Having anyone's freedoms dependent on available hospital capacity is a terrible way to run a society. Note that these freedoms were debated and won in an era where medicine was terrible.
Sharing limited resources is a major role of the government, and managing hospital capacity seems to fall under “promote general welfare” to me.
My $0.02
If the pandemic could be fixed by the government managing individual behavior we’d be done with it by now.
Instead the government should be focused on expanding highly covid specific care capacity. That is by far a better way to spend the covid relief money than distributing it to sustain a nebulous lockdown.
As far as I understand from talking with doctors, at no time within the last year have hospitals been at maximum emergency covid capacity, as in hospital beds in the hall ways, cafeteria, etc. This tells me that we are close to the amount of beds we need, and it would be feasible to build out additional capacity quickly, relieve the strain, and get back to normal.
This is not something the government can do. It's not something anyone can do. What you're asking for (though you may not know it) is for their to suddenly be more nurses and medical practitioners. That's not a thing that can just suddenly happen, or even happen with 2-3 years of prep. You need a decade to actually functionally increase the supply of nurses and specialists.
Now there are lots of short term fixes the government has done, such as activating the national guard in locations (to reduce non-medical load on nurses) and hospitals can pause elective services to free up space and time, but that has huge downsides since it means people get life saving nonemergency surgeries like cancer removal.
Similar things were said for the vaccine.
There is so much gatekeeping in the medical community that is not totally necessary. A doctor or nurse that immigrates to the US from a different country which has better health care than we do cannot practice were without jumping through tons of hoops. That is a pretty straightforward way the government – in a state of national emergency mind you! – could instantly and functionally increase the supply of nurses and specialists.
But yes. Yes, I'm advocating that people be just a little bit more open minded and flexible about this issue and, ideally, the so many others like it. Sometimes it's quite depressing to consider the giant gap between how society functions today and how it could function if it operated by different rules.
To give a couple examples. If a nurse moves to the US and learns he can't practice without going back to medical school, he may opt instead to work a different job and defer his medical career. If a doctor moves to the US and is in the same position, she may choose to remain a stay-at-home mom and let her husband be the primary breadwinner.
There's also the arbitrage aspect here: globally we may have a healthcare worker shortage, but it may be more severe in one place than another. Reducing the friction involved in moving the workforce could allow workers that are in relative over-supply to move to an area with relative under-supply, improving the overall efficiency of the system.
New York and New Jersey did this. In early 2020 (so two years ago). Despite this, they ran into extreme shortages. So now that we've done that, what next?
> If a doctor moves to the US and is in the same position, she may choose to remain a stay-at-home mom and let her husband be the primary breadwinner.
And is she just going to suddenly start working if the licensure requirement goes away? Some might, but a lot won't because they are already parenting. This is what I mean by these policies require years to have an impact.
How long would it take to train someone from a nursing adjacent field to treat 95% of what they are likely to see when treating a covid patient? Is anyone even asking that question? If not, why not?
It seems like we’re willing to take drastic action when it comes to mandate public behavior, but not when it comes to reforming bureaucracies, processes, and regulations.
I would love to see stats on that. From what I can tell, the actual percentage of medical practitioners quitting due to vaccine mandates is very small. My family work in the medical field in a red state and the set of people actually quitting over the vaccine requirement (as opposed to making a lot of noise and then deciding unemployment is unattractive) is tiny, but this may not be representative.
Sure. It's a pretty delicate balance between individual liberties and preventing bad collective outcomes, though.
If you lock down 340 million people for a week-- maybe the net effect is stealing 3.5 days of life's "enjoyment" or "quality" from each. That's 3.3 million years of quality life taken.
You need to save 20 years of quality life for 165,000 people to break even. In the first wave we probably exceeded that benefit, but it's highly doubtful any subsequent time passes that bar.
And, IMO, if there's ever anything close to a "tie", you need to favor individual liberty.
Maybe making people mask "costs" 0.2 days per week-- much smaller cost, but also a smaller effect. I think it's still justified, but only barely... It won't be soon.
Punishing the public with these awful mandates because “it’s too hard” is a huge failure of our government.
You should note that government regulations are designed to keep hospitals running nearer capacity. See "certificates of need", which are (in most places) required to get authorization to build a new hospital. You've got to prove to the gov't that a new hospital really is necessary. And thanks to regulatory capture, the tendency is for existing providers to try to sink such applications.
That was also an era when the US was subject to numerous epidemics and pandemics of diseases such as cholera, typhus, yellow fever, bubonic plague, smallpox, and influenza, and it was debated and found that placing restrictions to try to limit the harm from those epidemics was a legitimate exercise of the state's police power and not an infringement of civil rights.
My "freedom" to live because I have a medical issue but cannot get treatment will be severely impacted if hospitals are overrun with patients and worn out workers.
See, we can both play the "freedom" game.
In Texas, I can get hammered, drive a car drunk without a license behind a fence 10 feet next to the highway (property-side). And there's not a damn thing you can legally do about it, despite any fears I may plow through that fence. The suggested (stricken) OSHA mandates were basically forcing non-consensual penetration, or lose your job.
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>That's not totally true. This Texas-based DWI defense attorney says:
You conveniently skipped the top of the page where it explicitly says DWI in Texas must occur in public (a fenced in private property is almost never considered public). Sure a cop can probably find a reason to arrest you no matter what you're doing, if they want to.
>Obviously you should be able to be unvaccinated only on private property then...
Most businesses are on private property. Given that the fourth amendment protects us from handing over documents except on subpeona/court order or probable cause of crime (a few states do compel revealing your identity, although you don't have to reveal your age if the crime is age-related such as alcohol violation), and you can't tell by looking at someone if they're vaccinated, it would essentially be meaningless to make it a crime to be unvaccinated while walking to work for instance. Controlling vaccination is far easier on private property, where you have no freedom to travel and can thus be stopped and checked before entering.
> The police can arrest you if they have probable cause to do so for driving under the influence. Even if you are operating your motor vehicle on what you believe is your own property, the police still may have probable cause to believe your conduct is a threat to yourself or others. Therefore, you should not assume that you are completely safe from arrest or conviction if you are driving drunk on your own property. - http://jackpettit.com/blog/dwis-and-drunk-driving-on-private...
Is that really so different? If you need to drive for your job and try to do so without a licence you'll lose your job too. Conversely, if you're in your own home then nobody is going to make you wear a mask (well certainly not the government anyway).
- Infants/Toddlers (mask): linguistic development health risk
- Adults (vaccine): risk of anaphylaxis, TTS, GBS, Myocarditis, Pericarditis
Also the driving thing was somebody else, I just responded to it. If you didn't like it, it would have made more sense to have told them it was a bad example instead of me. It wasn't my example.
My understanding is masks mandates were only banned in places like public schools, where the owner is the public thus the individual public student has the decision to wear a mask or not. I would certainly disagree with this sort of control on private school, although I might add it could be a public health risk to mandate masks in school as it could harm the linguistic health of some young children developing language skills.
Employers were banned from vaccine mandates (even on their private property).
Court rulings were that these were abuse of the state government on smaller local governments and private entities.
Texas Penal Code 6.03(c): "A person acts recklessly, or is reckless, with respect to circumstances surrounding his conduct or the result of his conduct when he is aware of but consciously disregards a substantial and unjustifiable risk that the circumstances exist or the result will occur. The risk must be of such a nature and degree that its disregard constitutes a gross deviation from the standard of care that an ordinary person would exercise under all the circumstances as viewed from the actor's standpoint."
And what does the now-void sodomy law have to do with anything?
You're also mixing up indictment with conviction.
At any rate, you don't have to have a fact pattern that precisely matches a previously-recorded case to think "gee, maybe this is a bad idea and puts me at risk of violating some law." Most cases involve fact patterns that are at least somewhat different from previous case law. A prosecutor's job is to make their case based on the facts, the law, and the ability to draw parallels from other cases.
I know what the difference is between indictment and conviction, stop trying to act like this holier than thou. The 'fact pattern' of drunk driving on private property isn't a rare pattern, it shouldn't be difficult to dig up a conviction under that statute if it has been succesful.
>Reckless endangerment does not require you actually hit anyone. Where did you get that from?
No shit. I got it from my example, where the driver didn't hit anyone. That's what we were both talking about, a drunk driver on their own private property behind a fence. When did I ever say they hit someone? In my example they didn't, which is why I asked for a case where they didn't.
The sodomy law is an example of how overzealous prosecutors can prosecute "a ham sandwich" on whatever they want but it means jack in terms of whether they can actually convict someone, even if the exact letter of the law suggests they can.
>A prosecutor's job is to make their case based on the facts, the law, and the ability to draw parallels from other cases.
Sadly many prosecutors care more about convictions (or just dragging someone through the system, conviction or not) than any of those. And some care more about convictions than even justice, to the point they will imprison people for victimless crimes. A bad prosecutor is one of the most dangerous and despised members of society.
As for the sodomy law, before it was ruled unconstitutional (and therefore void), it was enforceable and people were convicted of it. See, e.g., https://www.glapn.org/sodomylaws/sensibilities/texas.htm
The fact that it has been voided since is something every prosecutor knows, and so they won’t even try to indict anyone for it. Getting the law off the books is a formality at this point.
Except I never said that no one had ever been convicted. I'm saying even though the law still is on paper, it doesn't mean someone can be successfully convicted of performing a 'fact pattern' that looks like it might violate the letter of the law. For someone formally trained in law you have a shockingly poor attention to detail or even accurately recalling facts.
> or you risk being removed from HN.
Is this some kind of threat? You have a power play fetish too eh? What would I _ever_ do without non-practicing lawyers arguing with me about the risk of me going to jail for some Texas penal code offense they can't even find a conviction for under one of the most common socially frowned upon 'fact patterns' known to man (Texan drunk at the wheel on his fenced-in property). But hey man, however you keep your razor sharp I guess.
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Other snips from Otterley's attacks on my character:
'Worse, you are a hypocrite: You gladly take full advantage of the protections the law affords you, while expressing disdain for the protections and fairness-guiding that the law affords others.'
'I think we've reached the end of this conversation with a clear understanding of the type of person you are. This is a garden-variety description of egotistical selfishness'
'Good for you. I bet you have a Black friend, too.'
Mr. Otterley: YOU are the hypocrite.
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Oh and another one for my friend Otterley from our old conversation, in case we don't meet each other under this username again:
'But I really thank you for the laughs. Maybe the next time I spark up a blunt, I'll stop and think to myself "lawless egotistical selfishness" and think back about dear Otterley'
The doctors and nurses you're asking treatment from are people who deserve freedom and work-life balance, too. Many have been fed up and are quitting. Would you support the government forcing them to continue working? Would you force young people to be doctors and nurses?
The freedom to roam is freedom. I understand the point you're trying to make, but the parent comment is correct in the usage of the world freedom, whether you like it or not.
nor do mask or vax mandates limit this concept of 'roaming' in any way.
This is not always the case, even with hospitals in the US. Few markets are 100% laissez-faire in the US, and definitely not regulated industries like healthcare.
For example, if you are a hospital in the US that participates in Medicare, you must provide basic treatment to stabilize a patient with an emergency medical condition, or transfer the patient to another facility that can.
https://www.cms.gov/Regulations-and-Guidance/Legislation/EMT...
So is letting people die from otherwise treatable injuries and infections so someone else can enjoy their "freedom" to ... you know what I'm driving at.
Freedom is literally worth sacrificing lives for. This is a fundamental founding idea of the US.
So we sacrifice other lives (young children) so our own adult lives can perhaps be saved.
The lives of their grandparents (and of older folks not related to us), you mean. You know, the ones actually the most vulnerable to this epidemic.
I agree that the choices are difficult, no matter what we do. But there's no need to distort the basic equation, and make this particular choice appear to be something plainly selfish (young and mid-life adults snubbing the kids to cover their own asses) when it plainly is not.
If the health system becomes incapacitated, and we have to push people out of ICUs to make way for the "freedom fighter" who won't vaccinate (which is already happening in some areas), then everyone suffers -- not just "mid 30s adults".
>If the health system becomes incapacitated
If the health care system isn't working, then we need to look at expanding healthcare; perhaps by eliminating a lot of the regulations that drag it down. You don't have the right to force someone to make sure there are beds at a hospital. I don't think the answer is compelling non-consensual activity in private business such as masks.
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>It's not that they "seek healthcare". But that they expect to have critical resources like ICU beds available to them (and therefore, denied to others) so they can enjoy their "freedom" (to ignore common sense) -- that folks take issue with.
You're seriously complaining that when someone seeks healthcare they are using a bed? You know how many people using beds are there for non-essential activities (motorcycling, roofing a non-essential shed, snake bite because they went hiking, whatever). Should we outlaw any non-essential activity that could send you to the ED?
It's 'common sense' to me that my (almost) 2 year old's speech development will be harmed if she can't see me speak (and at least one initial study suggests that is correct), so I don't wear a mask anywhere when she's with me nor do I enter establishments that require me to. Maybe that makes me a 'freedom fighter' for my kid's development.
Not happening in the short term.
complaining that people seek healthcare when they are ill.
It's not that they "seek healthcare". But that they expect to have critical resources like ICU beds available to them (and therefore, denied to others) so they can enjoy their "freedom" (to ignore common sense) -- that folks take issue with.
Why not? It's an emergency. It's completely possible to fix this short term in a way that lets us move on without all these socially toxic and corrosive restrictions. Probably would cost an order of magnitude less, even.
That's not what people in healthcare say. But hey, you can say whatever you want.
If hospital capacity was an issue caused by covid surges, we'd have fixed it already.
This is supposed to be an emergency, right? Give me a break. Covid specific healthcare capacity can easily be scaled up with the amount of resources we are pouring in this dumpster fire. Figure it out.
So I find that a very, very weird implication for you to make.
I interpreted you were holding them accountable to answer the question of expanding/fixing health care in the short term. Clearly their answers are going to be in the context of their limited power to change the whole system without the cooperation of others. They need the cooperation of both the capital holders / owners of the health care industry as well as regulators and legislators. I think when you answering this question, they are answering it within the context of working within their current constraints, which can be quite tight.
To say they are the one to answer the question, in my opinion, is to shift the onus on them to answer it. In fact we need the feedback of these workers, and they're critical in us solving current problems. They need our cooperation. But I think framing the question as something they're supposed to answer, as you have done, narrows the focus on people not to be blamed for the constraints that hold them back and thus force an otherwise unreasonable answer.
Along with the second most critical resource that we expect them to have for us: empathy. Especially for those who won't vax.
If somebody says it isn’t possible, fire them and find somebody who can figure it out. It’s a fucking emergency, remember? It’s completely possible. Saying otherwise is an excuse. Figure it the fuck out.
Zero excuses.
(Or the more simple answer is there actually isn’t a problem with hospital capacity because otherwise we’d have fixed it. You know… because it is something that could be fixed… with money alone)
No, not when they "seek healthcare". But when they go out and inevitably get themselves covid because they think they're making bold, individualist statement (as many of these people apparently do think) by not masking and not getting vaccinated.
Would you agree with this analogy:
"Going out into crowded public spaces unmasked and unvaccinated ... is not unlike riding a motorcycle without a helmet. And with a busted taillight and bad brakes too, because you're also putting other people at risk."
Being vaccinated is a strong tail light (having already had COVID before may be a strong tail light too). Being unvaccinated but never caught COVID is a legal but moderate tail light. Being deathly ill but sneezing on the produce is no tail light.
Also, the discussion in that podcast is a bit strange (for a bunch of reasons). For one thing, it seems to reduce the "mask question" to one of individual (or close family) risk -- "If I'm comfortable with the risk level (as affects me and my family), I should be able to decide whether to wear a mask or not (paraphrasing)" -- and completely sidesteps the community risk issue (especially in crowded public settings). Which is very different, and is of course what mask mandates (whether you agree with them or not) are designed to address.
For another, it dwells a lot on the "shame" and (what they think of) as quasi-religious aspects of mask wearing - this idea that people expect others to wear masks because those who do not are "unclean". Which may be what some people think, but to suggest that this is what most people think or that this should be part of the policy debate is just ... werid.
Is it a person's right to fly on an airplane without wearing a mask? I'd don't think so
Is it a person's right to decide what medicines they take? I'd say yes, definitely
You can take away freedoms in the interest of others, but not rights, in my opinion. The policies I've seen are pretty fuzzy on this distinction
Note that the mandates in question (those in Quebec) don't force you to get the vaccine.
They just say that if you don't, you no longer have an inalienable "right" to shop at Walmart.
All that an unregulated free market would change is how we decide who gets treated when there isn't enough capacity to treat everyone.
That's not freedom, that's an entitlement.
So why not build more capacity instead of forcing the public to adhere to a bunch of toxic and socially corrosive mandates?
That's not freedom. Freedom is not putting up barriers.
Edit: to be clear on where I stand. I think you can do whatever you want, as long as it doesn't affect me. If it affects me, maybe you should still be able to do it, but then we need some thought and discussion and isn't an automatic right because "freedom".
With Heroin, I'm not sure criminalization really had much affect at all on the percentage of heroin addicts. And I'd bet that it had less effect than the rate of prescriptions for synthetic opiates did.
what about laws banning second-hand smoke indoors?