Political Health Care Rationing

--by Sebastian

I realize that the UK has different ideas about free speech than the US.  So it doesn't come as a complete shock to me that someone might be jailed for a month for sending allegedly offensive pictures of aborted fetuses to hospital staff.  (I presume that katherine wouldn't be thrown in jail for sending pictures of torture victims to Gitmo) But look what else happened:

Ms. May said she received an envelope of “very upsetting and offensive literature” and became tearful when she told the Press, “It is upsetting for everyone. I believe people who work for the NHS, and particularly at Queen Elizabeth Hospital, are passionate about providing excellent care for their patients.”

Since the court case, Mr. Atkinson has been removed from the hospital’s wait list for an evaluation for hip surgery and has been banned from anything other than life-saving treatment as a punishment for his activism. A hospital spokesman said he had broken its “zero tolerance” policy by ignoring its warnings to stop. Hospital staff said they were upset and “quite disturbed’ by the images.

The hospital said, “We exercised our right to decline treatment for anything other than life-threatening conditions.”

As reported by the TimesOnline:

Mr Atkinson sounds like an unpleasant crank, and I am as much in favour of legalised abortion as he is against it. But his treatment (or the lack of it) is a scandal. This is about admitting a man to hospital, not electing him to Parliament. Even unhip old bigots need replacement hips.

Ruth May, the hospital’s chief executive, claims that the ban is justified because the “offensive” publications he mailed caused “great distress” to her and her staff and thus contravened the NHS policy of “zero tolerance”. Some may already feel that such policies make it seem as if a hospital’s priority is to protect its staff against the patients, rather than protecting patients from illness. This case goes farther, equating the posting of offensive photos with punching a nurse on the nose.

Why on earth should hospitals be distressed by pictures of the sort of operations that they carry out? An aborted late-term foetus can certainly make a grisly spectacle, and there is no point trying to sanitise abortion. But neither need anybody be intimidated by the handful of zealots who like to wave around such bloody abortion porn.

That sounds very close to government health care discrimination based on the political viewpoint of the patient.  I'm not comfortable with punishing him at all for free speech, but I'm really appalled that the hospital thinks political viewpoint discrimination regarding health care treatment is ok. 

Comments

[Gary Farber]

"Not only do i agree with the sentiment, the reference warms my little heart."

Better than the implications of "thou art god," or far worse, "her nipples went spung!"

Me, I know nozzink! Nozzink!

"I accept your apology for the intemperate nature of this response, but, yes, the root of the anti-choice/pro-choice split is misogyny/feminism."

"I accept your apology for the intemperate nature of this response, but, yes, the root of the anti-choice/pro-choice split is that anyone who views things at all differently from me is a completely evil maniac, and I will continue to stack my rhetoric to disallow any possibility of civil disagreement and legitimate differences of opinion. I shall continue to distort the words of those I disagree with to make it appear as if there's no room for different perspectives, because I am entirely right and they are entirely wrong, but they are fanatics. Thus, all shall eventually respect me and agree with me, if I just continue to do this, and I shall win, and justice and truth shall triumph via reframing and dishonesty."

[kenB]

Shorter KenB: Jesurgislac sucks and is ruining the site.

What's ruining this site is the lack of a clear statement of purpose, IMO, but that's a topic for HoCB. I just don't understand why this site interests you when you don't seem to have any desire for real discussion.

[Slartibartfast]

At least it's all in a good cause.

[socratic_me]

I thought the purpose was pretty clearly to promote and develop civil debate between those with conservative, liberal and any other type of leaning.

As an amusing sidebar, I blame W for "ruining" this site. The conservative voices here have started sounding like the liberal ones in many ways because he is just so bad in so many different ways.

[socratic_me]

Better than the implications of "thou art god," or far worse, "her nipples went spung!"

"Thou art God" has been a quote that is close to the heart as well. Then again, when I start talking God, I tend to come at it from a very "we are the children of God and ought to accept our divinty and, thus, our moral responsibilities and stop being weenies that hide behind original sin."

And while I don't recall the source for the nipples quote, I have to say I quite enjoy the implications ;-}

[Gary Farber]

"What's ruining this site is the lack of a clear statement of purpose, IMO, but that's a topic for HoCB."

Speaking strictly as my own idiosyncratic version of a lefty-liberal, the purpose is clear: a site for fair and faintly respectful dialogue between left and right.

It's failing, as I've been saying since about January, due to the lack of recruiting of new conservative/rightist/libertarian contributors who will post at least a couple of times a week, if not slightly more, so as to balance out the beloved and adored and wonderful Hilzoy (not that more posts from Katherine would be anything other than solicited, and, hey, if Edward doesn't start posting again, why not take him off the list, since he seems to have lost all interest in contributing?; much though I'd prefer he started posting again.)

There should be a 50/50 balance in posts, and perhaps in comments, not that there should be some sort of mandate or enforcement of the latter.

But absent a balance in posts, the site dies.

As I've been pointing out since January, and making practical suggests regarding, but I guess the blogowners have other priorities than fixing this.

[Gary Farber]

"And while I don't recall the source for the nipples quote"

Bad Heinlein.

[Sebastian Holsclaw]

"As I've been pointing out since January, and making practical suggests regarding, but I guess the blogowners have other priorities than fixing this."

If you have specific suggestions for people you think might be good, please email us.

[socratic_me]

It was a couple of weeks ago that I actually thought to myself, for the very first time, "Man, I sure do love hilzoy's posts, but I wish there were more balance here." It was creepy. Very very creepy.

[Prodigal]

Quoth Sebastian: Is being denied medical care considered a legitimate punishment for criminals in the UK? I suspect not.

And if he were being denied the right to get treatment from all UK hospitals, you would have a very good point. Unfortunately for your argument, that is not the case. "Delay" <> "Deny", and since the delay in question is at least partially due to his having spent a month in jail for harassing the staff of the hospital in question, my capacity for sympathy is steeply reduced. Forgive me for using the school analogy, but what's happened here is not someone being expelled from school - rather, that person has been told that they have to attend class in a different room.

Neither does your attmept to equate this with the cases of pharmacists refusing to fill prescriptions for RU-486, because in none of those cases were the women conducting a harassment campaign against the pharmacist at any time, much less prior to when they tried to get their prescriptions filled.

The continual harping on how Atkinson was wronged by facing the consequences of his own actions rings hollow. That's the same kind of "logic" that leads to abusers asking the question "Baby, why you gotta make me hurt you like that?"

From Niels: Why am I not surprised that the pro-abortion zealots on this thread refuse to see either 1) the free speech issues here, or 2) the wrongfulness of denying medical care?

Perhaps because you're so biased against their views that you are unable to see that neither of the two things you claim them to be blind to is the case here?

Freedom of speech is not the only thing protected by the First Amendment here in the US - aside from religion, there's also freedom of association. The hospital staff elected to exercise their freedom of association by not associating with Atkinson in any circumstances other than life-threatening health problems on his part.

And since there are numerous other hospitals near the one which denied Atkinson service, he is in no way being denied care. He is still completely free to obtain all forms of care from all hospitals whose staffs he did not harass.

[kenB]

Well, it probably achieves "faintly respectful" most of the time, but it's certainly not a hospitable community for conservatives, and I suspect that simply offering more conservative posts won't change that. If all we want is "faintly respectful" but with more conservative voices, why don't we all just go over to tacitus.org? Personally, I want something more than "faintly respectful"; but I dare say that some other people who comment here semi-regularly probably want less.

I guess the question that I think needs to be answered is, why does this community want more conservatives? Is it just to have more sparring partners? To lure in more people to proselytize, or to blame for re-electing Bush? Or to genuinely be open-minded to arguments from the right and try to reach a rapprochement? Or do we really only want certain types of conservative voices, ones that don't challenge our assumptions too too much (i.e. is a dislike for Bush a pre-requisite)? I don't think the community is of one mind on this.

[Jesurgislac]

kenB: I just don't understand why this site interests you when you don't seem to have any desire for real discussion.

I just don't understand how you can read this thread and think that I'm not interested in real discussion. Unless, from your point of view, "real discussion" excludes feminism by default?

[Gary Farber]

"I guess the question that I think needs to be answered is, why does this community want more conservatives?"

I can only speak for myself, but I'd like more dialogue here, and in our country, which we all love.

If you think you're up to posting well enough, I'd suggest that the blog owners give you a tryout.

I value debate, not chorus, myself. I want a competition of ideas, not a pile-on.

I want dialect to produce truth, not boring beat-downs.

[Gary Farber]

"Unless, from your point of view, "real discussion" excludes feminism by default?"

See, characterizing differing points of view this way suggests a lack of interest in debate, or at least a blindness to it.

It discards a differing point of view via your reframing of the different point of view in a blind or dishonest way.

Try to see that.

There are a lot of legitimate views about what feminism might call for. Some might even disagree with your point of view. And, yet, they might even still be feminist.

But if you pretend I'm not talking to you, you can't honestly respond. But, sure, enjoy that POV, if you prefer.

[kenB]

Jes, Gary's pretty much speaking for me, but since you addressed me, I'll just say briefly that to me, "real discussion" involves active listening as well as speaking.

Gary, I too value debate, not chorus. My point is that I don't think this opinion is necessarily shared by everyone who participates here, or at least not to the same degree, and there's no explicit official statement of that goal (nor consistent moderation to that end).

But that's too much meta-discussion for this, so I'll keep the rest of my responses confined to HoCB.

[notThat]

"But absent a balance in posts, the site dies."

Man, I don't get this. Any other site would be delighted to have hilzoy posting at it. Any other site that pretty much sucked would suddenly become essential reading if hilzoy started posting at it. If a site were just completely empty and hilzoy started up a solo blog, that would immediately be one of the ten best sites on the web.

But somehow if she becomes the last poster standing here by attrition, the site dies?

Sure, ObWi may no longer achieve some vision of left-right debate. But that vision was mostly an artefact of left-wing do-gooderism anyhow. If you want to know how the right reaches out to enage with the left, read Jeff Goldstein or Tacitus or Ann Coulter. It's baseball bats and foul-mouthed rants about traitors. (Pretty much as at the national level, it is only a few misty-eyed Democrats who have any remaining interest in "bi-partisanship". The Republican leadership has made its attitude towards bipartisanship amply clear over the last five years.)

The reason that a site with even and balanced participation from both sides is not currently a practical ideal is because the right is currently in a tail-spin. They sold out their ideals to follow a gang of crooks. Many of their ideas were bad to begin with. The level of honesty in debate on the right kept dropping and dropping until--well, I guess there's still Hugh Hewitt and Powerline, so we don't know how far it can drop.

Let's face it: there is not going to be a "responsible, honest conservative" element in this country to debate with until they perform a complete purge of the Bushes, Cheneys, Roves, and so on. Too many of them put their party above the country, and they haven't gotten out of that mind-set yet.

Meanwhile, you can have a site with occasional dishonest anti-abortion tantrums plus hilzoy, or you can have a site with just hilzoy. I prefer the second, but given hilzoy's presence I can't see why either of them would look like a dead site to anyone.

[Steve]

I think von should post more. He's a good egg.

[socratic_me]

Forgive me for using the school analogy, but what's happened here is not someone being expelled from school - rather, that person has been told that they have to attend class in a different room.

Actually, I disagree. It is exactly like being expelled from school (in a place like London). I have no doubt the students have multiple schools in a fairly small area where they could attend. One has the right to deny a student service based on criminal behavior against its staff. Merely moving the man to another classroom would be the equivalent of treating him anyway but assigning another secretary to open his mail.

"I guess the question that I think needs to be answered is, why does this community want more conservatives?"

My short answer is "what Gary said".

My long answer is that I have voted Libertarian and Democrat in the two elections I was old enough to vote in. I am considered liberal for OK, but generally think of myself as a moderate conservative (though, to be fair, I define that in a Burkeian sense which generally reads "have a healthy respect for institutions and don't change them if they aren't broke). I really don't think that we are at a loss for moderate to conservative voices in the comments section, though we do still have more liberal voices and certainly louder ones. However, I think that pro-Bush voices tend to feel isolated here, as they must be starting to feel isolated everywhere if the polls are any clue. This, I don't necessarily think is a bad thing.

What is the bad thing is the lack of a consistent positive effort by a more conservative voice to bring new stories and ideas to light in the form of posts. Comments are, by their very nature, reactionary. Even if we had a steady conservative voice in every string of comments, the fact that it is an article that caught hilzoy's more liberal eye and then is presented in her more liberal framework means that the conversation is already unbalanced. This is not necessarily a bad thing for any given post, but as a trend of all posts, it means I don't feel nearly as expanded by new ideas as I once did.

[Sebastian Holsclaw]

"But that vision was mostly an artefact of left-wing do-gooderism anyhow. If you want to know how the right reaches out to enage with the left, read Jeff Goldstein or Tacitus or Ann Coulter."

Actually it was an artifact of Moe Lane's vision at the time. And that he isn't left-wing by any stretch of the imagination I can come to.

[socratic_me]

noThat,

I think you are conflating "right/conservative" with "Republican". This is, in my view, a grave error. Pretty much every conservative I know left the Republican party in the last 5 years or so for exactly the reasons you list. If they commented here, they would still be a nice strong conservative voice.

[Prodigal]

Socratic saith: Actually, I disagree. It is exactly like being expelled from school (in a place like London).

Given the multitude of NHS hospitals within a convenient distance of Mr. Atkinson, I must continue to disagree.

I think you are conflating "right/conservative" with "Republican".

I can't think of any well-known conservatives who have a public forum that aren't doing the same thing. If the terminology being used is incorrect, then I have to argue that it's those working the hardest to propagate it who are to blame.

[Gary Farber]

"I just don't understand how you can read this thread and think that I'm not interested in real discussion. Unless, from your point of view, "real discussion" excludes feminism by default?"

Second sentence answers the first.

[Gary Farber]

In other words, someone interested in "real discussion" doesn't redefine their interlocuter as moral scum. As you do, Jes, constantly, by your retranslations of what they say.

[jayann]

It really isn't like being expelled from school. That means losing friends (perhaps; certainly not being able to see them so easily), leaving a known milieu, starting over.. . This man's being switched from one evaluation wait list to another. That happened to me (because the second hospital could see me faster); it simply involved a journey in a different direction. No loss of former daily contacts or known daily haunts or whatever... no switch from a medical team I knew, to strangers.. no loss of fellow patients... just a different journey to the appointment.

(And if the journey presents problems for Atkinson then the NHS may well have to arrange transport; not because of his circumstances but because it's part of the deal.)

[socratic_me]

Given the multitude of NHS hospitals within a convenient distance of Mr. Atkinson, I must continue to disagree.

Actually, this was rather my point. From what I recall, the UK education system, like the American education system, tends to place schools as closely as it places hospitals, if not more closely. However, jayann raises interesting social issues I hadn't considered. I was thinking only of the inconvenience of travelling and of the hassle of transferring from one to the other.

As for the conflating of words, I tend to hold very strongly to the maxim that one should read another's words in the most reasonable/benevolent way possible. Thus, when Gary or I bemoan the loss of conservatives, while also bemoaning the state of discourse on several of the threads lately, you can combine those to gather we mean something different from what those who have currently appropriated the term mean. Moreover, given that I have already defined conservatism (as I used it) to some extent already, it should be fairly easy to follow what I mean.

However, if you wish to establish that those currently in power are horribly misusing the word and intentionally using it to cover their incredibly non-conservative actions, far be it from me to disagree with you. They are bad men. Bad bad bad bad bad. With that established, I will go back to maintaining that what our political culture needs is more debate across divides and less association of party affiliation to conservatism/liberalism. This site attempts to accomplish that and, at its best, succeeds marvelously. At its worst, it gives threads like the one that started this.

NOTE: I find this complete threadjacking kind of fun. Maybe I should do it more often. This thread needed to be jacked.

[CMatt]

Gary, I must take issue with your implication that thinking someone was "excluding feminism by default" would be equivalent to thinking they're "moral scum". I might say this (as stated) excludes the middle more than Jes' comments. Does Jes think people who exclude feminism by default are "moral scum"? It's possible, though I've never seen her state that explicitly. I don't think it's necessary to mindread this either, as I can think of other reasons to draw a line in the sand at that particular point in a debate.

To me, the concept of responsible citizenship in a polity (whatever size we're discussing) involves asking what I/we would/should personally be willing to sacrifice in order to form a more perfect union with out fellow citizens. As opposed to what I/we are willing to have other people sacrifice for my benefit. Pointing out, particularly in discussing abortion, that less-affected members of that polity should consider this strikes me as, if not always called for, certainly not unreasonable. Pointed questions as to whether one's debate opponent made the first effort to consider the position of the people their policy suggestion affects can be rude (and certainly can be interpreted that way). However, if nothing I'm saying about a particular issue would lead even a generous person to conclude that I've definitely considered the position of the people who will be most affected by my policy proposal, questioning me is in order. Those questions could take the form of ad hominem attacks, but I don't think they have to. When they don't, I don't see a real problem.

Jes can be strident. Is that productive for her cause? Opinions probably vary. But as long as it is an ideological position being argued, and not the launching of ad hominem attacks, it is just vigorous debate. If neither side is persuasive to fence-sitters, well, effectiveness is a separate issue. I'd also like to note here that a discussion which is nonproductive between two people can still be informative for other readers. Dishonest argumentation (no examples, just a note that archives help limit this, for regulars) is a larger problem. But that's where we as readers have to contribute by pointing it out (accurately).

On preview: I started by responding to Gary, then wandered afield. I in no way intend the closing to remotely imply that I find Gary intellectually dishonest, in fact just the opposite. I don't see a quick and easy rewrite so I'm merely heading off possible misinterpretations here.

Why post this at all? First, socratic_me is right that the thread needs jacking at this point. Second, I read similar stridency from Jes on a different blog/thread and found it somewhat useful - because it does tie in to the citizenship belief I noted earlier. There are a lot of ways to address the people who will be most affected by policies you promote. You do have to address them, though, if you want to make an argument that'll be even slightly compelling to them.

Additionally, I'm more likely to respond when I disagree with Gary or Hilzoy because saying, "exactly!" all the time would be boring.

[Gary Farber]

CMatt should comment more.

[Bruce Baugh]

It seems to me that conservative discourse has a problem right now that liberal discourse didn't in the mid to late '90s. Clinton was never of the liberals the way Bush was/is of the conservatives - he was avowedly not tied to that particular branch of the party, so there were separate threads of argument about "is this good/bad" and "is this liberal/not". Bush and his crew tied themselves much more intimately to conservativism as an idea, or a set of semi-related ideas. So his problems in the realms of morality and competence are tangled up a lot more with those ideas - in particular, "how can someone talk such an acclaimed conservative line and apparently hoodwink basically everybody in the cause, then turn out to be such a disaster?" in a way that Clinton didn't for iberalism.

As an outsider to this, I know that it's ahrd to resist scoring points, and I know too I'm not alone in that. I realize that this doesn't make life easier for honest conservatives interested in figuring out what to do next when faced with the basically complete collapse of an administration that was supposed tob e the triumph of their cause. It's messy, ugly, and hard. It's quite possibly something best done mostly away from the rest of us - get an internal stability and then take it to the world, because neither astute informed sort of critique such as fine folks here would of course provide (right? right) nor the howler monkeys much help.

[Prodigal]

The right's increasing tendency to define "conservatism" as "agrees with the president" is a big problem in discussions of conservatism. When even John Sununu gets labeled a "liberal" because he's fallen on teh wrong end of the ideological divide from the Bush administration, it's hard to believe that the word "conservative" really means anything anymore.

But that's what the people who are being called conservatives (by themselves and others) are doing these days, so those who want to argue the case that conservatism is not automatically the same as being a Republican have their work cut out for them.

[Gary Farber]

"The right's increasing tendency to define 'conservatism' as 'agrees with the president' is a big problem in discussions of conservatism."

I think that's "decreasing tendency," given the recent tendency to redefine him as a "liberal" (!!!) as they rush away from him in droves.

[CaseyL]

The Right's attempts to redefine Bush as a "liberal" are hilarious - esp. as they're trying to pull that retcon only as Bush's flock of chickens comes home to roost and his poll numbers plummet.

I don't think the idea is getting any traction outside of the wingnut blogs, though I could be wrong since I've never listened to RW talkradio and don't watch TV news anymore. If the non-blog opinion leaders (Fox, Limbaugh et al.) try the scam, and make it stick, that would be an awe-inspiring triumph of newspeak.

[Jesurgislac]

CMatt: Does Jes think people who exclude feminism by default are "moral scum"? It's possible, though I've never seen her state that explicitly.

I really, really try very hard not to define anyone as moral scum. I may think what they believe is morally scummy, or that they have let themselves avoid the but entirely direct, obvious, and indeed already occurring lethal consequences of putting those beliefs into action, but - and this may answer kenB's intemperately posed question from yesterday - I try not to throw around words like "moral scum". (And, indeed, a quick check discovers that I have not called anyone moral scum on this thread or on any other.)

[kenB]

Jes, you're right, my first question was indeed intemperate. I see now that I'm expecting more of you than you're able to give -- I'll stop trying to change you from now on.

[Jesurgislac]

kenB: I see now that I'm expecting more of you than you're able to give -- I'll stop trying to change you from now on.

Thanks, Ken. I'd rather you didn't try to change me, and I'm certainly not capable of giving you what you want from me. I'll continue to expect more of you, even if you feel you're not able to give it - I prefer to assume people are capable of rising, rather than think they have to fall.

[Prodigal]

I really, really try very hard not to define anyone as moral scum. I may think what they believe is morally scummy, or that they have let themselves avoid the but entirely direct, obvious, and indeed already occurring lethal consequences of putting those beliefs into action, but - and this may answer kenB's intemperately posed question from yesterday - I try not to throw around words like "moral scum".

So you'll think people are moral scum, but just try not to call them that to their faces?

Because that's the impression the quote above gives, especially with how you stress how you try not to use the words. You've said nothing about not making moral judgments (and the part about people letting themseleves ignore the consequences of their ideas indicates that you are, indeed, making them), just that you try not to use a loaded term to describe the people you're judging.