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This is circling back to Hobby Lobby, but are there holes in this argument? Assumptions: 1 - Free practice of your religion is like the right to swing your fist. It ends at my nose. If your religion requires you give a non-believer a wedgie every full moon that doesn't mean you get to do this. No religious belief that involves violating the constitutional rights of *other people* is permitted constitutional protections. 2 - Medical treatments - even ones branded for a specific purpose - have off-label uses. You can't point at something and say, "Anytime this is used it is used to cause X". Viagra, for example, is also a blood pressure medication and that is in fact what it was initially developed for and sold as. The, ah, side effect, was discovered after it had been in use for awhile and they put it back through the FDA process to get it re-labeled as a boner pill. *But that doesn't mean that it isn't effective blood pressure medication or that it can't be used for that purpose*. 3 - Even on-label uses of items that are in theory proscribed can have situational applications where they are clearly the best moral/ethical options. It is medically dangerous, for example, for a new mother to get pregnant again too quickly. Say your middle manager's wife just delivered their firstborn after a touch and go pregnancy that had some scary complications. 2+ years of birth spacing is advised for her to recover her health. 9-12 months of breast feeding is also advised. Taking hormone treatments while breast feeding is not advised. It gets in the milk and thus into the baby. A copper IUD* doesn't put nasty hormones in babby's breast milk. Insisting your employee's wife be put on hormonal BC over the copper IUD is thus doing actual harm to an actual baby in the name of preventing imaginary harm to a potential fertilized egg. Per point number 1, you don't get a constitutional right to taint a child's milk in the name of your God. 4 - I as an individual have a right to doctor-patient confidentiality as well as general privacy that my employer may not breech. I may volunteer information if I choose but my employer has no right to this information. Self-insurance on the employers part does not entitle them to this information either. They are the insurer, not the doctor and not the patient. When a health condition effects an employee's ability to work the employer will find out of it as a matter of practicality. But since coverage is for entire families, not just employees, that is just a limited window to a tiny portion of lives covered. The spouses and children of employee's likewise have the right to privacy and confidentiality. Conclusions Due to the combination of 2, 3, and 4 my employer cannot make moral or ethical judgements about my treatments because they do not have adequate information to form such opinions and furthermore have no right to such information. They also, generally, lack the medical education to make informed judgements of that kind even if they had access to all the facts. They may not respond to this lack of information with wild-eyed supposition of immorality on the patient's part and seek to bar access to various medicines/techniques on religious grounds because doing so will cause harm to some statistical subset of patients and per assumption 1 the constitutional protections afforded their religious practices do not permit them to harm others. They can cover or not cover on *financial* grounds. But not on religious ones. And, of course, in order for what they are offering to qualify as health insurance it must meet minimum standards. If it doesn't they have to pay the penalty or provide real insurance. * The copper IUD works because copper (why copper? so weird) causes the womb and fallopian tubes to secrete a chemical that is lethal to sperm. It's like how sand irritates oysters and they secrete perl material in response. Copper makes human wombs secrete spermicide. People thought for awhile it was dislodging implanted zygotes but that would work even if it was, say plastic or stainless steel. It doesn't. Has to be copper. Some new ones are hormone impregnated plastic but thats the hormones doing stuff, not the plastic. The T shape is to keep the sucker from falling out. ** I've noticed that whenever this topic is tackled in debate everyone just assumes that the woman seeking birth control is the employee. This is inaccurate. She could be the employee's spouse. Phrasing it from the point of view of a husband seems to knock certain people off center because while they love vilifying "sluts" they tend to worship male sexuality and are strongly in favor of a dutiful dad coming home from a long day at work to an appreciative wife. Using a married male protagonist thus prevents them from suggesting abstinence as an alternative because they would not be comfortable suggesting years of abstinence to a man. Additionally, a man would face no negative social consequences for ridiculing that suggestion and thus can effectively laugh it off. These same people also tend to only be capable of seeing pregnancy as an economic issue when the point of view character is a man. They fundamentally don't acknowledge women as having economic lives and are willfully blind to the disruption an ill-concieved pregnancy has on our economic situations. Hell, they barely acknowledge its impact on our physical health and that only because maternal death stats prevent them from ignoring it entirely Fun fact, in 2006 bush had the CDC stop collecting maternal death statistics after Amnesty International did a report about how horrible ours are.. So that framing is much more effective when trying to get a listener to remember that employees have rights too.
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Dec 28, 2013 23:18
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OneEightHundred posted:Insurance companies already have that information and are explicit about their interaction with it in the plans, like their typical refusal to cover elective surgery and other options that the plan doesn't consider "medically necessary." We don't, actually. Have that information. I coded electronic claims processing software for three years as the data architect and there weren't any tables in our database for that level of detail. You had specific coverage events but not diagnosis details. HIPPA would make trying to obtain that information hella awkward. Edit to add info: The health insurance patient privacy act , HIPPA, means that even though hobby lobby self insures, mr. Green may not look at the claims histories of employees. This information is not rich detailed medical history to start with. Its jut claims. Jane went to an ob/GYN and got an Rx for pre-natal vitamins. We can infer from this that she's pregnant but we don't know. She may just be planning to get pregnant. Or it could be a fraudulent claim by the doc to get more money. But if mr green snoops ( say he's thinking of promoting jane and this info changes his mind ) and gets caught he can be fined up to $50,000 per record and face years of jail time. Just because insurers have to store claims data to operate their business doesn't mean that data can be shared, mined, sold, or perused. And god have mercy on your soul if you get hacked. So mr green faces a problem of schroedinger's slut. The woman in the hypothetical is a Madonna and a Whore at the same time. You don't know which one till you look and see. But he isn't allowed to look and see. The lack of this information means he isn't in a position to make ethical and moral decisions about these cases. His moral compass isn't much to start with but that doesn't matter because you can't apply any moral compass to situations when you don't know what the situation is. McAlister fucked around with this message at 08:59 on Dec 31, 2013 |
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Dec 31, 2013 07:42
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TinTower posted:Ginsburg would almost definitely sign onto 2-4, given her dissents in the Carhart cases. You could probably be able to tie 1 in on previous 1A rulings too. Thanks. And I don't think they can counter with "I'm not harming, I'm just not helping" because, per the ACA, providing these things is a minimum standard. It's something their employees have a right to in their health insurance. Taking away help that someone is entitled to and would get anywhere else is clearly harming. My go-to analogy for people like the Greens is a religious pizza delivery man who wants to take the pepperoni off the pizza you ordered because he thinks pork is unclean. He's not the pizza shop. He's not the customer. He's just a middleman. He has no right to stick his nose in your pizza. Lots of ability but zero right. Yes he takes your money and gives it to the shop for you. That is a service he provides. It is at no point his money. Likewise hobby lobby pays for work. Period. That's all they pay for. Its real nice of them to deduct some of your compensation pre-tax to get that plan cheaper than you could have bought it post tax. But all they are doing is exchanging your money for coverage. Just like a pizza delivery man exchanges your money for pizza. If it were their money you wouldn't have to work for it. That's the difference between compensation and a gift.
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Dec 31, 2013 09:21
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Rygar201 posted:Hobby lobby self insures, they are the insurance company in this case. As far as I can understand it at any rate And that doesn't matter because insurance companies don't have the information you think they have and mr green isn't allowed to look at the information they do have. He'd go to jail if he did. So he effectively doesn't have it.
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Dec 31, 2013 17:27
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falcon2424 posted:Second, are plans that don't cover contraceptives actuarially-cheaper than the alternative? Birth control pills cost money. But they should be cheap compared to babies? They are IF they cover maternity and birth. If they do not cover reproduction then the gain little from preventing it. Prior to the ACA crap plans routinely screwed women over by not covering reproductive care. Its part of why we have the highest maternal death rates in the first world. Post ACA, however, that's on the minimum coverage lists. You have to cover it. So birth control pays for itself. If you keep an eye out you can see very careful bitching about this. Its bad pr to complain about providing medical care to pregnant women so you rarely get someone openly complaining about it - but its between the lines in a lot of the ACA arguments. Prettying anytime someone starts talking about winners and losers in premiums they are tip toeing mightily around this gorilla. Of course hobby lobby probably plans to just fire any pregnant workers which would get them out of paying for reproduction being self insured and all.
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Mar 26, 2014 07:22
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I think it would be beneficial for folks debating this to know how PBMs ( pharmaceutical benefits managers ) work. I worked for a PBM for three years. I'm not intentionally making any arguments here. Just effort posting some knowledge. Take it or leave it. Edit ( effort posting on a phone. Apologies for typos ). PBMs are organizations that allow members to purchase Rx drugs at steep discounts. Their clients are insurance companies or employers like hobby lobby - not individual people. Hobby lobby wasn't one of ours but if they are not using a PBM they are morons of the first water. Yes, they are a very large company. But my first assignment on my first month was to import half a million lives from horizon New Jersey. Kaiser had over 30 million lives on record though not all were active. Our volumes vastly outstripped hobby lobby and thus the rates we negotiated with various pharma companies could be from 40% to 90% off depending. Pbm's are finances in two ways. Firstly by an up front annual cost per life. Ours was $10 a year per life with volume discounts for folks like kaiser who brought many lives. Secondly they can dip into the spread. If I negotiate a 53% discount for orthotricyclyn and give you a 52% discount I can pocket the 1%. So volume is everything. The more patients the more drug claims the greater the discounts we can negotiate the more attractive a PBM we are and the more profit from spread. We want to cover *everything* and we want every drug the patient buys to be on the drug plan so that next year when we negotiate discounts we can maintain or increase our discount. We don't care if its necessary or elective. We don't care how much of what's left over the insurer pays. Speaking of which. A claim breaks down into three important numbers. 1 patient out of pocket ( poop ): the amount left after the discount is applied. 2 plan pay (pp): how much of that the insurer pays. 3 true out of pocket ( troop ): the remainder after discount and plan pay that the patient actually pays. So after heart surgery a $1000 drug may be $450 after discount and the pp may be 85% of poop making the troop $67.50. Or after a bout of impotence a guys Viagra might have a 60% discount and the pp is 0% so the patient pays 40%. And this is why Viagra is covered. It isn't about the insurer. The insurer, be it kaiser or hobby lobby, is a third party here. Plan pay was ***** $0 ******. The patient has paid their $10 a year to access our discounts and -by god- they get our discounts. We want them to use our discounts.. Remember. Spread and volume. If they buy their boner pills off plan we don't get spread or volume from the sale. Which is why it pisses us off royally when an insurer -always some Podunk self insuring company- calls up and demands we deny drug claims for specific drugs to their employees with the threat that if we don't they'll drop us as a PBM and find a more accommodating competitor to screw over their employees with. And yes calling this a claim is dumb because that puts people in the mind of insurance and makes you think that denying it saves money when what we actually are is a SAMs club and denying claims costs us money. But that's the terminology used in the business so bleh. Crippling our plans for their employees doesn't save them a red cent. It's still $10 per year per life. Just those lives get less for their $10 than everyone else gets. And our administrative overhead is increased because we can't just pass on our discounts to everyone but must instead keep lists of people to screw over. These employers are not content to simply set their pp to $0 like they do for other electives like rogaine etc. They insist on destroying the discounts their employees paid for and are entitled to. Now some more detail on discounts. We didn't negotiate on a drug by drug basis. That would take FOREVER. There isn't enough time in the year. We negotiated with each pharmaceutical company individually and the topics are all brand drugs, all generic drugs, and a few individual drugs that are special/new. So when determining the discount on generics the relevant data point is our total purchase the prior year of every generic that company sells. Doesn't matter what they do. Your grandma's heart medicine and my niece's birth control may both be on the same list. Which means that if my niece isn't allowed to purchase on plan then her purchase doesn't contribute to our volumes which means we can't get as good a discount on your grandma's heart medicine. Forcing people off plan thus hurts everyone else by increasing their costs. Maintenance meds like birth control are more likely to matter than rare one offs since they have high volume/margin and can contribute enough to matter. Still with me? Whew. The issue that the ACA raised is that it requires *cost effective preventatives* to be covered with $0 troop. This means the pp has to be everything left over after the PBM's discount. But hobby lobby isn't simply contesting the pp/troop split. They are trying to take away the bulk purchasing discount too. They are inserting themselves between the patient and the PBM and demanding their employees be charged market rates instead of member rates.
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Mar 28, 2014 07:45
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esquilax posted:The mandate requires that they cover it under the plan AND pay the entire cost, so that wouldn't avoid the legal issue. Not the entire cost. Troop must be zero. How troop gets to zero can vary wildly. But at the end of the day PBMs don't deal with individuals ( well ok they do but when they do its something like drug card with only a 10% discount to the patient and huge spread in the PBM pocket as opposed to what corporations get where the vast majority of the discount is passed on ) so if you refuse to cover the drug entirely and force the PBM to deny it you are forcing the patient to pay not just what you aren't paying, but the discount amount too. Basically this all comes down to Medicare. Because the federal gov isn't allowed to negotiate drug rates, sticker prices are inflated to milk the government. Nobody else except the people with no insurance have to pay the bloated sticker prices or anything close to them. But hobby lobby is trying to make their female employees pay the sucker prices too.
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Mar 28, 2014 15:07
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VitalSigns posted:
Close ... The mandate requires their pp be high enough to reduce the troop to zero. But they ( hobby lobby ) aren't asking to just pass on their PBM discount without contributing any plan pay. They are asking that claims for things they don't like be denied. That these things not be covered at all. The PBM model is why stupid things like rogaine etc are "covered" even by crappy plans. The coverage is just access to the negotiated discount. So when I got elective LASIK surgery my super expensive eye drops were only $120 instead of around $300 because of my insurer's PBM discount. The savings wasn't coming out of the premiums or costing the insurer anything. If my employer believed glasses were God's Will and insisted that LASIK was defying god and demands that the PBM reject claims for those drops - would not have saved my insurer any money cause that $180 wasn't actually "paid" by the insurer. Them putting that on my statement is a fib to make them look like they are delivering value. If my drops were really covered and not just discounted the pp would have been 80% of the 120 and I would have paid $24. So the most hobby lobby could reasonably demand is to "cover" BC with copayment instead of with no copayment because the plan pay is the only part they actually pay. If they were demanding that then they would be more logically consistent. They are demanding a lot more than that. And since the discounts are so huge in pharma the part they have no right to take away is generally larger than their contribution. Basically they are like a pizza delivery man who thinks keeping kosher means picking the pepperoni you paid the pizza shop for off your pizza. They are an intermediary between the PBM and the patient and they are abusing this position to deny the patient something they paid for. But they are hiding this by rolling the PBM discount and the plan pay into the idea of "coverage" such that they are trying to take away both when - if their arguments weren't theocratic poo poo - the most they would have grounds to take away is the plan pay. Not the discount.
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Mar 28, 2014 15:32
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Radish posted:Let me see if I have this right. The employees through their plan should be able to use the bargained price that the insurance company has access to via a co-pay which would mean that Hobby Lobby does not actually "pay" for their birth control. However Hobby Lobby wants that option TOTALLY removed so that their employees now have to get the open market price which is much higher. Yes. So if hobby lobby wins what should happen from the PBM side is that BC would go from the covered list to the not-covered list. But all being on the not-covered list means is that when the claim hits the servers the insurers contribution is set to $0 so poop = troop. The PBM would still front load their discounts. Side note: another function of a PBM is making rebates look like discounts. Because of the language that prevents Medicare from negotiating bulk rates you can't actually sell your drugs at a discount or Medicare can say " hey! You sell it to everyone else for $x! That's the market rate! Not the sticker price!" So PBMs facilitate the rebate fiction by paying (sticker - troop) to the pharmacy then collecting the rebate from the pharmaceutical company and the plan pay from the insurer. For the insurance company the rebate functions like a discount. So everywhere I've been saying "discount" the mechanism is actually the PBM frontloading the rebate at time of sale. Anywho. What is likely to happen if they win is that the hobby lobbies of the world will continue their current practice of forcing the PBMs not to submit BC transactions in the roll up report which effectively shreds the patient's rebate check. They are, have been, and seek to continue being, thieves. I haven't seen any indication that the supremes understand how drug purchasing works in the real world so they won't catch this unless someone points it out to them. And I really want someone to do so because PBMs are giant moneyed corporate interests who want to include these transactions on the plans. Certain justices with soft spots for corporate persons would thus have a butt to kiss in this thing that isn't hobby lobby's.
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Mar 29, 2014 06:01
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evilweasel posted:No. Hobby Lobby is self-insured and required to cover contraceptive care under the contraceptive mandate so that it costs their employees nothing out of pocket. It is not an option to have employees cover the actual cost via co-pay: what he is describing is a separate issue. She. And it is an option if they win because all them winning should entitled them to do is to set their plan pay to zero. That would mean *they* aren't paying a red cent. They have no reasonable grounds to say their religion prevents the third party PBM from including the employees purchase at the third party pharmacy in the roll up report to the third party pharmaceutical company and then frontloading the negotiated rebate to the patient as effectively a discount. This transaction, literally, doesn't involve them in any way beyond the possibility of them providing plan pay to reduce the parent's troop. They could stop using a PBM if they don't like it. Course that would make their drug prices across the board skyrocket as they don't have the kind of volume we do which would be akin to paying the fine they don't want to pay.
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Mar 29, 2014 06:21
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duz posted:Since they aren't stopping their employees from using their paychecks to buy contraceptives, I think it's a safe guess that the Green's only care what they do and not what others do. Then they and people like them wouldn't be leveraging their position as gatekeeper to PBMs to cripple membership for their employees such that their serfs pay the same for membership as everyone else but get less benefit from their membership than everyone else. People like that absolutely do care about what their employees spend money on. Just paying in script is illegal and there isn't any wiggle room there so they have limited ability to do anything about it. They absolutely do champion laws that allow them to fire people for discovering they did something the owner doesn't like on their own time. Like being gay or getting divorced or voting democrat. That's as close as they can come to company script.
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Mar 29, 2014 18:32
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twodot posted:For as long as the Religious Freedom Restoration Act exists, yes we should continue to apply its restrictions to laws which fail to exempt themselves. Policy-wise, I think both the ACA and RFRA are pretty lovely laws that are putting our courts in no-win situations. I would certainly prefer a single payer set up that avoids all of these issues. I am asserting that it doesn't matter what their religious beliefs are as they are trying to constrain the actions of other people who do not share their beliefs in a manner that is financially harmful to those other people. The patient must overpay or go without. The pharmacy loses business from those who go without. The PBM loses spread and volume from all the transactions they are forced to reject. If you want to continue society loses out because unplanned/unwanted pregnancies are increased. Etc.
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Mar 29, 2014 18:48
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twodot posted:This is a wrong description of the reality of the US. Are you trying to argue for a policy change now? (Earlier you definitely made some sort of assertion about the Green's religious beliefs, but you've appeared to have dropped that). Stuff got busy irl and this is on a new topic (edit - last post by me ) but to clarify. There are two things religious meddlers like hobby lobby were *able* to block prior to the ACA. 1- by threatening to use another PBM they forced PBM's to give their employees fewer rebate/discounts *for the same membership fee*. Effectively stealing and shredding their employee rebate checks. 2 - by not covering the religiously verboten drug they also set their plan pay to zero. Forced coverage with no copayment stopped both actions ... Because of course when the discount/rebates are going into their personal pockets they want the PBM to collect and frontload them like they do for everything else. In the way hobby lobby is contesting the ACA they are trying to restore both methods of screwing with their employees private lives. However, they only have grounds to argue for one - the plan pay - which is the much smaller of the two. You can get a $60 BC pill pack down to $5 on rebate/discount alone. The religious beliefs of the person who withheld $10 of my compensation and sent it to a PBM to secure my access to rebates/discounts are a matter of no consequence whatsoever. The idea that the PBM should be bullied into denying me personally rebates that *I've paid for access to* because of the church the errand boy/employer who walked my membership fee from here to there is beyond absurd. Arguing about the plan pay portion is not absurd on its face as that involves active participation by the insurer. It's still bullshit for other reasons. I get that freedom of religion only prohibits government attempts to force religion on someone, not rich jerks. But making an exception to a generally applicable law to aid and abet rich jerks in forcing their religion on subordinates is a violation of the employees religious freedom since selectively not enforcing the generally applicable law that protected is a government action. But that is an argument you can only reasonably have over the plan pay. Rebate theft needs to stop. Period. McAlister fucked around with this message at 20:46 on Apr 2, 2014 |
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Apr 2, 2014 20:35
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Duke Igthorn posted:The first rule of using acronyms is to first establish what the acronyms means. YYNBBGFRT I did in the first effort post. In the first sentence. /shrug ------ edit: Thanks hobbesmaster. McAlister fucked around with this message at 08:41 on Apr 6, 2014 |
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Apr 6, 2014 08:35
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KernelSlanders posted:It appears this is the site in question, with the now-meaningless 35-foot line. One of these things is not like the others. One of these things, isn't the same. Political speech is important. Political speech should be protected. People crafting policy which affects you and me should not be allowed to "protect" themselves from listening to our political speech. A private citizen going to their doctor is not obliged to listen to a no-choice nutter rant in the way a representative or government official is. They have a duty to listen. I don't. Since I am not a holder of public office yelling at me isn't political. It's just being a loving rear end in a top hat. Edit to add: Also, its "planned" parenthood. Not "prevented" parenthood. They do pre-natal exams, programs to help addicted women get clean for/during a pregnancy, help out with maternal nutrition and pre natal vitamins, etc. So visibly pregnant women go into PP offices and come out still pregnant. They didn't get an abortion because that wasn't why they came to PP. Most abortions happen in the first 8 weeks before there is a visible indicator of pregnancy. And they sure a hell aren't going to tell the no-choice mob why they are there. So the women who get the worst treatment going in are the expectant mothers. And these are also where most/all "we changed their mind" anecdotes a come from. Oh noes! A visibly pregnant woman went in and we could not stop her!! Yay! She came out and didn't kill the innocent babyJesus in her tummy! She must have seen our signs and heard our voices and realized how wrong she was! Go team Jeebus! McAlister fucked around with this message at 01:25 on Jun 30, 2014 |
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Jun 30, 2014 01:03
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Its statistics. Given the number of retirees/empty nesters in an area looking for meaning in their remaining lives some tiny fraction of a fraction of a percent will gravitate to clinic protesting. What's five people out of millions? Unlike working in a soup kitchen or collecting signatures or other common ways to volunteer in your community, clinic protesting involves hanging out with your friends while shouting at your moral inferiors. This will always attract a certain kind of person when it is permitted.
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Jun 30, 2014 02:00
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Discendo Vox posted:My understanding is that there are also organizations dedicated enough to clinic protesting that they will bus folks in daily if there's nobody to protest them locally. That too. But that's usually for particular events. The regulars are likely to be locals. One of my favorite protestors was this absolute ditz dressed to the nines in clothing that was proper for a young woman back when she was a young woman. Aging prom queen in denial. She wasn't rude or threatening at all. She actually didn't speak much if you didn't go up to her and engage. Stood on a corner across the way with a sign facing the road. She talked about how horrible abortion providers are and how she was helping to save the babies - and I told her that if she didn't leave I would donate the price of one abortion to the clinic they were at ( not pp - a for profit place ) so that the next woman who would have been turned away due to inability to pay would instead get her abortion. Unless she skedaddled. After a back and forthe to wrap her head around the idea and demonstrate I had the money on hand/was serious about it she fell silent for a few moments. Then she decided to level with me. No appeals to her 1A rights or threats of damnation if I did this. Not her. What I needed to understand was how happy her being here made people. And right at that moment a passing car honked support and she got this beatific smile on her face and lifted her sign at them. Then she looked at me triumphantly. See! See! They love me! She didn't articulate in a way the translates well but she made eye contact and with a gesture asked: What kind of rear end in a top hat am I, that I would wreck this for her? Make her go away? All she has to do is stand here with this sign and she gets ... Well more attention than she'd probably gotten in a long time. Couldn't I just take my moral quandary elsewhere? Not a speck of bully in her. A rare protestor. summaryB] she highlighted for me just how little negative feedback these people get. We talk about self created echo chambers and bubbles. But protestors aren't in their basements on obscure newsgroups. They are on the streets in public among random passersbye. The no-choice give them positive feedback. Praise. Recognition. Social status within a church group perhaps. The pro-choice ignore them. The escorts ignore them. The patients don't want to talk to them. The medical staff likewise. [B]They aren't bubbling themselves. We are bubbling them. And I don't have a specific thing to advocate but a lot of people posting about clinic protestors assume that abortion is why they are there. I've been offering that Choice to protestors for years now and the conversations I have with them suggest that this is not the case. They protest more for the fun of it than anything else. Though for most protestors the fun is less from being honked at and more from seeing a victims shoulders hunch and their pace quicken.
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Jun 30, 2014 03:09
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computer parts posted:
Let's say I'm a bully. How many places can I go and yell filth at people without a nice policeman coming to cart me away to cool off/sober up? In groups? So we can outnumber our victim and thus be safe from physical reprisal? Come on. You know in your heart that those kids who used to throw buckets of blood on women in furs weren't motivated by ecological concern. They never did anything like that to guys in leather jackets. And at least some of the folks with hatchets chopping up bars in prohibition really just wanted to smash poo poo up for the hell of it and the temperance movement gave them the societal cover to behave badly. It ennobled them and protected them from the consequences those actions would normally result in. Habitual abortion protestors are mostly bullies who have found a way to get society to let them indulge themselves while at the same time crediting them with good intentions they don't actually have. Edit: see fertility clinics. They create embryos in batches and incinerate most if them. But there is no societal tolerance for protesting fertility clinics and people going for IVF will cheerfully yell right back at you and not be cowed at all. So no faux-life protestors. McAlister fucked around with this message at 03:33 on Jun 30, 2014 |
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Jun 30, 2014 03:23
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Javid posted:One of my lottery fantasies is rolling up to a random clinic at a random time once a week and donating $largesum per protester to the clinic. Like the quarter guy from the other thread, but with many more digits. In Colorado we have an "adopt a protestor" fund raiser. You can google it. If you donate a small sum during the "month of life" protests they tie a yellow ribbon to the rail in front if the clinic of your choice to show the protestors how many donations their protest has triggered.
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Jun 30, 2014 03:27
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DeusExMachinima posted:1A protects the right to be an rear end in a top hat. Don't like it? Don't go in public. Oh you're out in public? I'm sure you've got a lot of cool reasons why you don't have to hear it. So put on earplugs(or don't, whatevs). Prior restraint is prior restraint, smd. So let's be clear about this. If I want to make sure my (phone) employees (/phone) know that I want them to vote a certain way I can stand at the poling place door with a few friends and tell them so? Its political speech so it's protected by 1A ... Right? There are no laws or court rulings forbidding political speech directed and private individuals who don't want to listen to it at a place they have to go to. If there were how would that effect your stance?
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Jun 30, 2014 03:38
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Kiwi Ghost Chips posted:Lots of places? I was in DC a few weeks ago and a Black Muslim group yelled at me about Israel and white devils or something. At your doctors office while you were minding your own business? Kiwi Ghost Chips posted:And of course there's Westboro... Who are hated by pretty much everyone because they thrust their politics into the private lives of private citizens uninvited. Didn't volunteers form a human chain the last time they announced a funeral protest in advance to keep them away from the family? What is that, if not a restriction of their "free speech". Should the police have broken the human chain and given them access? Its a public cemetery.
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Jun 30, 2014 03:52
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Kiwi Ghost Chips posted:No, on the street, like abortion protesters. The key parts of that was "minding your own business" and "bullying". Are you worried now because they made a big deal of following you back to your car and taking pictures of your plates? What did they do to make it about you personally as opposed to randomly yelling political slogans? Describe, please, how you gave no indication that you wished to discuss politics and ended up with them indicating that they view you as murderous scum for not agreeing with them and personally condemned you in particular among all the passers bye. Kiwi Ghost Chips posted:
Its a lot harder for a small group to pose a credible threat to a large group - like a funeral party - than it is for a small group to threaten a single patient going to the doctor. The group dynamics are wildly different.
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Jun 30, 2014 04:08
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DeusExMachinima posted:If the remedy involves prior restraint? Tough tits, even if we were talking about nuclear proliferation. Question 1: So let's say I have an abusive ex who starts stalking me and I get a restraining order saying he can't get within X hundred feet of me. If I work at a reproductive health clinic and live next door to it can he protest at the clinic or not? Does his 1A rights trump my personal safety? Hell, the very concept if a restraining order is prior restraint. He hasn't attack me yet ... He's just obsessed with me and has a lot of hostility and uses a lot of violent language when talking about me ... But he still hasn't done anything yet. Should we wait till he does and then punish him for it rather than try to prevent it? Question two: What about the safety of the medical staff? threats are common and attacks happen. Question three: What if every clinic had a billboard type area where opponents could write their messages and contact information at the door? Then anyone interested in "consensual conversation" could call them. That allows political expression without compromising safety, no?
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Jun 30, 2014 04:27
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Femur posted:You got a good laugh, but you probably just refueled their crazy. I think the general rule is don't engage crazy people because they will stab you. You would understand if you've been to a corner store late late. ? The formal pledge-a-picketer program is all remote. Donations come over the Internet and the clinic staff ties the ribbons and published the totals. You don't actually get to adopt an individual protestor. I totally think they should but PP doesn't want to get personal on that level because they are better people than me.
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Jun 30, 2014 04:32
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Discendo Vox posted:McAlister, it might help refine your arguments on this subject if you familiarized yourself with the law on the different hypotheticals you're describing. They don't really provide any purchase or insight into the case at issue, because there's already fairly well accepted legal responses to each of these situations. And I'm looking at "why" those loopholes and exemptions exist to argue that a buffer zone around medical facilities is as much in the spirit of the first amendment as saying no yelling "fire" in a crowded theatre is. I want you to articulate in your own words why other exceptions exist and how other conflicts of rights are resolved so I can apply your own reasoning to this case. And I don't know if you'd let my crazy ex stalk me by pretending to care about abortion or not. Whether or not you would changes the arguments I go with next. If I have to guess every position you might take these posts are going to get really really long.
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Jun 30, 2014 04:43
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hobbesmaster posted:There is no restriction on yelling fire in a crowded theater. Ummmm .... There kinda is. Its a form of public endangerment and there are rules against it. Unless the is actually a fire of course. Though that's still a bad example as there are many reasons why "fire! In a theatre" lacks 1A protections ... It's not political speech, public endangerment, private property .... A buffer zone around medical facilities that are routinely harassed by assholes who claim the patients using those facilities are murderous whores going to hell who must be stopped to save imaginary babies ... is primarily a public safety issue. Women are part of the public after all. Most of it, actually.
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Jun 30, 2014 05:15
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DeusExMachinima posted:If the remedy involves prior restraint? Tough tits, even if we were talking about nuclear proliferation. Oh, and your nuclear proliferation link qa about an injunction to stop the publication of an article.We are talking about specific hounding and threatening of individuals seeking medical care and medical staff providing that care. These are completely separate topics and 1A doesn't let you threaten or harass individual people. Let's you be a total dick to abstract groups of people. You can say that gays should be wiped out with 1A protection ( not a "true threat", assumed hyperbole ) but you can't point to Bob over there in accounting and threaten him personally for being gay with 1A protections. Accosting people personally as they go to the doctor/to work and doing other things no-choice groups do is not like compiling publicly available academic research into a single research paper.
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Jun 30, 2014 05:38
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hobbesmaster posted:Right, but wouldn't a law against yelling "fire" in crowded places would fail the Brandenberg test? ...? I don't think that test is applicable as leaving a theatre isn't an illegal action so motivating me to do it isn't advocating I commit a crime. That test is whether or not to punish guy A who egged guy B into doing something illegal, no?
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Jun 30, 2014 05:43
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Discendo Vox posted:I'm not talking about my positions, I'm referring to the law's positions. If you continue to construct legal hypotheticals and ask us to play them out for you we have to recite to you, case by case, the entire first amendment jurisprudence while you look for things to object to. Doing responses as I read the link. 1- up front it says the justices are divided on reasoning. So, different justices different reasons. Which means that individual justices disagree with the reasoning of the other justices. What if they are all right about why the other justices are wrong? 2: the majority opinion: Basically they agree with the points I've been raising. 1A doesn't let you harass/intimidate/threaten people. It's good to be exposed to ideas in the public sphere, but people don't have to listen to you yap if they aren't interested. Just as 1A doesn't protect you from disagreement, it also doesn't compel me to listen to your spiel. The security interests of patients and doctors trump the 1A rights of protestors. The only disagreement was the size and placement of the buffer. And sure, if we were talking HUGE buffers this would be a concern. But 35 feet is well within shouting distance and readability for signs. So all we need to do to change their minds is get them to volunteer as escorts for a day at a clinic with active protestors in somewhere with a 6 foot personal buffer ( that they upheld because they totally agree with the spirit of the arguments I've been making ). This would educate them about practical realities and change their opinion on what the right size/placement of a buffer is. For comedy value, make it one of the majority of pp locations that doesn't even perform abortions but is aggressively picketed anyway ( of the 20 odd Mississippi locations, for example, only 7 perform abortion last I checked ). 2 - Scalia: RAWR! Tie those sluts down and make them listen to a nine month lecture about why abortion is a sin! My 1A rights mean you have to listen to meeeeeeeeeeeee! gently caress Scalia.
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Jun 30, 2014 06:32
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Discendo Vox posted:The majority opinion and its stated reasoning are binding. The others are unimportant with the exception of a set of potential future outcomes that are unlikely under these circumstances. Looking up the buffers around polling places they are typically between 25 and 50 feet. This is not, I can't help but note, to far away for consensual communication. It is to far away for effective interpersonal threatening and intimidation. Which are not protected speech. You keep trying to ignore this or imply that the Supreme Court hasn't said clearly in this and other opinions that free speech doesn't cover that behavior. But the very link you provided going over the majority opinion flat out said that your 1A rights don't let you do the stuff clinic protestors do and that the justices main request is that MA should try a smaller area first then increase it if that doesn't work. You literally posted a link that said the majority would be cool with the 35 foot buffer if there was better documentation showing that a smaller buffer had been tried but had failed to protect staff and patients adequately. This contradicts your assertions that buffers are flatly unconstitutional and prior restraint is never ever acceptable to the court. The link you provided also speculates that the liberal justices probably think its bullshit but supported Roberts because he would go full crazy otherwise. Now 1A legislation gets tricky because while threats and intimidation aren't protected speech regardless of their political content courts have differentiated between "hyperbole" and "true threats". This is like trying to legally define porn in that we can't describe it but we know it when we see it. And it allows justices a lot of leeway since they can deem this to be a true threat and thus illegal and that to be hyperbole and thus allowed under 1A. Well they have leeway right up until someone actually gets hurt at which point the speech retroactively becomes a true threat regardless of its prior designation and thus loses constitutional protection. At which point Scalia cries crocodile tears about how sad it is that doctor was murdered and has no replacement. Question: how many medical workers have been killed or assaulted by no-choice activists? I can think of three murders off the top of my head besides Tiller. And I haven't even touched google yet. What happens when we have a shortage of reproductive health workers and/or access to them? Hint: in countries without modern medicine up to 1 in 15 women die from reproductive related causes. Well baby visits and prenatal care are important and the intense harassment visibly pregnant low income women get for going to PP is an obstacle to getting adequate medical care. Which is probably part of why, in your own link, the liberal justices + Roberts noted that ensuring safe access to these facilities is a public safety issue compelling enough to override 1A protests. The only quibble was how much buffer is needed, not whether or not buffers are appropriate in this case. You keep trying to extract this to a general case while stripping it of pertinent facts like that we are talking about medical facilities specifically, the long history of criminality (true threats) on the part of protestors, or that the protestors goal isn't to speak to the public at large but to coerce individuals. When they want to speak to the public at large they seek out crowds or legislators.
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Jun 30, 2014 14:03
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Ok, I went to an engineering college and am friends with lots of civil engineers. They know something relevant to the Texas abortion law that I would like to relate. Ready? Most hospitals aren't up to code. Codes can change every year. The building codes for hospitals are immensely detailed as we learn from mistakes in the past and discover things like that hallways need to be wide enough for two gurneys to pass in opposite directions. But most building code changes for hospitals - and all code changes for most other buildings - do not apply to existing structures because that would be ex post facto making them illegal which article 1 of the constitution forbids. Now for places like hospitals we sometimes kind of ignore this and say "holy poo poo, you all have to do this within a reasonable amount of time or else" because we learned something really really important. Like say that Ebola is in Texas. State of emergency stuff. But the normal state of affairs is you leave existing medical facilities alone and the new requirements are only for new facilities. In this way we work towards improving our medical infrastructure without interrupting continuity of service. You do not shut down existing medical facilities unless they are wracking up a butchers bill. And then you do it because they are wracking up a butchers bill. So right off the bat, any legislation that would close existing clinics for any reason other than demonstrable harm to patients should be tossed into the shredder post haste - because that is how it works for every other medical facility. The discussion of undue burden/overbroad/pointless regs should be entirely about whether it is these things for future clinics - which should by the only clinics this law could apply to. You see the same thing in safety regs for all sorts of infrastructure that can't easily change to new rules. All those legacy coal plants, for example, that don't conform to EPA guidelines and limits because they were built before those rules. New coal plants must conform, but not the old ones etc. I personally find this deviation from the normal process by which infrastructure is improved to be proof that the authors have deep malice to this part of our medical infrastructure.
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Oct 16, 2014 03:39
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My friends said it was ex-post and that is why all building codes everywhere work that way - they only apply to future buildings. Their teacher told them that though he was an engineer not a lawyer so - /shrug. The building was legal and to-code at time of construction. All inspections are done to the code for the year the building was built unless it was substantially renovated at which point it must come into compliance with the new codes.
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Oct 16, 2014 03:59
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Also to address that 0.2x per 100,000 figure for deaths from abortion. That's misleading. It includes all methods of abortion and mixes elective and medical emergency abortions. So a woman with an ectopic pregnancy that has to have actual surgery and anesthesia done is being lumped in with a simple D&C which just inserts a tiny suction tube in an existing hole (that's big enough to shove a baby through) and sucks out the uterine lining which is made to detach and does so every 28 days on its own mostly. One of these things is much more dangerous and invasive than the other. Edit : D&E - dialation and evacuation. McAlister fucked around with this message at 05:52 on Oct 16, 2014 |
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Oct 16, 2014 04:07
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ActusRhesus posted:Incidentally, the AMA recommends against D&C. Corrected, D&E ... Dialation and evacuation. But I was still wrong because I thought D&E was the first 12 week method but that is Suction Aspiration (SA). D&E is SA plus pokey bits while base SA is just the suction tube and is how 89% of elective abortions happen. http://m.lovejoysurgicenter.com/?url=http%3A%2F%2Flovejoysurgicenter.com%2Fabortion-services%2Fabortion-5-12-weeks#2804 McAlister fucked around with this message at 06:03 on Oct 16, 2014 |
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Oct 16, 2014 05:54
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The point of the post that had the wrong procedure listed was that elective abortion isn't just 14 times safer than pregnancy. Its much safer than that. Our first problem here is that "abortion" is a political rather than medical term. There is no medical procedure called "abortion". There are a wide variety of medical procedures that terminate a pregnancy from Suction Aspiration to Cesarian Section - each one with its own risk profile. Lumping them into one statistic for political reasons is dumb. Writing any regs for "abortion" instead of a given method is even dumber. Regulating a nurse with a skype line to a doctor and a box of pills with the same law that covers anesthetizing someone and slicing open their abdomen to remove a 6lb dead fetus before it starts decomposing inside them ... Oye. And that's not even touching the fact that a C-Section is the same medical procedure whether done at 7 months or mid-delivery but only counted as "abortion" some of the time. Anyone actually interested in maternal safety would be breaking abortions out by method first and making rules on a per-method basis. I'm completely pro choice and completely in favor of requiring the laproscopic abortion of an ectopic pregnancy happen in a surgical theatre for example. Like refusal to grandfather existing facilities with impeccable safety records, talking about "abortion" instead of any particular medical procedure is drat good evidence that the speaker is not motivated by maternal safety.
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Oct 16, 2014 19:45
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On the topic of motive ... I went and re-read the majority opinion on Roe because I remembered a big part of it being what motives were allowable for reproductive legislation at all. And I hit pay dirt (link to full text of majority opinion) http://caselaw.lp.findlaw.com/scripts/getcase.pl?court=us&vol=410&invol=113 My stupid phone is not letting me copy paste but it is in section X the paragraph starting "with respect to the states legitimate and compelling interest in the health of the mother". Basically the court broke pregnancy into three phases based on medical knowledge at the time. The most important phase for the legality of abortion is the "viability" phase wherein the fetus could survive removal. At that point any method of terminating the pregnancy that ends fetal life can be outlawed if a state wishes because it is allowed to legislate in the interests of a viable fetus. Methods of ending the pregnancy that don't harm the fetus such as c-section and induced labor, however, presumably cannot/have not been. But there where two other phases. There was the period in which aborting is safer than pregnancy and the period in which aborting is more dangerous than pregnancy. Roe grants states the option of passing legislation (licensing, building codes, etc) for the purpose of maternal safety only after the point where aborting is as or more dangerous than pregnancy itself. Prior to that point states aren't allowed to pass laws with a rational based in maternal safety, " this is so because of the now-established medical fact, referred to above in 149, that until [that point] mortality in abortion [is] less than mortality in normal childbirth". So even if these concern trolling assholes were sincere, it shouldn't loving matter. Texas isn't allowed to pass laws with that stated motive until the procedure in question is racking up a higher body count than pregnancy. So, can we pass a law requiring hand washing before an abortion? Yes! Lack of hand washing makes abortion more lethal than pregnancy. Lack of admitting privileges, however, doesn't.
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Oct 16, 2014 22:03
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VitalSigns posted:Pretty sure Casey overturned a bunch of that amid furious handwaving about how they weren't really overturning anything. Just read Casey. Roe outlined the logic of the three phases and also set time periods for each. This was dumb. It should have just outlined the rational of competing interests and whose interests win when. Casey directly throws out the framework of specific dates set by roe while explicitly affirming the logic behind them (section g near the top) States may put the fetus first when it is viable and doing so doesn't endanger the mother. States may put maternal safety first when a danger is greater than pregnancy itself. Casey addressed one situation that roe didn't - minor children. This added a player to the equation that roe didn't consider as it spells out nothing about the rights of parents or guardians. And it mildly weakened the roe standard of no legitimate interest in fetal well being prior to viability at all to, ok, some legit interest but not allowed to hold that interest over maternal rights because prior to viability maternal rights trump Casey was the state wanting to proselytize its citizens to reconsider and various attempts to enlist the help of other citizens to pressure the woman into changing her mind. You must tell your gaurdians, you must tell your husband. The informed consent stuff was irrelevant - I have to listen to a spiel about what they are going to do and sign off on it at my dentist even though I don't want to because visualizing the drill cutting into my tooth is almost as bad as the actual procedure. It didn't deal with maternal safety at all so how would it overturn that aspect of roe? Which again, it explicitly affirmed in the section where it noted that medical advances had shifted the windows but the logic behind them remained sound.
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Oct 16, 2014 22:51
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VitalSigns posted:The issue in Casey as I understand it is that it lowered the standard from heightened scrutiny to undue burden. It changed it from heightened scrutiny to undue burden when your motive is to advance the interests if the fetus. The big change was going from not being able to state fetal interest as a motive at all prior to viability to saying you could but you had to hold the woman's interests as the more important. If you claim your motive to be women's health then Casey refers to Roe and roe says, you can only do something if the alternative is more dangerous than pregnancy itself. Which is something anyone actually interest in her wellbeing would do anyway so it's not like that statement is some twisted bizarre technicality. Now kicking it out because their stated motive doesn't allow it when we know their stated motive is a lie and they are actually motivated by fetal interests rather than maternal safety is nitpicky rules lawyering - but what better place for it?
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Oct 18, 2014 16:30
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VitalSigns posted:Planned Parenthood made this argument as well, but the Fifth Circuit did not agree. Holy poo poo. What the gently caress? Of course its possible to care about the woman's health without taking into account current or future children. Ignoring the whole "being a decent human being who acknowledges women are people" thing there are still situations where there are not and never will be children - ever. Women with genetic defects who have made the conscious decision never to have children. Childless women on the cusp of menopause who won't have time to get pregnant again even if they wanted to. Women who went pre-eclampsic every time they had a wanted pregnancy and have realized that regardless of desire pregnancy is to lethal for them. But regardless. If something is less dangerous than pregnancy then it is better for her current children and/or future wanted pregnancies to do that thing than to be pregnant. Particularly in the case where she is low income with existing children (roughly two thirds of abortions). The simple act of being pregnant denies scarce financial and temporal resources from her existing children. It spikes expenses while reducing income. If you actually cared about her existing children you would facilitate access to abortion as much as possible so that they can get to do things like eat multiple times every day. Texas, by the way, has rampant child poverty and food insecurity. http://www.texastribune.org/2013/12/03/report-texas-child-poverty-increases/
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Oct 18, 2014 23:15
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| # ¿ May 22, 2024 18:27 |
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FAUXTON posted:They're most jealous of the obamapenis. All you had today is that the obamapen is mightier than the sword, Trebeck.
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Jun 20, 2015 22:57
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