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"I apologize to the dead' not the GOP"
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"I apologize to the dead' not the GOP" |
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JenniferMaxwell
since 2006-09-14
Posts 2423 |
September 30, 2009 Grayson: 'I apologize to the dead' not the GOP U.S. Rep. Alan Grayson, under fire for his heated speech last night, took the House floor awhile ago and offered an apology, but not the one Republicans wanted to hear. "Last night, I gave a speech and I'm not going to recount everything I said, but after that speech, several Republicans asked me to apologize. I would like to apologize. "I would like to apologize, and here's why. According to this study, health insurance and mortality in adults which was published two weeks ago, 44,000 Americans die every year because they have no health insurance. 44,789 Americans die every year according to the Harvard study. And you can see it by going to our Web site at grayson.house.gov. That is 10 times more than the number of Americans who have died in Iraq and who died in 9/11. But that was just once. This is every single year. That's right. Every single year. "Take a look at this. Read it and weep. And I mean that, read it and weep, because of all these Americans who are dying because they don't have health insurance. Now, I think we should do something about that, and the Democratic health care plan does do something about that. It makes health care affordable for those who can't afford insurance, and it saves these peoples' lives. "Let's remember we should care about people even after they're born. I call upon the Democratic members of the House, I call upon the Republican members of the House, I call upon all of us to do our jobs for the sake of America, for the sake of those dying people and their families. I apologize to the dead and their families that we haven't voted sooner to end this holocaust in America. I yield the rest of my time." |
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JenniferMaxwell
since 2006-09-14
Posts 2423 |
"Rush Limbaugh is a has-been hypocrite loser, who craves attention. His right-wing lunacy sounds like Mikhail Gorbachev, extolling the virtues of communism. Limbaugh actually was more lucid when he was a drug addict. If America ever did 1% of what he wanted us to do, then we'd all need pain killers." "The development fund of Iraq was looted by war profiteers..." "I’m sorry Limbaugh called for harsh sentences for drug addicts while he was a drug addict. I’m also sorry that he’s bent on seeing America fail. And I’m sorry that Limbaugh is one sorry excuse for a human being." Grayson - A bit of a drama queen, yes, but spot on about a lot more than just the need of health care reform. |
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icebox Member Elite
since 2003-05-03
Posts 4383in the shadows |
44,000? OK, what about 98,000 deaths from "medical misadventure" (2004 data)? |
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Bob K Member Elite
since 2007-11-03
Posts 4208 |
Medical misadventure and lack of insurance may be two entirely different categories. Medicine is something we tend to think of as helpful to the society. It is actually a mixed blessing. On the whole we are better off with it. I personally depend upon it, but the very process of treatment kills a certain number of folks every year. Then there are the mistakes in treatment that kill a certain number of people every year. I think those would be misadventure. They certainly wouldn't be my idea of Bob's Fabulous Adventure if I had any option in the matter between successful or unsuccessful treatment. And I certainly wouldn't pick Bobs Exciting Misadventure from the menu, either. No no, not for me. But I don't thing either qualify as no insurance, no treatment. Or No insurance, you can't afford medication to follow up your emergency room treatment or options like those. That's your 48,000 person figure. I think it's a lowball figure, by the way. |
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Balladeer
Administrator
Member Empyrean
since 1999-06-05
Posts 25505Ft. Lauderdale, Fl USA |
What does that have to do with the idiotic statements Grayson made? |
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Bob K Member Elite
since 2007-11-03
Posts 4208 |
You're begging the question here, Mike. You haven't yet established that Grayson's statements were idiotic. You've already confessed to not having understood my comment attempting to distinguish between deaths caused from lack of insurance and deaths caused by screwed up medical treatment. The two figures are different because they are different things. The Republican indifference to the current state of medical coverage, and their apparent willingness to side with the insurance companies in this matter is what suggests that what Representative Grayson had to say is functionally somewhat less provocative than the Republican comments about death panels and rationing health care to the elderly and trying to get veterans to decide to kill themselves rather than to prolong their lives, and in the same spirit. It also shows that the Republicans believing in dishing it out, but believe they should be exempt from taking it. The number of Republican statements that have tried to say the same things about the Democratic health care plan that have come out of Republican mouths and — I should say as well — the mouths of some of the more conservative Democrats have been worse and have been coming a lot faster and longer. Oops. When you say stuff like that about your Democratic Colleagues, sometimes your Democratic Colleagues end up responding in language that you seem to understand. It is a terrible loss of civility, of course. It also happens to bear an uncomfortable resemblance to the truth, which has more to be said for it than the Republican accusations (and those of the Blue dog Democrats). The bill as I understand it now seems to be written as a gift to the insurance industry and as a way of stealing from the people of this country. Calling Grayson idiotic doesn't make him idiotic. You would actually have to prove that to people who don't agree with you already. Name calling is an impoverished method of argumentation. It convinces mostly by repetition and volume and not by fact or logic. I urge you to marshall some fact and logic on the matter and make a case and to discuss it on its merits. The fact is that many of the people who are uninsured are people who may have difficulty voting. I don't know this; I would have to do further research into who these people are exactly. You might try to find out the same. Are these people potential Republican voters? Are they potential Democratic voters? Would action for this particular community swing a block of votes on either side, either for or against? It's on matters like this, as well as who can help fund re-election campaigns, that many such decisions are made. How does this break down on a Democratic versus Republican basis, Mike? Not simply on a who's committed the latest and greatest outrage basis. There's an underlying political logic to this that is written in power, and we ignore it at our peril. BK |
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Ron
Administrator
Member Rara Avis
since 1999-05-19
Posts 8669Michigan, US |
quote: LOL. Can I assume you're talking to Grayson, Bob? It would certainly be ironic if we were to think you might be defending his rants with those homilies, don't you think?  |
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Balladeer
Administrator
Member Empyrean
since 1999-06-05
Posts 25505Ft. Lauderdale, Fl USA |
You haven't yet established that Grayson's statements were idiotic. Ok, Bob, you've won me over. Republicans want people to die quickly if they get sick. Obviously you must agree if that's not an idiotic statement to you. You condemn Wilson's two word "You lie" outburst (even though it was true) and defend Grayson's several minute presentation on the floor of Congress how Republicans want people to die quickly. I've seen political bias taken to some pretty high exremes but you have just raised the bar. If you need proof that a speech like that is idiotic, then you are too far gone for me to try to reach. |
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JenniferMaxwell
since 2006-09-14
Posts 2423 |
Speaking of idiotic, where is the Republican health care plan? Both Bob and I have asked for links/sources that show the details, and so far, nada. Neither you nor Denise have responded. Makes one think you're either ashamed of it, there really isn't one, or like so many other right-wingers, you're so busy pointing fingers at the Dems, you really don't have a clue. Anyway, why condemn Grayson for saying on the Floor about the Republicans, pretty much what they've been saying about the Dems for months? Another pot/kettle thing just like Denise was pointing out. |
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JenniferMaxwell
since 2006-09-14
Posts 2423 |
A few examples of idiotic Republican Floor speeches. Maybe Grayson was just following their lead? REP. GINNY BROWN-WAITE ®, FLORIDA (July 21): Last week, Democrats released a health care bill which essentially said to America‘s seniors: Drop dead. REP. STEVE KING ®, IOWA (July 15): They‘re going to save money by rationing care, getting you in a long line. Places like Canada, United Kingdom and Europe, people die when they‘re line. REP. LOUIE GOHMERT ®, TEXAS (July 15): One in five people have to die because they went to socialized medicine. REP. PAUL BROWN ®, GEORGIA (July 10): This program of government option is being touted as being this panacea, the savior of allowing people to have quality health care, at an affordable price is going to kill people. REP. VIRGINIA FOXX ®, NORTH CAROLINA: Republicans have a better solution that won‘t put the government in charge of people‘s health care and is pro-life because it will not put seniors in a position of being put to death by their government. BROWN: A lot of people are going to die. GOHMERT: I would hate to think that among five women, one of them is going to die because we go to socialized care. REP. MICHELE BACHMANN ®, MINNESOTA (July 27): The president‘s advisor, Dr. Emanuel, says medical care should be reserved for the non-disabled. So watch out if you‘re disabled. |
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Denise
Moderator
Member Seraphic
since 1999-08-22
Posts 22648 |
You are capable of doing your own research, Jennifer. Why do you need us to supply more links? You obviously haven't read Zeke Emanuel's writings. |
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JenniferMaxwell
since 2006-09-14
Posts 2423 |
Interesting, still no links. I wonder why that is. Reminds me of another recent Alley discussion. Anyway, which of Emanuel's writings have you read, Denise? Have you the books at hand? Maybe you could quote book and page number so I could check out what you're alluding to. And your opinion please, do you seriously think Grayson's remarks were more out of line than the examples of Republican fear mongering I posted in 9? |
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Balladeer
Administrator
Member Empyrean
since 1999-06-05
Posts 25505Ft. Lauderdale, Fl USA |
Jennifer, I wonder if you think that Wilson's remark was worse than Grayson's comments. As far as the Republican plans for health care, you won't see them because (1) Democrats vote them down immediatly (2 more yesterday) and (2) mainstream media won't cover them. Small wonder no one sees them. |
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Grinch Member Elite
since 2005-12-31
Posts 2929Whoville |
Denise posted three Republican plans. I remember distinctly because I read all three and commented on them. I'll find them and post a link. . |
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Grinch Member Elite
since 2005-12-31
Posts 2929Whoville |
/pip/Forum6/HTML/001845-9.html#220 |
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JenniferMaxwell
since 2006-09-14
Posts 2423 |
Thank you Grinch! |
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JenniferMaxwell
since 2006-09-14
Posts 2423 |
Thanks again, Grinch, got the ball rolling for me! And for anyone else who's interested, here's a partial list of Republican proposed health care reforms. Some go back a while so you might want to start with the most recent, in this case, H.R. 3478 H.R. 77; H.R. 109; H.R. 198; H.R. 270; H.R. 321; H.R. 464; H.R. 502; H.R. 544; H.R. 917; H.R. 1086; H.R. 1118; H.R. 1441; H.R. 1458; H.R. 1468; H.R. 1658; H.R. 1891; H.R. 2520; H.R. 2607; H.R. 2692; H.R. 2784; H.R. 2785; H.R. 2786; H.R. 2787; H.R. 3141; H.R. 3217; H.R. 3218; H.R. 3356; H.R. 3372; H.R. 3400; H.R. 3438; H.R. 3454; and H.R. 3478. |
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Balladeer
Administrator
Member Empyrean
since 1999-06-05
Posts 25505Ft. Lauderdale, Fl USA |
Interesting...you complain about no links and then come up with a lot of links. Makes sense to me  Nice way to avoid answering my question, anyway. |
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JenniferMaxwell
since 2006-09-14
Posts 2423 |
This the question you're referring to, Balladeer? "Jennifer, I wonder if you think that Wilson's remark was worse than Grayson's comments." Another of your distractions but I'll be polite and answer anyway. Grayson had the floor, and as you can see in #9, his remarks were no more outrageous than those previously made by Replublicans which, judging by your silence, you seem to condone. Wilson didn't have the floor. The President of the United States was speaking. Wilson interrupted the President of the United States and called him a liar in front of members of the House and Senate and millions of viewers. Not only was Wilson rude and acting like a riffraff right-wing fringe element heckler, he was totally wrong in his charge, and he was out of order. |
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Bob K Member Elite
since 2007-11-03
Posts 4208 |
Dear Ron, In offering your quotation of my position, you would have made my position more clear if you had included the topic sentence of the paragraph, which I offer below. quote: I put it to you that calling Grayson 's thinking idiotic did not prove anything, least of all that Grayson was wrong. You believe that I was talking about Grayson's tactics. I was pointing out that Hearing Mike call Grayson idiotic was unconvincing because it made no logical assertions one way or the other about what Grayson had said. If Mike had wished to be convincing, he was wasting his time by calling Grayson names. It was unconvincing because it was not an attempt to convince. Had he been interested in being convincing, he might be better served by attacking Mr. Grayson's logic or facts, since even an idiot can be right on occasion. This is the reason, as you know, why ad hominem attacks are considered a logical fallacy. I had also pointed out that Mike had not shown that Grayson's comments were idiotic, so that his comments about my posting, which attempted to stay with a lower figure for the number of deaths from lack of insurance and would actually been to his benefit, had he thought about it, had been dismissed while attempting to assert something that was not an agreed upon fact into the discussion. In fact, Grayson's comments were an attempt to use Republican tactics from this debate against them. In this case, I thought that the comments had the advantage of having more truth to them than the Republican comments have had over the past several months. There are no death panels: They are a Republican invention. The AARP doesn't believe that the Democratic plans will effect Medicare, and so on down the line. The Republicans continue to repeat them as though they hadn't been debunked already. By continuing to support the status quo, or by supporting an increase in profit margins for the insurance companies, fewer services will be provided to fewer people at greater cost. Unless some sort of magic will add money to the pockets of the insurance companies while increasing services. I think that unlikely. Simply because Grayson was blunt doesn't make him idiotic or wrong. It requires somebody to show that he was wrong to make sure that his analysis was wrong; a simple sarcastic suggestion will not do. It requires that somebody show that Grayson was idiotic to prove that the use of the term was more than a smear. Letting it stand simply will not do as proof. Yours, Bob Kaven |
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Grinch Member Elite
since 2005-12-31
Posts 2929Whoville |
quote: Regarding Mike's question I'd go even further Jen, Grayson's remarks weren't even in the same ballpark as the previous Republican efforts. The big difference is that when you see the republicans making their statements - like "the Democrats want you to drop dead", they're said with almost total conviction and a fair amount of venom. They're said in a way that suggests that they are either convinced that it's true, or in a way that suggests that they're trying to convince other people that it's true. Grayson's "die quickly" remark however, although seemingly as bad when written down side by side, was completely different when looked at in context. Grayson's remark was the political equivalent of asking the Republican's when they last hit their wife. His aim wasn't to prove that the Republican's wanted people to die quickly - that was simply a tongue-in-cheek, slippery slope, hyperbolic exaggeration of a possible assumption. He simply wanted to highlight the fact that they couldn't prove the absurd assumption was false. It works like this: If you don't have insurance the best thing to do is not get sick. If you do get sick, terminally sick, the best thing to hope for is that you'll die quickly. The alternatives are suffering prolonged pain or accumulating mountains of debt. The Democrats, it seems, don't want that to happen so they're trying to ensure that everyone has insurance. They've put forward a plan to make that happen but the republicans are blocking that plan, and worse still, they haven't got a real alternative plan to replace it, so the assumption must be that they prefer the don't get sick and die quickly options. It's an absurd assumption that seems logically correct. It's so absurd that nobody actually believes it but the irony is that the republicans are struggling to disprove a fact that nobody really believes and looking a little silly while trying. I've recounted an incident in the past in these forums that highlights the situation that the Republicans now find themselves in, it may be worth repeating here: When the witch hunts in the UK were in full swing a rather irate gentlemen turned to a fellow drinker in a tavern and suggested that he was nothing more than a witch. The fellow in question, to protect his good name and avoid the slur from going further, decided to take he matter to court to obtain damages and a public apology. When in court however the irate chap was still somewhat upset and refused to retract his claim. The judge suggested that if the plaintif could prove he wasn't a witch he'd win the case and damages. Unfortunately he couldn't and so he lost the case. Even more unfortunately, because he couldn't prove he wasn't a witch, the judge assumed that he must therefore be one and ordered that he be put to death. I thought Grayson played this political trick exceptionally well. In his first speech he made a potentially inflammatory, if tongue-in-cheek claim knowing that the Republicans would call foul and ask for an apology. Instead he brought out fairly convincing evidence that suggested that 44,000 people a year died because they didn't have insurance and allowed the lack of evidence that the republicans had a plan to stop that happening add weight to his earlier absurd, but logical assumption. The fact that the evidence he presented which suggests that 44,000 people die each year because they are uninsured isn't as conclusive as it first seems doesn't really matter - the republicans are too busy trying to prove that they aren't witches.  [This message has been edited by Grinch (10-03-2009 08:39 AM).] |
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Ron
Administrator
Member Rara Avis
since 1999-05-19
Posts 8669Michigan, US |
quote: I think you missed my point, Bob. Grayson wasn't being blunt in the quotations posted by Jennifer. He was, rather, engaging in "an impoverished method of argumentation," clearly hoping to convince "by repetition and volume and not by fact or logic." He was being churlish. You're right, of course, that calling Grayson idiotic doesn't make him idiotic. Just as calling Limbaugh a has-been hypocrite loser didn't make him one. On the other hand, a lack of supporting evidence doesn't necessarily make the statements wrong, either. My point, however, was that your attempts to defend Grayson by contending that no one else should do precisely what Grayson did bordered on funny. Maybe that was just me? |
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Balladeer
Administrator
Member Empyrean
since 1999-06-05
Posts 25505Ft. Lauderdale, Fl USA |
If Mike had wished to be convincing, he was wasting his time by calling Grayson names. It was unconvincing because it was not an attempt to convince. I wasn't even trying to be convincing, Bob. I was simply pointing out an act which I feel anyone with a sense of common decency would acknowledge as being wrong. No, Ron, not just you. |
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Denise
Moderator
Member Seraphic
since 1999-08-22
Posts 22648 |
I've read excerpts from Emanuel and Sunstein, Jennifer. Here are a few in video format: http://www.ireport.com/docs/DOC-315691 The allocation of care, when scarcity of resources exist, as with the current H1N1 vaccine, will be given accornding to QALY and the Complete Lives System. I just heard on the radio yesterday that vaccinations will only be given to those 5 years thru 49 years, including pregnant women. No others can receive the vaccination, regardless of susceptablilty and underlying health conditions. If that isn't a 'Just Die' health policy, for those under 5 and those 50 and older, I don't know what is. |
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Denise
Moderator
Member Seraphic
since 1999-08-22
Posts 22648 |
 Maybe some on the left would like to implement this guy's idea for healthcare distribution: quote: http://www.chicagotribune.com/news/columnists/chi-oped0930keillorsep30,0,1198390.column |
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Denise
Moderator
Member Seraphic
since 1999-08-22
Posts 22648 |
Here's some straight talk from Newt Gingrich: http://www.healthtransformation.net/cs/opeds_news?pressrelease.id=3406 |
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Grinch Member Elite
since 2005-12-31
Posts 2929Whoville |
quote: I have. I think it's an absolute travesty that certain political figures have misquoted and misrepresented his writings and demonised a well-respected opponent of euthanasia by taking parts of his well thought out writings out of context. What's your opinion of him Denise? |
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Denise
Moderator
Member Seraphic
since 1999-08-22
Posts 22648 |
I don't agree with his philosphy of age-based medical treatment, which has already been implemented with the H1N1 vaccine. Funny that there is a scarcity requiring age restricted rationing when we have already arranged to give our 'surplus' to other countries through the U.N. I guess there is more than one understanding of a shortage, one real, due to formulation problems and delays, and the other, a manufactured shortage, because we are shipping some overseas to other countries, to presumably more age-worthy recipients. |
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Grinch Member Elite
since 2005-12-31
Posts 2929Whoville |
quote: In that case Denise you'll absolutely love Emanuel - he doesn't agree with it either. quote: That's an interesting accusation Denise. As I understand it the vaccine hasn't yet been released by the manufacturers. The first batches - 600,000 doses of the nasal spray version aren't due to be delivered until Tuesday of next week. As I understand it what you are saying is that shipments have already been sent abroad? Is that true or simply a repeated rumour? . |
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Denise
Moderator
Member Seraphic
since 1999-08-22
Posts 22648 |
Has Emanuel recently retracted what he said previously? No, I didn't say that they have already been shipped, Grinch. They have been scheduled to be shipped to 3 or 4 other countries through a deal made with the U.N. Sorry I don't have a link. I heard it on the news. |
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Grinch Member Elite
since 2005-12-31
Posts 2929Whoville |
quote: Not as far as I'm aware, he's been fairly consistent. What previous comment are you talking about? The US manufacturers have agreed to supply a proportion of their produced vaccine to the third world, as far as I know so has every other manufacturer worldwide. The last article I read put the expected amount to be about 10% of the vaccine each manufacturer produces leaving 90% to be sold on the open market. It seems like a good plan to me. America, along with every other developed country can purchase as much vaccine as it needs from all manufacturers worldwide but 10% is ring fenced for underdeveloped countries. . |
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Denise
Moderator
Member Seraphic
since 1999-08-22
Posts 22648 |
I'm talking about his "Principles For Allocation Of Scarce Medical Interventions" which you can download here: http://blog.jonolan.net/wp-content/uploads/2009/08/complete-lives.pdf http://blog.jonolan.net/politics/complete-lives-system/ Below is an article with some highlights from the Emanuel paper: quote: http://www.humanevents.com/article.php?id=33100 I'm all for sharing our resources with the rest of the world once everyone in this country who wants to receive it can. |
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Grinch Member Elite
since 2005-12-31
Posts 2929Whoville |
quote: That sounds like an interesting plan Denise. If you don't mind me saying though there's one itsy-bitsy flaw in it - the US doesn't actually have the capacity to produce enough vaccine to cover it's own population. Far from having a surplus the US actually buys its shortfall from foreign producers. The agreement that the US has signed up to is that all manufacturers, including those in the US, reserve 10% of their production for third world countries. That means that 90% of world production is available on the open market, so you get the chance to buy enough to cover your population but the third world countries are guaranteed to have at least some once the feeding frenzy is over. Or are you suggesting that every country keeps the vaccine it produces for their own consumption? If so what are you going to tell the 220 million Americans who won't receive the vaccine? . |
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Grinch Member Elite
since 2005-12-31
Posts 2929Whoville |
Newt Gingrich is wrong Denise. The figure isn't $45,000 it's £45,000. He's also got the calculation slightly awry too. It isn't £45,000 per year it's £45,000 for each additional year a treatment will extend your life by. There's a big difference. If a treatment extends your life for 10 years you can add a zero onto the £45,000 figure an allowable treatment could cost and it would still pass the NICE criteria. I explained QALY a while back to Huan here it is in case you missed it. quote: . |
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Denise
Moderator
Member Seraphic
since 1999-08-22
Posts 22648 |
It seems we're obviously not getting enough to cover our own population even with the 90%, or we wouldn't be rationing by age or any other critera. Yes, I read the QALY that you shared before. The problem I have with the QALY and the Complete Lives System is that a government bureaucracy is assigning a quality of life factor and/or a benefit to society in determining who gets treatment, and/or level of treatment. |
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Grinch Member Elite
since 2005-12-31
Posts 2929Whoville |
quote: You're not Denise, you wouldn't be if you could get the other 10% either. The world capacity for flu vaccine is 400 million doses per year, they're trying to increase that but the production process is making that difficult. With 6.7 billion people in the world there's a fairly large difference between supply and demand, some are going to have to do without. It's actually worse than it seems, the figures for production are per year but when it comes to a vaccine you don't want to spread delivery over a year, you want to vaccinate everyone in the shortest time possible. So what do you do? The most logical thing to do is vaccinate the most susceptible and key people first, nurses and doctors etc.. In the case of swine flu, as opposed to other strains, the older you are the less susceptible you are so your vaccination schedule has to take that into account. quote: As opposed to a health insurance company who decide based on what supplying treatment will do to their bottom line? Health insurance companies use the same method Denise. They just don't advertise the fact. . [This message has been edited by Grinch (10-04-2009 05:45 PM).] |
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Denise
Moderator
Member Seraphic
since 1999-08-22
Posts 22648 |
Who has determined that the older a person is the less susceptible they are to this particular flu? Have studies been done? Why are they less susceptible than they are to the regular flu? Are the sickly elderly with underlying health problems and compromised immune systems less susceptible than the general population? Private insurance companies do not engage in rationing of care the way that government run heatlh care systems do, and the way that ours will if it takes over our healthcare system. If they did 85% of people who have insurance would not be happy with what they have. Even Medicare patients can currently get the treatment that they need, which will be denied them when the government implements the drastic cuts to Medicare to help pay for their 'healtcare for all' plan. |
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Grinch Member Elite
since 2005-12-31
Posts 2929Whoville |
You've got lots of questions there Denise, questions are a good thing you should ask more of them. Who says older people are less susceptible to this type of flu? Statistics. With any type of flu the health experts look at who's catching it, who gets sicker and ultimately who dies as a result of it, they collate all the statistics and then work out the best way of fighting it. This particular strain is odd in that regard, normally older people contract flu to a greater degree, it makes them sicker and fatalities are almost always greater amongst the elderly. Swine Flu is different; it's the younger generations that are most at risk in every regard. Why is that? The truth is nobody knows, all that anyone can say is the statistics show that that's how it is. Are older people safe then? No, while old people are less susceptible they aren't immune, in fact if they have underlying health problems any advantage they may have in being in a low risk group (older) gets wiped out by being in a high risk group (having an underlying condition). That's why older people with underlying conditions are included in the vaccination program. Do private insurance companies ration health care like public health care systems? I could simply say yes to that - but it wouldn't be the whole story. They both do it in different ways Denise, one of them, at least to my mind, far more morally preferable to the other. . |
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Bob K Member Elite
since 2007-11-03
Posts 4208 |
So, with not enough vaccine to go around in this country, and with the conditions as Grinch describes them, who does Denise say should get the vaccine in this country, Denise? And why? |
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Grinch Member Elite
since 2005-12-31
Posts 2929Whoville |
Bob, Isn't it a little unfair to ask Denise to make such a big decision with only half the information she needs? There are lots very important questions that haven't been asked yet, questions that, once answered, might change the vaccination plans completely. Questions like: How serious a threat is swine flu? What's the predicted mortality rate based on the current data? Are there better ways of fighting this flu strain? How dangerous is the vaccine itself? While we're busy making swine flu vaccine what happens to seasonal flu vaccine production? That's not an exclusive list Bob - but it's good enough as a starting point. Once you answer the above questions though you may find that your own answers to the questions you asked Denise are somewhat different that what you might expect. |
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Bob K Member Elite
since 2007-11-03
Posts 4208 |
Dear Grinch, You seem to be able to make sense to Denise where I cannot. She now has the information from you to understand that her initial reasoning about the distribution of doses was wrong and that she was being misled about the situation. The United States has not produced enough vaccine for everybody in the country and has to purchase from overseas. Even then, there will probably not be enough for the time window in which it must be distributed. 6.7 Billion People versus 400 million doses worldwide versus 300 million in the United States (I think). I recall Denise was still firm on the women and children and elderly first thinking when last we spoke. If I misrecall, I am sorry; but that is how I remember it. That seems to assume that three out of four doses in the world will go to the United States. The point is, to my mind at least, that no matter what is done, there has to be some rationing of health care. I think that it is a mistake specifically to limit ourselves to this issue, but for now, let's do that. I think that any distribution plan that one settles on — and I mean distribution plan here, a way of sending vaccine to distribution points when there isn't enough to go around — is in fact a rationing plan in itself. Some places and people must get the vaccine first. Even if the distribution plan is to be completely random about sending the vaccine out, you have made a series of decisions about the importance of some lives over other lives and the importance of having a functioning country over not having a functioning country. Any decision has consequences, even the decision not to make a decision. It is fair to say that you don't like a decision — the administration's decision, for example — but then it seems that you should be willing to say what you don't like about it. One of those things can't be that it rations health care. The fact that the government has chosen to allow doctors to live wherever they want to live has, all by itself, rationed health care. People who don't live in places with access to large hospitals and universities and a bustling cultural life have rationed their own access to health care. There are all sorts of factors, governmental by action or non-action, as well as non-governmental (are you a Christian Scientist?) that ration health care access one way or another. Some of these you will like, some you will not like. There are ways that non-governmental forces ration health care as well. Insurance companies are an enormous factor in this sector. So are Drug companies, by their pricing policies. If you don't like the way the government rations health care, say how. Don't pretend that not rationing health care is an option for any government anywhere. How would they go about it? Simply by not telling doctors and other health care workers where to live, they are rationing access to health care. As they would if they did tell them where to live. If doctors and nurses did not get first shot (pun intended) at flu vaccines, or other vaccines as well in an epidemic, 1) Vaccines would soon stop being distributed at all as folks who actually knew how to run the clinics would not be available to do the work; 2) larger numbers of the then non-vaccinated population at large would fall ill; 3) the morbidity and mortality rates overall would be much higher. Therefore, if you don't actively seek to kill people you don't actually need to kill, the health care workers get the first vaccines off the line. Purely as a matter of pragmatics, how are you going to stop the medical personnel from vaccinating themselves first. In terms of enlightened self interest, why would you even expect them not to vaccinate themselves first; and would you trust a vaccine that the health care givers didn't trust enough to use first anyway? Wouldn't you be a little more nervous about using it? Anyway, a few thoughts on rationing. Sincerely, Bob Kaven |
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Grinch Member Elite
since 2005-12-31
Posts 2929Whoville |
quote: You won't get any arguments about that from me Bob. I agree entirely; there has to be rationing in one form or another when it comes to health care. With regard to swine flu vaccine though I do have a problem. I think the knee-jerk reaction to the current flu variant is the wrong way to go. Denise wants to vaccinate everyone, you want to vaccinate as many as possible based on how much vaccine we can produce and I think the answer is to vaccinate as few people as possible. |
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Denise
Moderator
Member Seraphic
since 1999-08-22
Posts 22648 |
I think the way to go is to first vaccinate the health care workers and first responders, as has always been done, to my knowledge. Next I think that the people with underlying health problems and weakened immunity, regardless of age, should be next in line. Then after that make it available to the general population beginning with those determined to be hardest hit by a particular flu and then work your way down for as long as the vaccine is available. Maybe I'm wrong, but I always thought that was the way it was done in the past. |
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Bob K Member Elite
since 2007-11-03
Posts 4208 |
Dear Denise, Thank you for a concise and well thought out answer. Grinch — there's nothing wrong with being parsimonious. This art is in understanding where the few is artful and where it is too few. That's where statistical elegance becomes so vital. It is beyond my skill level, so sorry, but I admire it. Thank you both. Sincerely, Bob Kaven |
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Grinch Member Elite
since 2005-12-31
Posts 2929Whoville |
Denise, Your suggested vaccination plan is almost word for word the same as the plans of the UN, the UK and the US. Personally I think it's the wrong way to go. Swine flu vaccine and seasonal flu vaccine are two different vaccines, one vaccine doesn't work on both flu strains - it's an either\or scenario. While the world's flu vaccine manufacturers are working flat out to make swine flu vaccine they aren't making seasonal flu vaccine. Let me say that again, it's an important point and one that people aren't being told. The vaccine manufacturers can only produce a finite amount of flu vaccine every year and, at the moment, they're producing vaccine for swine flu that has caused the deaths of a few thousand people. While they're doing that they're not producing seasonal flu vaccine. That's a big mistake. Seasonal flu kills half a million people a year, that's a lot of people but it's nowhere near the amount of people that it would kill without the continued worldwide vaccination programs. While the world is concentrating on the potential threat of swine flu it's ignoring the real threat of a seasonal flu pandemic left unchecked because of a lack of seasonal flu vaccine. But swine flu has the potential to kill more people, hasn't it? Sure, it might, statistics so far though show that it's killed only a few thousand people and that's without a comprehensive vaccination plan being in place. To become a real threat the current strain would need to mutate which raises another issue. If swine flu mutates into a more virulent form the chances are that the current vaccine would be ineffective, a new vaccine would need to be developed. At that point we'd have no seasonal flu vaccine and no swine flu vaccine but that's only if the virus mutates into a more virulent strain. If it doesn't we'll have a vaccine against a mild flu strain and a seasonal flu pandemic. They're building flood defences in the back yard in case it rains more than it did last year but they're forgetting that they've left the taps running in the bathroom. . |
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Denise
Moderator
Member Seraphic
since 1999-08-22
Posts 22648 |
It seems the main difference between my suggested plan and those of the organizations is that I think it should be given to those with underlying health problems and compromised immune systems regardless of age prior to be given to other groups. Regarding Emanuel, given his above views that I provided, do you still believe that he doesn't advocate treatment based on age? |
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Local Rebel Member Ascendant
since 1999-12-21
Posts 5767Southern Abstentia |
The active nasal vaccine can't be given to people with compromised immune systems Denise. Only the dead virus injection -- which isn't available yet -- and even then if an immune system is compromised it doesn't build up a lot of antibodies anyway -- the best way to go is 'herd' immunity -- which is to immunize those affected by the virus the most -- and those who are in close contact to one another who are likely to spread it around -- like in schools -- and that's the kids. We had an 11 year-old girl here die just this tuesday from H1N1 -- she was absolutely fine the day before. Where I disagree with Grinch is in the assessment that it's a mistake to put so much emphasis on this special H1N1 strain -- because we simply don't know what it's going to morph into -- this is still a very young strain -- and if it had been more virulent than it has been -- the world would be weeping already because of our inability to respond. What I love about this issue though is it brings out all the left-wing loonies who don't believe in science, maybe when some people hear how irrational they are in their fear of vaccines maybe some righties who don't believe in climate science will realize how ridiculous they sound. |
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Grinch Member Elite
since 2005-12-31
Posts 2929Whoville |
quote: Denise, the UN. US and UK plans all contain provision for high-risk groups which includes people with underlying conditions, regardless of age. Just to prove the point I've just had my second flu vaccination reminder from my doctor who keeps insisting I should have the vaccine due to my medical history which puts me in a high risk group for both seasonal and swine flu. quote: Of course he advocates treatment based on age in extreme and pandemic conditions where the resource to treat people are scarce - in exactly the same way that your vaccination plan was based on age. It's just common sense. Govind Persad, Alan Wertheimer and Ezekiel J Emanuel in co-wrote "Principles for allocation of scarce medical interventions" to look at the best way to react to an extreme health emergency. They examined the current methods of rationing a scare resource, such as vaccine, and came up with a better alternative. Some ignorant wing-nuts on the far right took certain sections of that white paper and quoted them out of context, presumably for political reasons. In short Denise those wing-nuts lied to you. They don't believe that you are intelligent enough to know that Denise, or resourceful enough to find the evidence to disprove it. They're hoping that you'll just repeat the lie with enough conviction to convince other people that it's true - they believe that if enough people believe it to be true it'll somehow become true. You have all the necessary tools to prove them wrong Denise. Here's the most potent of them. ? . |
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Denise
Moderator
Member Seraphic
since 1999-08-22
Posts 22648 |
What is the lie you speak of, Grinch, in my assertion that he advocates an age-based allocation of resources when resources are limited? Wasn't that my earlier assertion? |
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Grinch Member Elite
since 2005-12-31
Posts 2929Whoville |
The lie? The lie is that there's something wrong with Emanuel's suggestions, that they are somehow inherently different from how medical shortages are already dealt with - they aren't. Applying Emanuel's system to seasonal flu wouldn't produce a vaccination program any different from the current plan. Apply it to the swine flu pandemic and you get the same result. The wing nuts are highlighting Emanuel's system for dealing with scarce medical resources and implying that it's a manifesto for all health care, it isn't. They throw up their hands gasp in mock horror and tell you that it isn't how they'd supply heath care. They're lying Denise, it's exactly how they would deal with a scarce medical resource - at least it would be if they had any sense. That's the lie Denise, and all you have to do to expose it is to ask them what their alternative plan is, but don't be too surprised if their plan looks suspiciously like Emanuel's plan or the plan you gave come to that. . |
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Denise
Moderator
Member Seraphic
since 1999-08-22
Posts 22648 |
Many of us think there is something wrong with his philosophy, Grinch. That doesn't make the contention a lie when we point it out. Rationing predicated on a person's 'worth' to society based on their age, has never been the 'norm', at least not here in the States. I have never heard of allocating resources based on age before, but always to the weakest and sickest first, and then to others as resources allow. |
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Grinch Member Elite
since 2005-12-31
Posts 2929Whoville |
quote: I must be misunderstanding his philosophy Denise. Can you explain exactly what you find 'wrong' with his system? . |
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Denise
Moderator
Member Seraphic
since 1999-08-22
Posts 22648 |
His philosophy appears to be the allocation of limited resources in a society to those deemed most worthy by those in power in that society. That 'worthiness' is based on age. Those aged 5 thru 49 are deemed most worthy. He believes that society hasn't invested enough financially in those under 5 to consider their potential demise as a great loss to a society and those 50 and above have already had their fair share at availing themselves of society's resources, and so society should not allocate scarce resources to them. I believe that's The Complete Lives System in a nutshell. I suppose one of the things that really bothers me about this is that 'those in power in society' seem to think that they are the 'owners' of the resources in society and have the moral authority to determine who it is who should receive those resources, completely ignoring the fact that it is the people in a society who have created, cultivated, or contributed to the creation of those resources, and it is they who should have a say in their allocation. |
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Grinch Member Elite
since 2005-12-31
Posts 2929Whoville |
quote: I can't argue with that Denise, that's exactly what he's suggesting but that suggestion is nothing new, in fact it's exactly how it works at present. Emanuel simply took all the existing methods of setting the criteria of who gets what and when in a scenario where resources are scarce and selected the best of each to create an amalgamation that made more sense. quote: That's not true Denise. Allocation based on age is only one of the current methods that Emanuel included in his revised system but it isn't the overriding method of selection - Emanuel emphasises that fact several times in the white paper you linked to. If a 19 year old and a 70 year old both need a heart transplant and only one heart is available the prognosis of success and compatibility may well override the age criteria. If the 19 year old is less likely to survive whereas the 70 year old almost certainly will Emanuel's system suggests that the 70 year old should get the heart. What Emanuel does say is that when no other criteria can be used allocation of a scarce resource should be determined by relative age. In the above scenario if both people have an equal chance of survival the 19 year old would get the heart based on potential life years saved. But even that isn't a certainty. If the 70 year old is the President of the US then usefulness to society might tip the scale in their favour. quote: Denise, those in power within the health care system already make those choices, and for very good reason, they're the people who are best placed to make them, all Emanuel has done is collected together all the methods currently used in isolation and investigated the pros and cons of each. He's then suggested the one of them - the youngest first method of selection - needs to be amended and that none of them, if at all possible, should be used in isolation. I think it makes perfect sense when a medical resource is scarce. . [This message has been edited by Grinch (10-12-2009 04:50 PM).] |
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Denise
Moderator
Member Seraphic
since 1999-08-22
Posts 22648 |
"[Health services should not be guaranteed to] individuals who are irreversibly prevented from being or becoming participating citizens. An obvious example is not guaranteeing health services to patients with dementia." --EZEKIEL EMANUEL Is this the kind of policy that you could stand behind, Grinch? |
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Grinch Member Elite
since 2005-12-31
Posts 2929Whoville |
quote: No Denise that would be an example of the kind of lie I was talking about. Some wing nut (Betsy McCaughey) took one sentence out of context and sold it to you as the truth. Can you hear her laughing? I can. She was relying on you not to check out the lie she was peddling, she was hoping you'd swallow it hook line and sinker and spread the lie without question. It seems she was right Denise. This is what Emmanuel wrote: "An obvious example is not guaranteeing health services to patients with dementia." This one sentence was ripped out of a philosophical deliberation regarding ethical trends in medicine written in 1996. It's been twisted from it's context to make it look like Emmanuel is advocating the communitarian view as a viable policy. He wasn't putting forward his view Denise, he was explaining the view held by others, which is pretty clear if you take the time to read the whole paragraph rather than listen to lying wing nuts. "Communitarians endorse civic republicanism and a growing number of liberals endorse some version of deliberative democracy. … This civic republican or deliberative democratic conception of the good provides both procedural and substantive insights for developing a just allocation of health care resources. … Substantively, it suggests services that promote the continuation of the polity – those that ensure healthy future generations, ensure development of practical reasoning skills, and ensure full and active participation by citizens in public deliberations – are to be socially guaranteed as basic. Conversely, services provided to individuals who are irreversibly prevented from being or becoming participating citizens are not basic and should not be guaranteed. An obvious example is not guaranteeing health services to patients with dementia. A less obvious example is guaranteeing neuropsychological services to ensure children with learning disabilities can read and learn to reason." . |
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Denise
Moderator
Member Seraphic
since 1999-08-22
Posts 22648 |
Yes, he is relaying the views of others, views of which he states there may be a consensus between the Communitarians and Liberals that suggests, stubstantively, services should be considered basic to those that promote healthy future generations, and conversely, services should not be considered basic to those who are prevented from being or becoming full participating citizens, such as those with dementia. But he goes on to state that this overlap "points to a way of introducing the good back into medical ethics and devising a principled way of distinguising basic from discretionary health care services", seemingly endorsing that consensus, despite his statements distancing himself from it by pointing out that he was speaking in the third person of philosophical trends. He also stated that "this overlap inspires hope for making progress on the just allocation of health care resources." All of this proceeds from the government's desire, and failure, so far, to enact universal health coverage and the percentage of GNP spent on healthcare, and part of that is due to a "failure to provide a philosophically defensible and practical mechanism to distinguish basic from discretionary health care services", which I think he attempts to lay out in his article by citing the consenus view, in which he seems to find hope for progress in that direction. |
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Grinch Member Elite
since 2005-12-31
Posts 2929Whoville |
Are you talking about the same article I'm talking about Denise? I have to ask because your explanation of its contents seems so far from the actual content it's unrecognisable. Here's the original article in full: http://www.ncpa.org/pdfs/Where_Civic_Republicanism_and_Deliberative_Democracy_Meet.pdf How do you get from what it says to what you say it says? . |
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Denise
Moderator
Member Seraphic
since 1999-08-22
Posts 22648 |
Yes, Grinch, I did read the entire article several times. That's how it reads to me. |
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threadbear Senior Member
since 2008-07-10
Posts 817Indy |
In the same vein, check out this nutball politican's goat-mouth: "http://www.politico.com/blogs/glennthrush/1009/Skeltons_stick_it_up_your_a_moment.html" House Armed Services Chairman Ike Skelton (D-Mo.) comments to Rep. Todd Akin. |
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Denise
Moderator
Member Seraphic
since 1999-08-22
Posts 22648 |
Revealing Video: http://www.youtube.com/watch?v=IT7Y0TOBuG4 |
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Grinch Member Elite
since 2005-12-31
Posts 2929Whoville |
A little more revealing if you listen to the whole thing Denise instead of taking a tiny portion out of context. http://webcast.berkeley.edu/stream.php?type=download&webcastid=20057 . |
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Denise
Moderator
Member Seraphic
since 1999-08-22
Posts 22648 |
Can you give me the gist of the context, Grinch? My computer gave me a message that I don't have the software to handle the download. |
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Denise
Moderator
Member Seraphic
since 1999-08-22
Posts 22648 |
In a 2007 speech at the University of California at Berkeley, Reich began his address by saying he was going to deliver a refreshingly honest talk about health care from the vantage point of an insider who would never run for president. “In other words, this is what the truth is," he said. Reich admitted: "If you're very old, we're not going to give you all that technology and all those drugs for the last couple of years of your life. It’s too expensive...so we're going to let you die." “Also, I'm going to use the bargaining leverage of the federal government … to force drug companies and insurance companies and medical suppliers to reduce their costs," he admitted. "What that means, less innovation and that means less new products and less new drugs on the market which means you are probably not going to live much longer than your parents.” http://www.lifenews.com/bio2982.html How does the context change the meaning of what he said here? |
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Denise
Moderator
Member Seraphic
since 1999-08-22
Posts 22648 |
Can't you give me some help here, Grinch? I would really like to know how the 'context' would help mitigate his 'truth' telling. Please show me that those in power have a bit more regard for the life, and the quality of life, of its citizens than the regard they have for the 'bottom line' that this statement seems to indicate. |
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Grinch Member Elite
since 2005-12-31
Posts 2929Whoville |
quote: Certainly. http://uk.real.com/realplayer/ . |
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Denise
Moderator
Member Seraphic
since 1999-08-22
Posts 22648 |
Is this different than the standard RealPlayer (which I have)? My computer isn't the latest and greatest and I don't want to risk crashing it because I can't afford a new one right now. |
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Grinch Member Elite
since 2005-12-31
Posts 2929Whoville |
I don't blame you for being reluctant to load the software Denise, puters can be temperamental at the best of times and if they're working it's best to leave them that way. I can give you a brief synopsis of the recording - it'll take me a while though - Mrs Grinch has a new list of chores I need to address first. |
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Denise
Moderator
Member Seraphic
since 1999-08-22
Posts 22648 |
Thanks, Grinch, I appreciate it. And your 'honey-do' list reminded me of this funny video: http://www.youtube.com/watch?v=vcPMKD8GFkI We can all use a good laugh from time to time! |
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