ERs in the US are required to provide stabilizing care to patients who come in, even if the patient can't pay, by law. It's a law because otherwise some of them wouldn't.
I hope that was a joke
They protected the neighbouring property.
Did you miss that part where US Americans ration their insulin and die or collect money for life saving surgeries via gofundme?
This mandate makes sense from a moral point of view, especially for true emergency situations. However, the act didn't take care of the cost of care, which was placed on hospitals and ultimately passed on to other patients and the government. Obamacare attempted to address this issue.
EMTALA also distorted US healthcare be redirecting poorer people to expensive emergency care rather than preventive or primary care, which might well serve many of their needs better. That's also something that Obamacare was designed to fix.
$80 billion of 3.4 trillion. A rounding error.
It's one thing to declare something too dangerous and work on containment, but what's being described here isn't that.
Reinstating the penalty is going to cost political goodwill, which is why the Dems aren't doing it.
Regardless of whether the penalty is or is not in place, I wouldn't recommend being poor and sick, regardless of whether you are insured, or are freeloading.
Additionally, the whole point of these cases was not simply to get rid of the penalty. The idea was to get rid of the penalty so they could go back to the supreme court and again claim that the mandate is unconstitutional because now there is no "tax" associated with it.
I don't know where things are at now, but it seems unlikely to go anywhere now because it would be difficult to argue that buying insurance is required at all at this point. So we are left with the backup gop strategy of hoping that disarming the mandate will simply bankrupt the program. At least until republican voters wake up and realize that the program is miles better than what we had before.
The court case as a whole argued that because the GOP changed the ACA in a manner that made part of it (the $0 fee) illegal, the entirety of the ACA should be made illegal.
The fifth circuit agreed with some of the arguments in the case (the fee one), but did not practically change anything about the ACA.
And then SCOTUS, surprising ~everyone, ruled that actually the whole of the ACA is constitutional.
Look at this timeline, and you tell me - who spent years trying to re-introduce the free rider problem, and to break the ACA? Congress, the president, and the plaintiff states... or the fifth circuit, which ruled that a $0 fee (whatever that is) isn't a tax?
Now, as of 2022, we are in a world where the ACA has been thoroughly litigated, and is still here, with the free rider problem hanging like a millstone over its neck.
It should have never been a tax specifically because it's an unconstitutional act. Calling it a tax is the letter vs the spirit of the constitution.
If you and others like yourself want to ensure everyone has health insurance then __make it mandatory for the state to pay for it__. Anything else and you're just taxing the poor for being poor.
That is an interesting opinion, but at this point, both a conservative, and then a super-conservative, packed-with-federalist-society SCOTUS has disagreed with you twice on this issue (5-4) and then (7-2). It's about as written-in-stone as you can get in the United States.
The courts think this is above-board, the executive thinks this is above-board, most of the public thinks its above-board, it's safe to say its above-board.
lets not use that as justification, shall we?
carrying private service X is required for you to exist in the united states. If you don't pay for X, you get fined Y as a punishment.
yep, I'm sure the powers-that-be considering that above-board should be the only justification we need!
It was also perfectly constitutional, hence the need for that 13th amendment.
You're going to need a better complaint than 'it's unconstitutional', as this is pretty verifiably constitutional. The people who have been empowered[1] by the founding fathers to determine what is, and what is not constitutional have determined that this is constitutional. It's not a matter of opinion at this point.
> carrying private service X is required for you to exist in the united states.
And that's nothing new. Government can compel all sorts of things from you. Showing up to contribute your labour to a jury duty. Involuntary servitude in the military. Taxing the land you live on. Every society - even this society - provides you with privileges, and requires obligations from you.
This obligation has been ruled to be well within the legal framework of this society, and if you don't like it, you should look into passing a constitutional amendment on the subject.
[1] Actually, SCOTUS' powers in this sphere are what's unconstitutional, but we all pretend that they are.
the question is whether or not the government can force you to pay for a __PRIVATE__ service just for __EXISTING__ within the borders of the US.
There is __NO PRECEDENT__ for this. The closest you can get are things like car insurance where you're required to carry insurance in order to drive on US roads. You can choose not to drive, you cannot choose to "not exist".
That puts this into an entirely different category. The fact that it originally got rationalized as a tax opens a whole different can of worms. Good luck refusing to pay taxes.
It also pales in comparison to the burden and costs of existing system in the US.
If your point is just that the US healthcare system is far more-broken than most, and in some unique ways, all for no good reason—sure, yeah, of course that's true.
For deaths, there's maybe 300 accidental deaths, 10,000 - 15,000 homicides, and like 60,000 suicides. Non-death injuries scale similarly, with the caveat that like 6,000 ish people per year try to kill themselves with a gun and fail, but still injure themselves.
Reading the article, that's not true.
They watered down the fence line to protect someone else's land.
> Firefighters did eventually show up, but only to fight the fire on the neighboring property, whose owner had paid the fee.
> "They put water out on the fence line out here. They never said nothing to me. Never acknowledged. They stood out here and watched it burn," Cranick said.
So to your examples...
> They will save your life. They won't treat your trick knee, erectile dysfunction, or failing vision.
It would be closer to the story if it was "they won't save you, but they'll spray down everyone else with a disinfectant to protect them from your disease."
I thought in the US, hospitals were only required to stabilize, not treat, non-paying patients. For example, if someone has cancer, they are not required to perform surgery or chemotherapy, just stabilize their symptoms at the moment.
So will firefighters. They'll save your life to the best of their ability, no matter any contracts, payments, taxes, etc.
Saving your house is another matter.
We’ll always risk to reward. But more and more the phase after life saving is trending toward “surround and drown” - not that I want to fight like detroit in the 2010’s, but yes we do make a call sometimes to stop risking when lives are all confirmed safe.
Did capitalism hit America so hard that they kicked them back to the Roman Era (yes, I'm referring to Crassus here)?
The United States is enormous and many parts of it are incredibly sparsely populated. For example, Niobrara County in Wyoming has a population of 2,467 and an area of 6,810 km^2, or a population density of 0.36/km^2.
For comparison, the Northern Borders province, the least dense province in Saudi Arabia, has as population density of 3.4/km^2, almost ten times more people per square kilometer.
People outside of the US really have no idea how empty much of the country is. I think there's an assumption that just because much of the land is livable (i.e. not desert, bare rock, etc.), it must occupied. But that's simply not the case here.
I am not judging the way things work in the US, just commenting that I don't think that population density is relevant here as the issue is one of right.
Now, of course, if you live 100 miles from the nearest town it may well take hours for the police or firefighters to show up when you call them. That's another issue.
As a side note, in this very case the issue wasn't remoteness since they could have had access to firefighters for a small annual fee. Rather it was a legal and administrative issue. But I would indeed be curious if voluntarily paying a fee rather then being taxed can have an impact on any enforceable expectation of service.
It is absolutely relevant because services can only be logistically and economically viable at certain levels of density. Fire services aren't very useful if it takes them a two-hour drive to reach the fire. So they have a maximum radius where they are useful. They only provide value to the people within that radius. If the density is too low, then there aren't enough people in there to afford supporting fire services.
You're not addressing my point, either, which is that there is a big difference between getting a crap service because you're hard to reach (which does happen including here in Europe) and having no right to call for help in the first place.
Again, I am not criticising, I am just thinking that there are different, separate issues here.
They inherently are. If these neighborhoods have fire coverage equivalent to that of a metropolis, but they would be paid for via taxation at the rate of $50K per year per household, that's not economically viable.
So in general people who live is more isolated houses end up being effectively subsidised by everyone else.
In your example the 'problem' stems from a tax base that is too narrow because of administrative and political choices.
In any case, that is NOT the point of my previous comments.
That being said, the locality in question sounds very much like the low density suburban locale that I'm currently living in. It costs a pretty penny for the government to maintain services here, since there are only about 100 homes in an area at the edge of the desert (which at a rate of 75 per home per month as stated in the article wouldn't be able to cover a basic firefighting service). Of course, that does not bother the government in providing funds for everything from a local police station, hospital (yes, not a clinic), fire station, municipality, garbage collection, etc. The only thing missing (for the local Arabs mostly) is a government school, but then folks with families don't bother with it.
I could draw a similar example of my place in India, which has similar low density characteristics, and to make matters worse, is located in a hilly part of the district, but that doesn't stop the govt. from providing a local police force and fire fighting service complete with a helicopter.
Some amenities are basic needs that if you don't receive, then what the hell are you paying taxes for? Freedoms per second?
And no, I'm not a stranger to America's vast landscape. The fact stands that there should have been better zoning - or don't expect any facility at all, but don't make news out of it.
On a side note, the main link of this thread quotes the example of insurance companies in London in the 1830s, who would compensate each other in case their firefighters took action on fires not in their jurisdiction. If our forebears had such sensible foresight and collective responsibility, then why not America today?
Or you could just let people live where they want to live and make sure they are aware of and agree to the consequences of that choice, which it sounds like they were in this case.
> If our forebears had such sensible foresight and collective responsibility, then why not America today?
Seems like you're generalizing an awful lot from one random news article that is news largely by virtue of the fact that what it describes is unusual.
Neighbourhood is the operative word here. In some parts of the rural United States, homes are far away and far between. Public services of the kind expected in populated areas are impractical, particularly for protection of property rather than life.
With that as a baseline, some "rural" areas maintain this peculiar, low-cost characteristic even as they become more populated. There's a degree of self-sorting behaviour as well, since some residents become attracted to the area specifically for its vanishingly small local tax burden.
“Unincorporated land” means that the landowners have chosen not to incorporate (create) a municipal (ie city/neighborhood) government.
It’s “rugged individualism”.
Virginia is also technically a Commonwealth and not a state as well.
In fact Hospitals were not required to treat you until 1986, which was part of the COBRA act.
Prior to that there was a large practice of "Patient Dumping" where a hospital would kick you out if they found out they you couldn't pay for your treatment. Hospitals in the US would literally let you die out side the ER doors.
https://en.wikipedia.org/wiki/Emergency_Medical_Treatment_an...
The same logic could apply to police... what if all the crime is coming from an unincorporated part of town? Do you just go and start policing it (kind of like an invading army occupying)? Or do you erect borders / station patrol cars near key locations?
They will save you from an acute emergency, stabilize you, then dump you into a care home with inadequate care or to the street as appropriate, where you play the long game of succumbing to whatever ails you.
The FD had tried for years to find a workable solution and failed because the people in the unincorporated part of the county just didn't want to pay for fire services. IIRC, the county had tried three times in the previous decade to pass taxes to either fund the municipal FD or set up their own; three times the residents of the unincorporated part voted against it. The FD had tried retroactively charging owners, and spent more on collections than they'd earn.
If you don't pay, you'd have the lowest priority. But there is no reason other than bureaucracy that they couldn't have handled it.
> South Fulton's mayor said that the fire department can't let homeowners pay the fee on the spot, because the only people who would pay would be those whose homes are on fire.
Though I am fully in support of just letting the house burn.
And it doesn't have to be guaranteed if it works 90% of the time.
The second part is more significant in people simply don't have the money to pay.
[1] https://stories.opengov.com/somervillema/published/BhSqQ0eG2
Or there would simply be no fire service at all because the rural area isn't profitable to service.
Even then, there's still the value of the land.
Or do you have any evidence they actively opted out of the $75 payment?
I discussed the case a lot at the time it happened, and it never came out that he "forgot" to pay the fee. It was very clear at the time that he thought he didn't need to and they'd put out the fire anyway.
1) Insured by another company. The sensible course of action is to fight the fire and bill them. Every company benefits from such cooperation.
2) Uninsured. The moral hazard problem, if too many people are not paying the only sensible approach is to let uninsured buildings burn.
At any rate, in response to the story, the county changed it so paying when your house was already ablaze was a punitive but not impossible option. I believe it was $3,500 when they instituted it.
Which, frankly, seems like the proper way to handle the moral hazard.
How do you deal with freeloaders in society?
Meanwhile, governments have excellent was of collecting on low-four figure debts secured by real estate.
This whole "unincorporated land" execuse is a sad state of affairs. The whole "You're not with us, so it's not our problem" mindset is really why America is so low down on every single ranking in the world, except for military might. It seems like a constant battle to make sure you're doing ok at the expense of others. School kids getting shot? It's ok, I can still have my gun. Unarmed people getting shot by police? It's ok, they haven't shot me. Corrupt police officer hired a town over? It's ok, he's their problem now. People dying because they can't afford to visit a doctor? That's ok, I can.
Instead of grouping together the US has decided to constantly separate it self among itself. Other countries have orginisations that deal with entire areas. The US each town has to have it's own. It results in a lower quality of service. Not every town can afford x,y,z fire equipment that is only going to be used once a month but an biradge that deals with 10 towns and would be using it two times a week can.
The thing is, the solution to most of the US' problems aren't hard. They're already figured out by everyone else. We all just have to put up with hearing about the craziness that comes from the country that thinks it's great while their ass is on fire.
But in the rest of the world, we act like grown ups and accept that sometimes, it's perfectly okay.
And acting like a grownup also means letting people take the consequences of their decisions. According to other posters in this thread, the family in question repeatedly refused to pay a fair price for firefighting coverage, and the fire was started by a family member. That means the consequences are on them.
If you truly believe this, your perspective have been warped by the culture you are immersed in.
It sounds like you don’t find value in living in a society.
Try living in a different culture than USA for 6 months to a year and I suspect your eyes will be opened.
I value living a society where cooperation is voluntary. Involuntary cooperation is indistinguishable from a degree of slavery.
Point being that liberty itself is a value that it is reasonable to optimize over negative utilitarianism.
Willfully becoming a homeless drifter is in fact hurtful to society :)
Nor does charity for those in genuine need need to be provided by governments. Indeed, charity throughout human history has worked best when it is provided by private institutions made up of people who genuinely want to help others, of which there are plenty in the US as there are everywhere, not by government departments staffed by bureaucrats.
There's a very childish culture in America where people react to the idea of cooperation by stomping their feet and crying "You're not the boss of me! You can't tell me what to do!". It makes it very hard to work together to improve things.
It's also a very selfish culture where people aren't just indifferent to the terrible things that happen to other people, they convince themselves that those people deserved terrible things to happen to them. It's as if they think that everyone looking out only for themselves will cause only the "best" people to succeed and therefore everyone else can and should be ignored. It is childishness and it really hurts us as a nation.
Also, allowing people to suffer bad consequences from their own choices does not mean being indifferent. It just means refusing to adopt a "cure" that is worse than the disease.
Adults also know that collective agreements to provide the means to help those who are in trouble through no fault of their own are called "charity", and are best done by private institutions made up of people who genuinely want to help others (and there are plenty of those in the US just as there are everywhere), not government departments staffed by bureaucrats.
While your other arguments are subjective, this one is just plain factually wrong. It will always be far less efficient to depend on a few individuals to shoulder large expenses or for disparate organizations (each with their own overhead expenses) to find and collect smaller contributions than it is for everyone to pay just a small amount and collectively cover an expense through a single origination.
In addition to the massive inefficiencies of charity, and the fact that many charities are really little more than scams, there are still several other problems with them. See for example:
https://www.bbc.co.uk/ethics/charity/against_1.shtml
https://harvardpolitics.com/charity-band-aid/
Some of these problems are even seen by some people as benefits. For example, federal or state aid to victims of a natural disaster would go to help everyone impacted, but a charity to help them can allow someone to only support certain people while discriminating against others. Some people actually find it extremely preferable to restrict all their charitable giving to only people with a certain religion, or skin color, or political opinion, but the freedom that gives a person to be an asshole to "the wrong kind of people" is still a massive problem when your goal is to help everyone impacted.
Charity is great, when it's not a total scam, and it's equitable, and the origination is lucky enough to find enough people willing to take the time to research them and give them enough donations to accomplish what needs to be done, but it's still no substitute for government programs.
On the assumption that the single organization will actually do the job, perhaps. But it won't. Ask anyone who has actual experience with such government organizations, as, for example, my wife and I have (she far more than me--she was a social worker for 20 years). They don't actually help the people they're supposed to help.
So your claim is factually wrong, not mine. I did not claim that private charities are perfect. I only claimed that charity is best done by private institutions, i.e., that on net they do better than government programs.
I also have family who worked in social services and they always wished they could do more to help people, but too many of the people around them were preventing that. Too many people voted against plans to increase funding and refused to hold officials responsible perhaps because of the letter next to that official's name, or because they didn't want to help "the wrong kinds of people" at all, or because they thought as you do that charity is enough to fix everything. If charities were the answer they'd have already stepped in to fill all the gaps left over after the government has done what it can, but of course they haven't.
This is the main weakness of government programs. They depend on people working together and holding their elected officials accountable. People vote against government programs, and refuse to hold anyone accountable, and then complain when the programs don't solve their problems and use that as evidence that the whole system can't work, but it's still clearly the most efficient way to solve many problems, and often the only way some people are currently getting any help at all. Improving it just requires us to put in the effort.
No, it's the weakness of government solutions. If I want to help people, I can start a private charity and go help people. If I want to government to help people, I have to get a majority of the country to vote for politicians that will make that happen--assuming there even are any.
> You and those around you come together to vote on what needs to be done, how it should be done, and who is responsible for overseeing that.
If you believe people should be helped, you can go help them. If you and a bunch of your friends all believe that, so much the better: you can get together to help more people. This is how helping is supposed to work, and how it has worked all through human history when it has actually worked at all.
If you want the government to force everybody to pay for helping people, you are imposing your value judgments on them. That's not how freedom is supposed to work. It's also lazy on your part: you say you want to help people, but instead of actually doing the work of helping--figuring out the individual needs of individuals who need help, deciding whether they deserve to be helped, and then doing what is needed to help them--you're punting it to a government bureaucracy. Which, as I have already said, won't actually do it anyway. And it's no answer to that to say that, if only people would just vote the right way, governments would magically change. That utopian vision has never worked.
> Improving it just requires us to put in the effort.
Your efforts would be much better directed at helping people yourself, than trying to use government force to do it.
I could, but how is that better? If there's a natural disaster on the other side of the country and I can see that people need help should I immediately pack up my car with water bottles, food, and blankets and drive for three or four days to "go help them?"
I have responsibilities here too. I have a job and a family who need me here. Should I just leave them at a moment's notice? And not just me, you want everyone to do this? Have thousands of people drop everything they are responsible for to drive however many days/hours it takes to "go help"? Getting to the people who need the help in a timely manner would be hard enough, but imagine the roads being blocked by all the traffic at a time when emergency responders are trying to work. Clearly my efforts are not better directed at helping people myself.
It's stupidly inefficient for everyone to respond to people in need by going to help them. It's sure as hell not how it's "supposed to work" and that's why we've set up the response systems that we have. We need to depend on others to do the helping so that we can contribute to their efforts while still living our lives and without wasting massive amounts of time and resources causing new problems.
Because we're stuck depending on others to help collect needed supplies and funding, coordinate with local emergency response teams, and disseminate whatever aid is needed the fewer organizations we task with doing all that the better and more efficiently it all works.
> than trying to use government force to do it.
"The government" isn't forcing anyone to help people. It's your neighbors, my neighbors, and everyone around and between us choosing to help others. We decided we want state and federal aid for people who need it. It wasn't even a decision we made one time, we continuously decide that it's the best way to handle aid. If we ever change our minds and decide that everyone packing up their cars and rushing in to personally deliver assistance is preferable we can vote to stop it. No one is forcing us, it was our choice. You might not agree with it, but that's just life in a democracy. Collectively we may choose things you don't personally care for, and thank goodness because it sounds like you haven't really thought through your "Everyone go help whoever they think needs it directly" strategy at all.
By "go help them" I did not mean literally drop what you're doing at any moment. I meant, set up private means to help people, funded by volutary contributions. That would entail some people actually physically going to help, but not everyone involved. A private institution could take all of the measures you describe as being more efficient. Indeed, historically private institutions have done so. The monopolization of "helping people" by governments, on the theory (mistaken--see below) that governments can do it more efficiently, is a fairly recent development.
> "The government" isn't forcing anyone to help people.
Yes, it is. No one has the option of not paying their taxes because they don't agree with what the government is doing with the money. Try that and you will go to jail. That's force. All government laws and policies are backed up by force and the threat of force.
> It's your neighbors, my neighbors, and everyone around and between us choosing to help others.
No, it isn't. What that would look like is not passing laws. What it would look like is you, your neighbors, and everyone else who agreed with you forming a private institution to help others, funded by voluntary contributions.
> You might not agree with it, but that's just life in a democracy.
In other words, you agree that democracy forces some people to pay for things they do not support. Thank you. But you realize, of course, that you are contradicting your earlier statement that the government isn't forcing anyone to help people.
> it sounds like you haven't really thought through your "Everyone go help whoever they think needs it directly" strategy at all.
On the contrary, you are the one who hasn't thought through your position, because, aside from contradicting yourself (see above), you are helping yourself to the extremely implausible (I could say "demonstrably false", but I'll go easy on you for now) claims that (1) democratic processes as they actually exist in our country and others actually do a good job of giving all viewpoints a fair hearing and deciding questions on the merits and not on irrelevant grounds of political expediency or cronyism or... (I could go on and on), and (2) that the government programs that result from these democratic processes actually do what they are ostensibly created to do, and (3) that they do it more efficiently (i.e., with more actual good done per dollar contributed by the people) that private charitable institutions would.
It's precisely because I have thought through these things, and have seen, through both first-hand experience and through looking at the overall performance of government programs in general, that all three of the above claims are false, that I have come to the views I have been expressing.
Except when it's about treating everyone like terrorists in airports, I presume.
This isn't a thing in the US. Hospitals will stabilize anyone, regardless of ability to pay. First responders- police, ambulance, fire fighters- will save any life they are able to. Preventative health care is a different story, and even that is complicated.
Unincorporated land holds a very tiny percentage of the population of the US; trying to use this as an analogy for the rest of society is just disingenuous.
> Other countries have orginisations that deal with entire areas.
So does the US. Even unincorporated land falls under the jurisdiction of whatever county it happens to be in as well as the state and federal governments; the only difference is it doesn't have a local town government... because there is no local town.
The US has preventable death rate in the developed world. People die because they don't get to see a doctor. First responders will save you. However, the amount of deaths because people couldn't pay is massive for a so-called developed country. Have diabetes and no insurance? That's pretty much a death sentence and they'll watch you die. Need surgery? No insurance? No surgery and death because of complications caused by the lack of surgery.
> Unincorporated land holds a very tiny percentage of the population of the US; trying to use this as an analogy for the rest of society is just disingenuous.
As used with the multiple other examples, it's an entire culture. Not just "Oh unincorporated land, that's just crazy". It's disingenuous to act like my point is hinged on unincorporated land.
> So does the US. Even unincorporated land falls under the jurisdiction of whatever county it happens to be in as well as the state and federal governments; the only difference is it doesn't have a local town government... because there is no local town.
There are state troopers who have jurisction over certaint things. However, there is then an array of other law enforcement agencies such as towns having a police department and sheriff departments which have jurisictions over certain things. They don't have a simple police force that deals with everything in that area. This results in crimes not being truly investigated because no one is sure whose job it is.
There is no regional fire department as shown in the linked news article. The fire department that was paid by a neighbour to ensure they didn't get fire damage ignored a fire nearby because they weren't paid by someone else. The ignoring of that fire resulted in fire damage to the paying customer. A regional fire department would have dealt with that.
They also have by far the highest obesity rate in the developed world.
> Have diabetes and no insurance? That's pretty much a death sentence and they'll watch you die. Need surgery? No insurance? No surgery and death because of complications caused by the lack of surgery.
I'm supportive of universal healthcare, but this is a huge exaggeration. If policy decisions are motivated by uninformed memes like this, then if we ever do get universal healthcare, it will be a disaster.
You can buy human insulin for $25 a vial at Walmart. It's not as good, but it's what people used a couple decades ago. Countries with nationalized healthcare often have long backlogs for treatments. The cancer backlog in the UK is over 2 million people and it's continuing to grow [1]. Also, if you are insured, you're typically going to get new and more sophisticated treatments on the US compared to most places with nationalized healthcare.
[1] https://news.cancerresearchuk.org/2020/06/01/over-2-million-...
>> They also have by far the highest obesity rate in the developed world.
So... I am sure that is one reason of the highest preventable death rate. doesn't invalidate GP point.
> I'm supportive of universal healthcare, but this is a huge exaggeration.
Sadly in a way its not an exaggeration at all, will doctors and nurses literally watch you die of course not. If you go into the ER they legally have to stabilize you. But that's it. If I have cancer and and really sick, If they take to me to the ER, they will stabilize me but they want start treating the cancer. Even if its still early, they will watch you die over time as the cancer advances and makes you worse.
To be fair, I am certain the doctors and nurses want to treat you. But the hospital won't/can't allow it for bullshit reasons.
> You can buy human insulin for $25 a vial at Walmart. It's not as good, but it's what people used a couple decades ago.
I can't believe your defending poor people having to use worse insulin. How is that okay for you? We are talking about peoples lives, can the richest country on earth aim a little higher then throwing decades old medical knowledge at poor people to shut them up?
> I'm supportive of universal healthcare,
No you aren't, after that claim about supporting it, you spend the rest of your post shooting down universal healthcare.
> Countries with nationalized healthcare often have long backlogs for treatments. The cancer backlog in the UK is over 2 million people and it's continuing to grow [1].
> Also, if you are insured, you're typically going to get new and more sophisticated treatments on the US compared to most places with nationalized healthcare.
The UK has its issue, but from what I can see its because they are purposely starving it of money so they can ultimately privatize it.
America's health care is fucking garbage. There is no defending it, I'm so tired of spending my time calling several different companies to figure out why I am getting billed for something I shouldn't be. I'm not exaggerating either, literally one or twice a month I get the joy of calling my insurance and whatever doctor sent the bill and try and solve why my insurance won't cover it.
https://www.theguardian.com/world/2003/may/23/aids.suzannego...
https://en.wikipedia.org/wiki/Peanut_Corporation_of_America#...
Oh boy, Wells Fargo is so shitty, most of their page is about their various scandals.
https://en.wikipedia.org/wiki/Wells_Fargo#Lawsuits,_fines_an...
While not all are directly related to healthcare or the FDA, I present this 3 articles as evidence that corporations don't give a shit about you and unless they are kept in check they will happily sell you a faulty or bad product to help their bottom line.
I can produce many many more articles of various scandals if you want. There is plenty of them. Reducing regulation does nothing, but help corporations provide even worse health care to people.
Healthcare should not nor ever be for profit. Its an inelastic good, the so called "free market" doesn't even apply to it.
Bullshit reasons like they don't want to go bankrupt and not be able to serve anyone at all?
I got news for you its going to happen regardless, turns out trying to extract as much profit from healthcare as possible is a terrible idea.
Hospitals closing down
https://www.vox.com/policy-and-politics/2022/11/28/23424682/...
https://www.clarionledger.com/story/news/2022/11/22/rural-ho...
Or they can't afford to be staffed fully
https://arstechnica.com/science/2022/11/us-hospitals-are-so-...
For profit health care is a scam and the US healthcare system is failing rapidly. And its only getting worse.
This isn't true. Healthcare spending has grown every year and has never significantly fallen relative to GDP. https://www.ons.gov.uk/peoplepopulationandcommunity/healthan...
> America's health care is fucking garbage.
I agree, but it's not for a lack of spending. The US government actually spends more per capita on healthcare than the UK in total. I'm not opposed to universal healthcare. I'm opposed to politicians throwing money at a problem to buy votes, but that is the only thing that can result from a universal policy that results from healthcare at all costs rhetoric.
No it's not. There are reports constantly of people dying in the US because they tried to get their insulin to last them multiple days and ended up dying. Not everyone has $25. But your post that they can just buy it for $25 proves the point earlier of "They didn't pay, so they die".
The problem with these emotionally charged characterizations is that they can be used against you. Conservatives will use the rationing caused by large cancer backlog in the UK as evidence for "death panels."
The US, quite famously, generally has the highest cancer survival rates in the world. The standard bearers for cancer survival rates in Europe have traditionally been Switzerland and France, which are close to the same level as the US. A decade ago in the UK there was a public outcry when studies showed it had one of the poorest cancer survival rates in the developed world; in the well-known Lancet study, survival rates in the US were 50% higher than the UK.
The UK has improved their cancer survival rates significantly over the last decade in response to those studies but it isn't near the top tier.
In the US, everyone gets essentially the same cancer treatments, even if they are poor. The economic stratification occurs around enrollment in experimental cancer treatments, by virtue of needing to be located where experimental therapies are being tested. Experimental therapies are a big deal in the US because most state-of-the-art treatments are developed and tested there before being widely available. If you want to enroll in experimental cancer treatments outside of where they are being tested, you need to have the economic means to travel there. I personally know people on welfare in the US who survived Stage 4 cancer because they happened to live where highly effective experimental cancer therapies were being tested, making it readily available to them.
The US lives a little bit in the future for state-of-the-art cancer treatments. I know several people that survived cancer in the US thanks to experimental therapies that are now standard therapies. It usually takes a while for these to propagate to other parts of the world.
The segment of the US with most challenging cost problems are the lower-middle class. Not poor enough for the government to pay for everything while also being at risk of having little or no insurance. For people comfortably in the middle-class and up, this is much less likely to be the case.
The overall story is complicated. Demographics and health matter (not great in the US). The US medical system is profligate about speculative and preventative diagnostic tests which catch more cancers earlier (at great cost). But also early access to rapidly improving cancer treatments. It all blends together into the top-line numbers.
Where are the "reports constantly of people dying in the US because they tried to get their insulin to last them multiple days and ended up dying"? There are isolated cases where someone doesn't take care of it and dies, but it isn't widespread.
Maybe take a break from the propaganda you're reading (In Ireland, I assume?).
This is the bare minimum to avoid a PR disaster. When someone is dying slowing of a chronic condition (diabetes, heart disease, kidney disease) the US system will just watch them die unless they have insurance.
(This is, to my mind, what caused the United States to end up with socialized medicine-- albeit a socialized medicine system where we don't get to have public discourse about how it works.)
[0] https://en.wikipedia.org/wiki/Emergency_Medical_Treatment_an...
Uninsured and under-insured people are cited as one reason why treatment costs are so high. Whether these cases actually contribute to costs in a substantive way doesn't stop the mandate to provide free emergency care being used as a political football.
This is like a burger joint telling you they don't serve onion rings, and then you insisting that in fact they do, because they put circle-cut onions on their burgers, and technically those are both rings and onions. Like... OK? So what? Which framing: "this place serves onion rings", or "this place does NOT serve onion rings", is more likely to confuse a diner?
The only times I've seen people really, seriously try to frame this as "socialized medicine" is when they don't understand how very limited the mandated scope of care is. It doesn't amount to much more than "you can't let someone simply die or give birth on the curb right outside your ER". The vast majority of what counts as medical care isn't part of it.
Where I live, in a rural area of a red state with a lot of wealth disparity, giving free medical care to anybody absolutely is seen as "socialized medicine". (Of course, there'll be a healthy dose of divisive racial and class politics mixed in to the argument, too.) The reasons behind that opinion are absolutely motivated by lack of understanding, but there are strong political beliefs there as well.
I'd like to see substantive discussion about how the US healthcare "system" really works. This is a detail that a lot of people don't know about or understand. I think the idea that "we already don't let people who can't pay just die" has a good moral argument behind it.
Suburb in a red state here, grew up mostly in rural red America, so I get what you mean. I'm sure there's also a lot of thinking that free ER care is a lot more expansive than it really is, and belief that "welfare types" (ahem, cough, cough, lay-finger-along-side-of-nose) regularly use ERs to get ordinary healthcare for free. As is usually the case, I expect laying out what's actually available and how the mandate actually works tends to soften resistance to it. I'm well aware that the Left does some of this too, but god I wish right-wing media would stop misleading Republicans about how basic things like social-safety-net programs and taxes work. The death of the Fairness Doctrine, however not-entirely-comfortable I may be with the thing, has been a curse on this country, in practice.
> I'd like to see substantive discussion about how the US healthcare "system" really works. This is a detail that a lot of people don't know about or understand. I think the idea that "we already don't let people who can't pay just die" has a good moral argument behind it.
Ugh, tell me about it. I especially think the enormous proportion of medical spending that's already public isn't well-understood enough. Especially since some of those tend to cover some of the most expensive demographics—the elderly, the disabled, soldiers. Failure to grasp how our current system already works leads to those infamous "keep government out of my medicare!" protest signs and, more importantly, failure to appreciate that shifting to cover everyone with one variety or another of government-funded healthcare is actually a far less radical shift than some seem to suppose it is.
Sorry if I pounced on you there, BTW. I could have been less confrontational with that previous post.
It's good. The nerd pedant in me can't let a mention of EMTALA go by without hammering on it. It's a bit of cognitive dissonance to inflict on the "free healthcare market"-types who have moral qualms about letting people die but aren't about to give an inch on "socialism".
They will stabilize you and then kick you out to the curb quickly. And depending how they felt that day they will send you an outrageous bill.
Patients get discharged when doctors say so.
> This isn't a thing in the US. Hospitals will stabilize anyone, regardless of ability to pay.
It's weird that you think you've offered a retort here. A person who cannot afford medical treatment and experiences one or more of these emergency room visits followed by immediate discharge as soon as legally permissible is likely to die before their time, perhaps shortly after being discharged.
> First responders- police, ambulance, fire fighters- will save any life they are able to.
They do that sometimes when it suits them, but they certainly aren't legally obligated to.
It's not just a question of money, but legal arrangements. Going into a fire isn't a game--it puts the firefighters and their equipment at risk. What does the firefighters' insurance contract look like? If one of the firefighters gets hurt, is their insurance going to cover it when the fire was outside the jurisdiction of that fire department? Insofar as this illustrates a "problem" it's not a "third-world" one, but a distinctly American one. Americans are the most legalistic people in the world, and reflexively accept the consequences of the legal state of affairs. In many other contexts, that's a strength, not a weakness.
> This whole "unincorporated land" execuse is a sad state of affairs. The whole "You're not with us, so it's not our problem" mindset is really why America is so low down on every single ranking in the world, except for military might.
Even Americans aren't so tribal as to hold grudges between towns and adjacent unincorporated land. The significance of the house being on unincorporated land is that it demarcates the legal boundaries of the fire department's jurisdiction. A public body acting outside its jurisdiction can have all sorts of consequences.
Parent summarized well why people like me would never want to spend their lives or raise kids in places like US although we like visiting there, not when I can see in (some parts) of Europe how modern society should work as 1 unit, taking care and helping the weak because its simply the right fucking moral thing to do. It is in some aspects Star Trekkish utopia that actually works long term and improves lives of everybody involved.
Yes it costs money, almost nobody here has comparable US wages, but what are those numbers for when 1 serious visit to emergency can financially wipe out poorer families and good luck sending few kids to university, which are both basically no-topics here. Suddenly that million or two in the bank account seem more like necessary minimal backup rather than actually free usable money. And how many US families actually have those numbers sitting around, its rather mortgages left and right.
The amount of constant backstage stress for endless stream of regular blue and also white collar joes this removes is significant but hard to measure in easy-to-present numbers. I tend to call it one very important part of quality of life.
We can't have a functioning society if people who opt out of paying for it demand to benefit from it anyway. If people could get away with that, nobody would pay for the fire department and it wouldn't exist. By caving in this situation, the fire department would have signaled to everyone else that it's ok to not pay.
Maybe the tax that supports the fire department ought to be mandatory? Sure, that is how it works almost everywhere in the US. People who live in places where that is not the case are doing so on purpose, and they would vote against changing it.
Want to live in the middle of nowhere and depend on the government for little or nothing? Go for it, but don't complain when you want the government's help. Want to live in a city with a lot of government services? You can do that too. At least people have a choice.
We clearly can. Why can't you?
Over here, we help first, figure out who owes who later. In America, first you gotta figure out who's paying, then you get help.
In the last decade you failed to offer help to hundreds of thousands of refugees because nobody could figure out who owed who. https://en.wikipedia.org/wiki/2015_European_migrant_crisis
In the last year you failed to aid Ukraine in their war against Russia, failing to even provide weapons that you’d agreed to provide (but only agreeing after terms had been reached to make sure you got paid something). https://www.cnbc.com/2022/09/16/ukraine-slams-germany-for-fa...
In the last month you failed to provide public transportation because you couldn’t agree on wages. https://www.wantedinrome.com/news/italy-national-general-str...
And that’s just on the continent in the last 20 years. If we were to go back to say around 1945 I’m sure we could find a couple more instances of Europeans being not so helpful.
The public transit point is fair, but my understanding is that that is due to the right wing government, which is also the root problem in America.
Not helping someone until you figure out who’s paying is a way of life for Europeans.
As an ex fireman, in a so-called "3rd world" [1] country, we often got involved in fires "beyond our juristriction". Our job was to put fires out, not worry about insurance or legal liability etc. We were never reprimanded for doing so, and there was never a suggestion of anything other than gratitude.
[1] 3rd world was originally the term for non-aligned nations during the cold War. The West was the "first world" (obviously), the USSR was the second world, and the rest was the 3rd world.
Not surprisingly, since a majority of the unaligned countries were in Africa, South America and Asia, 3rd World became a perjoritive term for "undeveloped" or "backward".
If being "backward" means not having the "money rules everything" approach of the USA, then long may we remain backward.
Instead in Americans are extremely rigid about rules and norms. You never just “not worry” about “legal liability.” It’s a country where criminals can sue you if they injure themselves robbing your house. For the most part, this is a good thing. Americans will also never ask you for a bribe, like is typical in the third world country I’m from.
Medicaid is extremely stringent when it comes to income and asset thresholds for nursing homes (and in many states receiving social security can effectively disqualify you from Medicaid, even though Medicaid would be more helpful). So in many cases that public money is only applied once hospitals and nursing home facilities have plundered the estate of the soon-to-be deceased until the debt is paid or there is nothing left. Something as routine as old age will often wipe out any potential generational wealth building in all but the upper class.
I bring this up because I think this actually goes back to the original argument in the US that money does, in fact, rule everything. That's ultimately why Americans don't question their legal frameworks-- that's what guarantees the liabilities and debts and who keeps what in the end, not the other way around.
You see this all over the place. American schools will spend $50,000/year ensuring a child with dyslexia can get individualized educational support. But they won’t give free lunches to kids whose parents could technically afford them but don’t use their money wisely.
Going thru this now with my own elderly parents - I am perfectly OK with medicare ending up owning the equity left in their house, and meager other assets - to recoup money spent on their care - people should support themselves with whatever resources they have available, before taxpayers are asked to pick up the expense.
The thing is that death is a universal experience; Many, if not most of us, will end up needing some form of late-life care. Private insurance companies often won't cover what is ultimately inevitable. It would make sense for more of our public policy to aid in what is so common.
The average nursing home cost is $7k/mo. The average nursing home stay is 1-2 years. That's enough money to bankrupt most US families entirely yet comparatively little in the public budget. We spend _much_ more public money on incarceration every year.
But why shouldn't they be drained of their life savings if they move into a nursing home and need to pay for care? If they have the money - any money - that is only going to be left to their heirs, why shouldn't it be used to pay for their own care?
It is an honest question - why should I inherit money from my parents estate, and the taxpayers pickup the bill for their care? If they died today, and medicare didn't claw back from their estate, there would maybe be 200K that needs to be split 5 ways - why should my siblings and I get this 'windfall' and expect the taxpayers to fund their nursing home?
I honestly don't understand why this isn't fair.
They aren't? Cuz I'm seeing this exact thing every day on my local Nextdoor.
Do they have a public healthcare system? Nope. What sort of society doesn't look after it's own?
Do they have police who have a duty to save you? Nope. That alone is just an absolute shit show. What sort of country says the police have no obligation to protect you? Only to show up and solve the crime once it's happened? What sort of society doesn't look after it's own?
I could carry on but it's a bit pointless since those are two massive things. You need to remember, how fucked up the US is, is well documented. It's documented by your own media. And confirmed and defended by people like you.
No kind of society doesn't look after it's own. That's what a society is.
Keep in mind that what gets reported on and popularized is what sells clicks/views/etc, and is not very representative of "normal life."
It's true that services and norms vary widely across the different states, and in that sense perhaps there is not a "society" so much as "a patchwork of societies, not always working together." But I don't think it's quite the black-and-white either/or question that seems to be argued in this thread.
It comes from reading/listening/etc the responses of Americans to all the crazy shit that happens there. There are factual things that happen. They are talked about, Americans are talking about them, I listen. That is first hand experience of the American culture I talked about.
Here is the thing. The Americans I meet, you should see how embarrassed they are when you start talking about the latest American stuff you've seen. The faces of the Americans I worked with when I talked about the time the cops shoot up a stolen UPS van in the middle of the highway killing everyone including the hostage and endangered the lives of random drivers who couldn't get away. Like they know that stuff happens. And at the same time, there are Americans I've met personally and talked to frequently online who would defend that. "They stole it, they couldn't risk the lives of the police officers", etc.
When talking about culture problems, how Americans act is first hand experience.
https://en.wikipedia.org/wiki/Christchurch_mosque_shootings
Wee video here: https://www.stuff.co.nz/national/christchurch-shooting/11195...
Honestly I think our Police do a lot of good. There's some bad apples, there's complaints - but that is normal. Overall, they tend to make good judgement calls (most of the time).
To the defence of the US, sometimes their system does work: https://www.1news.co.nz/2022/11/24/us-jury-charge-police-off... honestly though, shooting a guy in a car that wasn't in immediate danger to anyone else around him (he rung the police originally because he was having a mental health crisis - in NZ you do call the cops if you can) so they shoot him with beanbag rounds, tase him then shoot him six times fatally. A bit over the top...
[caution: good-natured linguistic pedantry follows. Apologies in advance!]
As a point of interest, this usage of "bad apple" derives from the old folk wisdom: "one bad apple spoils the bunch".
Unlike quite a lot of old folk wisdom, this saying is literally true: mold growing on one apple will quickly jump to and colonise other nearby apples, and overripe apples emit a gas which causes other nearby fruit to ripen (and then overripen) much faster than normal; so it's important not to store overripe/moldy apples together with regular fruit!
Anyhow, my point is just this: "bad apples" doesn't mean that something is in the minority and therefore doesn't have much effect and can be safely ignored -- it means that something is in the minority but is likely to infect everything around it if urgent action isn't taken to separate them. If that wasn't your intended meaning, then "bad apples" was definitely the wrong metaphor to reach for. :)
Right, no disagreement from me that these things happen. And responses are varied, as you say.
What I was trying to get across was that you get a very lopsided view by concentrating on "crazy shit" and people's responses to it.
For example:
I live in the US. It's snowing where I am. It makes things beautiful. Some birds are at the feeder, and the furnace just turned on. I'm thankful for the warmth. I have some cookies to deliver to the neighbors later on (they recently gave us a loaf of their bread, which was delicious).
----
There you go, that was some real American culture (still second-hand for you, and admittedly not entirely representative). Not very interesting, but it's home. Multiply that by hundreds of millions of people, and yes, sprinkle in a handful of crazy shit too for good measure. Maybe that gets you a little bit closer to reality.
Still plenty that needs fixing, of course. And I'm glad I don't live in Mississippi (:
You may as well read "Florida man" headlines and come to conclude that all 20 million people in the state are crazed meth heads brandishing alligators as weapons at gas station clerks to rob cigarette cartons. The rare sensational shit is what gets reported, not normal mundane everyday life.
You are very poorly informed and confidently blind to your biases.
If you wouldn't mind reviewing https://news.ycombinator.com/newsguidelines.html and taking the intended spirit of the site more to heart, we'd be grateful.
As for "well documented", if you believe what the media tells you about anything, let alone the US, you are in no position to judge anyone else.
As for "confirmed and defended", since it's impossible to have a government that actually does the things you claim, of course I can "confirm" that the US doesn't. And of course I'll defend freedom, particularly when that means explaining what freedom actually means to people who don't understand it.
They show video footage... Jesus christ, you've bought into the Trump propaganda of fake news so much you're just saying believing the media is foolish. This whole the media is lying wasn't such a thing before Trump.
Video footage can tell you that some small group of people did some particular things at some particular time and place.
Video footage cannot tell you what isn't on the video. Which is the vast majority of what the vast majority of actual Americans do with their time every day. Which does not look at all like your media-inspired, uniformed caricature.
> This whole the media is lying wasn't such a thing before Trump.
Excuse me? The media has always lied. The evidence for that is overwhelming for anyone who actually cares to look.
Decades ago, we had no way of knowing about the extent of lies being told to us by the media (and by our politicians, for that matter) at the time they were told to us, because we had no other sources of information. Now we do. We can spot the lies told to us by all of our so-called "trusted" sources, just as they can spot lies told to us by Trump. There are no genuinely trustworthy sources of information. I agree that sucks, but it's the fact, and trying to ignore it or sugar coat it just makes it worse.
"Don't feed egregious comments by replying; flag them instead."
Insurances (including fire service or roadside assistance) has to be payed. You cannot just opt back into it once you need it. If parent is right and they had chances to opt into fire service but decided not to, you cannot just bill them for a single instance. Otherwise they're behavior would be reward, and everyone else had incentive to do the same.
What is the rising cost of going back to being on the public system?
For those younger, it seems to be mostly about not earning a lot. Here the limits are even smaller for those already private in 2002.
What country puts that kind of positive obligation on the police? I'm not aware of any that do.
In full, she said [1]:
I think we have gone through a period when too many children and people have been given to understand ‘I have a problem, it is the Government’s job to cope with it!’ or ‘I have a problem, I will go and get a grant to cope with it!’ ‘I am homeless, the Government must house me!’ and so they are casting their problems on society and who is society? There is no such thing! There are individual men and women and there are families and no government can do anything except through people and people look to themselves first.
[It] is, I think, one of the tragedies in which many of the benefits we give, which were meant to reassure people that if they were sick or ill there was a safety net and there was help, that many of the benefits which were meant to help people who were unfortunate … [t]hat was the objective, but somehow there are some people who have been manipulating the system … when people come and say: ‘But what is the point of working? I can get as much on the dole!’
Nationalistic flamewar is not welcome here, regardless of which country you have a problem with. Please don't do this on HN again.
The reason you think this may be because your preconceptions stopped you reading what was written. This is not what happened, not what happens.
I'm really curious where you're from.
On the specific point of unincorporated land, I think you're vastly underestimating how physically large the US is.
For example, Rovaniemi seems pretty isolated from the rest of Europe, right?
It's level of isolation (both in terms of distance to the next large city and hospitability of the land in between) is similar to Las Vegas. Salt Lake City isn't too far off either. America is huge.
The US just has too much empty land to offer urban-level fire services to everyone who chooses to live in the country side. It's logistically not possible. So instead if you choose to live in the wilderness, you can also choose to pay for protection, but if you don't, then I'm not sure exactly what your expectations are.
In terms of 'whataboutism' - Europe (assuming that's where you are) sure loves shedding the responsibility for the chaos they caused in the colonies, while living in buildings paid for by/made out of materials physically stolen from those colonies.
Right. The issue isn't so much that "America lets people die because they don't pay." It's that "America gives people the freedom to live in the middle of fucking nowhere, including where a state or local government can't reasonably commit to offering reliable emergency services."
The issue is the US can't get it's shit together. And they can't get their shit together because Americans accept it. They just think "That's they're problem".
I'd encourage you to travel around America a bit. Foreigners are often shocked by how nice and helpful people are here. Americans are by far the most financially charitable people in the world [1] but can be famously neighborly in many more ways than that.
[1]: https://en.m.wikipedia.org/wiki/List_of_countries_by_charita...
What pray tell makes a legitimate charity and why did you get to decide?
https://en.wikipedia.org/wiki/South_Fulton,_Tennessee#%22Pay...
You are revealing your lack of knowledge about the American wilderness simply by stating this. The US is so vast that there are massive swaths of land that you could not get a fire truck to the scene in half a day. It is difficult to imagine such a place if you have spent your life living in a heavily urbanized European country with no actual wilderness (I've seen what Germans and French call 'wilderness' and it is actually a medium-sized park)
So is Russia, they don't have these problems. The US is vast so we can't have basic stuff.
And most of the US population is next to each other with large areas of nothing.
Really, Russia doesn't have any similar problems? You want to rethink that by any chance? because now you are making yourself sound quite ignorant.
Do you really think that metrics on quality of life in Krasnoyarsk Krai or Northwest Territories are drastically better than Wyoming?
I wont even get started on what life is like in Xinjiang.
EDIT: Also, you're saying that Australia, Canada, Russia and Brazil have good train infrastructure? And getting even more pedantic, you're a fan of the trains west of Chengdu?
https://www.chinahighlights.com/china-trains/urumqi-lanzhou-...
LOL, keep spreading that propaganda comrade!
The US is populated end to end
Like sure China has fast trains in a small area, but west of Chengdu, they don’t, so saying “China is a country nearly as large as the US with a robust train network” is a red herring.
The US is much more spread out than China or Russia, even if land areas are of similar scale.
This supports the original point that it’s hard for large countries to have robust train networks, which was the idea that was being challenged.
Did you not read the whole thread?
It is practical though. Those 21 trains a day to/from Urumqi aren't running empty; I'm sure part of the motivation was national pride (as with most megaprojects anywhere), but those high speed lines were built primarily because they're useful.
> Like sure China has fast trains in a small area, but west of Chengdu, they don’t
And yet, as per your own link and my response, train service west of Chengdu is still significantly better than in the US. The US being big and spread out is just an excuse.
You've unfortunately been posting unsubstantive and flamebait comments in other places too. Would you please stop? It's not what this site is for, and destroys what it is for, so we eventually have to ban accounts that do it.
If you wouldn't mind reviewing https://news.ycombinator.com/newsguidelines.html and taking the intended spirit of the site more to heart, we'd be grateful.
I assume insurance of any kind doesn't exist in the rest of the world, since everyone else would have long figured out that you just don't need to pay it and then reap the rewards afterwards by just claiming it then? Or would insurance companies in Europe just stand by with their big bank accounts and refuse to pay? Sad state of affairs, very third world of them.
This didn't happen. A building burned but everybody was fine. Had lives been at risk, the firefighters would have intervened. The "moral" you are taking from this story is predicated on gross misinformation.
Again, more misinformation! They did go out, and made sure the fire didn't spread off the property. If anybody had been imperiled, the firefighters would have helped. FFS, it's right in that article:
> They put water out on the fence line out here. They never said nothing to me. Never acknowledged. They stood out here and watched it burn," Cranick said.
No, they went out after the neighbour phoned up because of a fire on their property. Anyone who has fully read the article will know that. So stop your nonsense.
"Firefighters did eventually show up, but only to fight the fire on the neighboring property, whose owner had paid the fee."
Do you personally work at a company? If so, I demand you to help me fix a problem I'm having. I haven't paid you, but that shouldn't matter. What's that? You won't help me? But you helped my competitor who did establish a contract with you in which they paid you a monthly fee in exchange for a guarantee you'd help them when the needed it.
The horror. The absolute travesty. Society has failed.
The article doesn't say that does it. They say the fire department was contacted and responded that they weren't on the list. They refused to accept any payment. And only turned up when someone who was on the list called.
We have a phrase for people like you, jog on.
The claim “firefighters wouldn’t come if someone’s life was in danger from a fire” is extraordinary. The evidence “firefighters didn’t come when no one’s life was in danger from a fire” isn’t.
Come up with real evidence or quit bellyaching.
that the firefighters didn't know if anyone's live was in danger because they didn't show up.
The evidence is
that they refused to show up when called and only showed up when called by someone else. Without being prescene at the scene it is not possible for a firefigther to know if someone's life is endanger or not because the person calling isn't trained to know that.
The real evidence for the very basic claim is there.
Yeah... that's about the weakest argument I've heard this week. Firefighters don't have magical spidey senses to tell them whether someone is trapped in a burning building. They will go based on what the homeowner says -- it doesn't take special training to verify that 3 people live at your house and all of them are on the road with you watching it burn.
Fire department certainly isn't risking life and limb to comb through an actively burning building verifying it to be empty when the homeowner themselves already said it was.
>that the firefighters didn't know if anyone's live was in danger because they didn't show up.
Person: Hello, my house is on fire come save it please.
FireDepartment: Is anyone's life in danger?
Person: No.
FireDepartment: Thank you for letting me know.
That's how easy it is, same conversation would happen whether or not they were on "the list".
a.k.a. please don't feed the trolls
The claim of callous disregard for human life you're making about American firefighters is completely unsupported by evidence. The closest example you have is case where nobody was harmed. But we've already established that you don't let facts interfere with your narratives.
The person on the phone often doesn't have all the info. It often happens that fire department only discover a risk to life upon arriving where someone mentions that someone is in the house. Or that X,Y,Z is there.
Someone phoned the fire department. The fire department didn't visit because they weren't on a list. The person who was making the decision if there was a risk to life was not on scene nor trained to make that decision. Someone dies the lawsuit would be massive for that level of incomptence.
a.k.a. please don't feed the trolls
> always come down to a 50.001% majority
It's not a person-vote-majority, but some sort of aggregate. Due to the aggregation scheme it becomes even easier to manipulate/game with "key counties" and "key states". A party does not even need to convince the general population anymore, but just focus on a tiny fraction.
Please reconsider your apparent lack of appreciation for the work and risks of others. Firefighting is not "playing with toys."
If they had access to water, a standoff approach with "a water gun" would only control the fire from spreading more broadly than building and damage the structure through inundation. If the structure was salvable, then the work of a firefighter is to control combustion to extinction using tools to manage the movement of air and other gases so building materials stop burning and do not reignite. It is a close-in effort.
On the other hand no sane adult will refuse medical insurance: it's an outright suicidal behavior, unless you have a seven-digit sum in your account.
So...?
> story is America has some
> very serious third-world
> problems.
That's true, and that's true of other first-world nations, too. America has plenty of problems. However, this fire brigade isn't one of them. It they work through insurance then, if you havent paid the insurance, you shouldn't be suprised when they don't put out your fire.
I was a volunteer fire fighter for a while, and I did it because 1.) I'm kind of an idiot about danger, and 2.) I think it's important to help others.
There are many other people in the US that will go to ridiculous lengths to help others.
> Not only that, the fire department
>refused to accept money to put it out.
It that's how it's supposed to work? Your building catches fire, the F.D. rolls up, and you hand them $75 right there? Are they supposed to carry cash in case you don't have exact change? Set up a stripe account so they can take credit or debit?
And when the consequences of their actions came calling, the rest of civilization stared, agape and aghast.
Here's the question though: Should it be legal for people to opt out of these things? Can they be forced to comply? If your answer is "no sane person would opt out of fire insurance", I would agree. But sanity is in short supply in the US lately.
I would argue that it's not a question of laws in isolation, it's a question of laws perverted by brainwashed people acting against their own self-interest because they've been sold a tribal identity of exceptionalism, by America's enemies, for the purpose of weakening America, and it is working better than they possibly could have dreamed.
Your argument is based on a false premise. Nobody died. In a life/death situation, the fire fighters will do whatever is necessary to attempt to save lives, but they aren't worried about a structure that a homeowner chose not to protect.
In your country, if someone chooses not to insure a home, will the government rebuild it for free? What's the difference? I'm assuming the non-indigent case where someone can afford to pay the insurance. If someone is indigent they probably don't own a house. If it is government housing, then it of course would be rebuilt by the government.
There are plenty of problems in the US, but you have greatly exaggerated this particular issue.
Pass the guacymolo.
As an aside, “You're not with us, so it's not our problem” could better be stated as “you organized your entire life around not contributing to the collective welfare by dodging taxes in unincorporated land, then not contributing to the fire brigade.” The state should not incentivize people to engage in the worst antisocial behavior, and giving services to tax dodgers who should know better is a seriously misaligned incentive.
Perhaps life insurance companies should pay out to anyone who signs up and pays $20 from their deathbeds?
I wasn't able to find it again but there also people in Germany who lack health insurance due to an inability to pay and must rely on charity clinics. These are mostly elderly Germans who paid into a private system, foregoing the public system, and eventually lost health insurance after their earnings declined. It's just the US that has these "third world problems."
We detached this subthread from https://news.ycombinator.com/item?id=34054804.
If you're in the middle of nowhere you're probably also on unincorporated land, but the challenges of being in the middle of nowhere have nothing to do with the land being unincorporated.
People do live in some of these less-accessible part of the island, but it's outside of the department's service area. Fires in other areas are officially the responsibility of the regional fire service, like for forest fires. Our department might go on certain calls, especially life safety, but will typically keep some people and vehicles back in our own service area in case calls come in there as well.
I think the term for people outside of the district is "self-insured", because nobody else will be able to assist quickly.