinders on, but I think hardly anyone agrees with option 2 in general. And I think almost everyone, other than "Get off my lawn" suburbanites, agrees with option 3. Too much minor shit is illegal. But I also think those are minor compared to the first issue.

That leaves the issue of illegal immigrants and their reluctance to have any contact with authorities, including medical services, which is why Al went on tilt. Unless you either refuse to enforce immigration laws, or make them officially legal immigrants, both of which are equivalent to an open borders policy, they are going to remain fearful of seeking medical treatment and the problem remains.

>distrust of medicine (doctors, generally) was the result of aggressive law enforcement.

Perhaps I am reading it wrong, but the quote is:

>[...] people didn’t distrust medical authorities like they do now [...], and didn’t fear [...]coming into contact with government agencies [...].

Which says "AND didn't fear" not "because of fear".

I can't definitively say what the parent meant to post, but the way I read it (which could be wrong, too) is that they are saying there are two reasons we are not as equipped to deal with an outbreak like we did with polio/smallpox:

One reason is because of erosion of trust in healthcare. The other (separate) reason is because of the fear of police/immigration officials.

And you cited something claiming trust in the medical system was 80% in 1973 and dropped to 39% in 2016, but I couldn't and you couldn't find the actual source of that 39% figure to find out what poll question(s) it was the result of. Without being able to see them, I suspect that the poll questions were different or were so vague that respondents' interpretations changed dramatically over 43 years.

61% might not trust the healthcare system in some sense; maybe they don't trust medical research studies, maybe they don't trust doctors to prescribe the lowest-cost effective treatment, maybe they don't trust that they can afford medical care, maybe they think the whole medical industry is conspiring to rip them off (approximately true). But I guarantee you if 100 people break their arms you'll see more than 39 of them in the ER. Same if they have the flu and the symptoms turn severe. Almost all of them will trust primary and ER care just fine, unless there are other considerations, and immigration status and fear of discovery is the most common consideration by far. One hears it constantly in immigration pieces on media like NPR.

There's a tricky game being played. For instance, everyone is "against open borders", but they're for decriminalizing border crossing, against deporting anyone, and want free healthcare, housing, and education for everyone irrespective of legal presence. Then people cook up these theories about various forms of law enforcement supposedly promoting crime and disease by making people fearful of taking preventative actions, and we're expected to consider these arguments in isolation and believe you when you say "no one is arguing for" the thing every word you say argues for.

Maybe you two should try arguing in good faith.

You asked for, and I supplied, a citation about trust in healthcare. What is bad faith about that?

I don't know what any of the other border stuff or law enforcement theories your talking about has to do with trust in the healthcare system, but feel free to continue making noise about it.

No one has said that open borders and no prisons prevents diseases.

Why don't you tell us what your positions on those topics are? I'm trying to look below the surface here.

I didn't see the citation when you first posted. I don't doubt it's valid, but the issue I had up the comment thread was with the theory that lowered faith in medical institutions is because of anti-vaxxers and fear of incarceration and deportation. Your source says nothing of the sort.

I don't know what effect the fear of incarceration and deportation have in regards to lowering faith in medical institutions.

I don't know if the folk who are against vaccination are the sole cause of eroding trust in healthcare, but given that healthcare trust is eroding and anti-vaccination believers are rising, it's not much of a stretch to think the two might be related.

What I do know is that according to the study I linked, trust in healthcare has fallen quite a bit and that is likely to hinder our ability to slow an outbreak.

I called you out for bad faith, not because of your position on the topic, but because I have re-read this thread over and over and still cannot find anyone making the argument that opening borders and opening prisons is going to prevent diseases.

You and others (top-level comment spawning this subthread) seem to be implying (correctly, I think) that immigrants are afraid to engage with the medical establishment (or police... they're all lumped together under "authorities") because they're worried about getting caught up in the immigration enforcement dragnet.

The obvious solution to distrust and lack of engagement between immigrant communities and the authorities — unless you have another non-obvious one — is to stop enforcing immigration laws at all. In other words, the government should never check someone's citizenship/immigration status, except maybe when someone's caught committing a crime (maybe... at least if it's a serious crime... then we'll check immigration status and send them back if they're not a permanent resident). That's what set Al on tilt, because it is essentially an open borders policy.

I have very specifically gone out of my way in this thread to not convey any opinion, implied or otherwise, regarding immigration or border policy. I only wanted to give a source for the fact that trust in healthcare is falling.

Reply on news.ycombinator.com