I'm not immune to it myself especially with people I consider lost causes.

When making decisions about one's own body, there isn't a need for one's arguments to be understood as rational anyway. — Tzeentch

A non-rational argument is a contradiction in terms so I have no clue whatsoever what your point is.

Obviously decisions about your body need to be weighed against the interest of others if those decisions have consequences for others and once you reached a conclusion you'll have to argue for it. And your decisions can also have consequences. You're free to drink, but you don't get to drive. You're welcome to walk around naked, just not in public.

If a theory is predictive then it is presumed correct until it is falsified.
Scientists are trustworthy.
Therefore the theory is correct.

:chin:

Trust isn't rational at all. It's a rather obvious point really. I could be right 99 times, that's no reason at all to trust I'll be right the 100th time. Trusting scientific consensus generally works for a basis to make decisions but it's not a rational decision making process.

Edit: I'm not saying it's a bad heuristic and that you shouldn't employ it, I'm merely pointing out that it's not rational. And if you understand that, you can imagine that such a heuristic fundamentally cannot work fit someone who has general distrust. So repeating "but the scientific consensus" means absolutely nothing for those who think "but the government is evil". You trust the consensus, they distrust anything the government promotes. Nobody is talking about the same thing at that point.

Sure, we can say that these people are irrational, that they are jumping to conclusions, and so on. That they rely on the government too much, that they are even childish and "can't think for themselves". But right now, this is irrelevant. For these people, trust is the primary heuristic, and that's how they function. — baker

I totally agree that it makes little to no difference telling people they are irrational. I do think it helps, if you're intent on changing minds, to understand the "heuristic" isn't a rational decision making process. Rational arguments aren't going to convince many as is clear with respect to the entrenched positions even on a board like this where rational thinking is presumably above average.

And your plan takes too long for the issue at hand. And it's true for both sides in a way. Assuming pro-vaxxers are right, what's the best way to go about convincing anti-vaxxers? Assuming anti-vaxxers are right, what's the best way to go about convincing pro-vaxxers?

Pro-vaxxers have a heurestic too, where the most used one is "scientific consensus". Even that is posited as a rational decision making process but it really isn't. But since most people tend to agree with the fact it's a pretty good heurestic they don't get challenged on it.

A start to at least get a meaningful conversation going is that both sides realise they've not rationally arrived at their position, unless they're expert epidemiologists or virologists and some doctors, and stop assuming only the other is irrational.

A question could be, what makes a good heuristic decision making process and why? Maybe that can take the conversation further, I don't know.

The R-factor is much lower in Norway because it isn't densely populated. So a 68% vaccination rate is sufficient to reach that. Different regions require different approaches. 68% vaccination in rural areas in the Netherlands would be enough as well - not so much in Amsterdam.

As I tried to demonstrate with the Apple example, it's hardly rational to assume that because you had a bad experience with the government in one area that you will necessarily have a bad experience again and in particular in another area. Cause for concern? Sure. But so far I'm missing the evidence that Big Pharma and the government are lying and are untrustworthy with respect to the Covid vaccines.

There's different discussion to be had about the efficacy of policies in general and why Covid and not obesity and smoking and eating too much sugar and salt, etc. But those are still not reasons not to get a vaccination since the money has already been spend - your vaccine has been ordered.

Indeed, it isn't evidence, but it is cause for action, or in the case of those who don't get vaccinated, inaction. — baker

No, that's just a heuristic approach that you confuse with making a rational decision. There's an important difference. If I have bad experiences with Apple products, that's no reason to assume their next phone will be shit too. Those bad experiences are a reason to do proper research on the next phone whether the issues I had with previous versions are resolved or not. It's also doubtful my experience with their phones can be carried over to other product lines such as laptops and desktops.

Of course, I can also choose to categorically not but Apple products as a stand in for doing that research but that's not rational because it's quite possible their next phone is the one best suited to my needs.

Enough slapping each other on the backs. Get a private room. If you cannot unearth and empathise why anti-vaxxer believe what they do, you're never going to convince them otherwise. They're not irrational or stupid as much as you want to find a reason why you're not able to convince them otherwise.

It's not fundamentally irrational to distrust governments or the pharmaceutical companies. I think government action in respect of Covid has been pretty shit in general.

In the Netherlands, thanks to this site, I argued for a lock down about 2 weeks before they implemented nation wide restrictions. That means people who's job it was to understand pandemics should've known even earlier. I assume they did, since the writing was on the wall by then and most likely politicians didn't listen because "the economy".

And then this summer when cases per citizen were higher than surrounding countries, the experts advised not to fully open up and the Netherlands being the god-damn most populous country in Europe, they fucking caved on the political pressure from a vocal minority and fully opened up. Predictably, that didn't end well. They then failed to take responsibility for it, which pisses me off even more and we went into lock-down again.

Then there was the wishy-washy communication on masks, which could've been avoided if they had simply said: "Masks work, we just need to prioritise them for front line healthcare workers, so the sale of them are banned until such time as the supply of PEP for front line workers is guaranteed. We've set up a special task force to but PEP." Instead of suggesting they're not effective.

Governments make decisions based on a variety of different social, economic and political interests and as we have seen, saving human lives is not their primary interest in most cases. The economy, e.g. those people who can buy influence and vote for status quo parties, are almost always prioritised and regular people pay the price. Normally that's just about taxes, this time it's about lives, which makes it especially egregious.

So yeah, I get the distrust, I just don't think it translates into having to distrust vaccinations. There's no particular reasons to distrust vaccines other than general distrust of governments and big pharma and that simply isn't evidence.

I stand corrected?

Still doesn't change the healthcare problem, now does it? Also try to remember this is a pandemic. The world doesn't revolve around the USA.

How did most people develop a resistance to the annual flu - by getting it and now they have the anti-bodies? Why doesn't the same concept work for Covid? — Harry Hindu

The answer was in my previous post. It would eventually work for Covid but not before crippling the healthcare system for months and causing unnecessary deaths.

I don't get this part. If closing down air traffic with China is problematic, which is in essence keeping people separated to prevent the spread then keeping people 6-feet apart and limiting the number of people in a room would be problematic. China was the one that prevented any information from getting out about the virus and how it originated. And if you believe anything the Chinese govt. says then that is problematic. — Harry Hindu

I already answered that too. It's about political will of whatever relevant government. I'm not even talking about the Chinese government here but our own.

Many people are arguing that people should get the vaccine to prevent the virus from mutating and spreading, but the research shows that the virus can be spread even by those that are vaccinated. And if the virus can mutate even among the vaccinated, then why are we not making the same argument regarding the common flu? — Harry Hindu

The vaccination claim of manufacturers was never about reducing spread. People assumed this to be the case because this has been the effect of other vaccinations like polio or measles (but not the flu shot for instance, which is also a vaccination). Covid vaccination was and is about protecting people against hospitalisation so that the burden on the healthcare system would be acceptable. Initially it also reduced spread and with the delta variant a larger proportion of vaccinated people can pass on the virus than happened with previous variants.

To reduce spread, social distancing and mask wearing remains important for everyone, whether vaccinated or not.

If Covid-19 naturally mutated from a non-lethal virus to a lethal virus, then what is to prevent the regular annual flu from mutating into something more dangerous? Why aren't the annual flu shots being mandated if this is the case, and we should never stop wearing masks for the fear of some virus naturally mutating into something more lethal? — Harry Hindu

The flu sometimes does mutate in a more deadly strain but because the virus is endemic most people have some resistance to it, even against a new deadlier strain. So that never resulted in pressure on healthcare capacity as Covid has and does (I've not heard of triage because of the flu, except maybe the Spanish one). Since we all rather not live in continuous lock downs (I presume) to avoid total deterioration of the healthcare system, a way out is getting enough people vaccinated instead of infected.

Every policy decision was to avoid a collapse of the healthcare system, not to save every life out there, as the knock on effects of a healthcare system unavailable for any other type of care would result in even more deaths as those with other life-threatening diseases could not be helped and Covid-care wouldn't be much more than getting a bed in a tent in a parking lot of a hospital if you're lucky.

With proper detection, isolation and contact tracing, a lot of nasty bugs could be squashed before they really can do damage, as NZ did, but it requires political will which is often absent because $$$. Closing down air traffic with China is apparently problematic.

And there's definitely something to be said for including mask wearing as a general hygiene precaution in busy areas. As some cultures already do. Incorrect mask wearing notwithstanding as large scale research has confirmed.

If Covid-19 was manufactured in a lab, then that brings a whole host of other implications that we should consider and be fearful of. One implication is that we should be more angry at the scientists manufacturing lethal viruses and unleashing the on the world, than being angry at those that are unvaccinated, which the internet shows most blacks haven't yet been vaccinated thanks to the Left's scare tactics last year when Trump was president. So are you being racist by bashing the un-vaxxed? — Harry Hindu

This makes little sense to me. Whether it was manufactured or not doesn't change the healthcare problem. Being angry with those who allegedly made it, wouldn't diminish my annoyance towards those advocating bad policies or personal decisions.

I'm not aware of a causal link between "scare tactics" (which ones?) and getting a vaccination. Care to share your insights on that?

Luckily, all those people have the decency not to die at more or less the same time or do it far away from where we live.

What a nonsense reply. I shouldn't need to make my case because 1) common decency would require that if I kindly ask something that is a minor inconvenience to the other, the other would do it to make me feel more comfortable and 2) it was a condition for using a private service.

Now generally, I don't have either the time or inclination to have to make my case for people who refuse to follow the rules. We can have such discussions here, we can do that during a protest, we can do that in Parliament but we don't do it in a fucking train where the majority of people are too scared to speak up because they're afraid a bunch of teenage assholes will beat them up.

It's also funny that you think I took pride in doing this, which was totally not the point of the story. But I didn't expect anything else but for your and Tzeentch to jump on this.

Yeah yeah, you can't read, we know about your dyslexia. Move along now.

I'm not backpeddling at all. It goes as follows:

1. I ask them to follow a rule established in trains
2. they get angry and threaten me
3. in a lawless environment, I would've broken their legs for the threat to me. It's called self defence, look it up.
4. Since it's not a lawless environment and the law was on my side, I didn't have to resort to 3 at all

Does that compute in your tiny reptilian brain?

Aww, you poor thing, you really can't read can you?

The only ones threatening with violence where those guys themselves towards me simply because I cordially asked them to follow the rules. They were itching for a fight; I simply refused to give them an excuse. These were rules they agreed to when they decided to use a service that requires them to do so and they were fully aware of the rule as the little sycophants were wearing the masks right before the ticket inspector arrived. So they're little pussies that have a big mouth when there's no consequences to their behaviour - much like some posters here I suspect.

In a lawless environment where I could've beaten the shit out of them without repercussion, I would have. So, thank god for "implicit" threats of violence. Saved those kids a few broken legs.

If you don't want to wear a mask, don't get on the train.

Yesterday I was in the train and there were two teenagers next to me not wearing their face masks properly (under their chin). I asked them "Could you please wear your face mask over your mouth and nose?" (Which is repeatedly broadcasted as the rule on Dutch trains). Well, I was accused of all sorts of things, including a Nazi. And they were banging on about "I do what I want".

So I asked them "You've never helped anyone out of your own volition?" "You've never done something for someone else?" That's when they started cussing me out (it's all on the net somewhere because they were filming all the time, I might go viral, hooray!). No reply really.

Any way, they didn't do it, so I waved down the ticket inspector. All of a sudden face masks were on. It's amazing how afraid these people are of people in a uniform and immediately listen. In the end they blindly obey authority when they're confronted with it (whatever happened to "I do what I want"?). She still kicked them off the train though at the stop. Lots of swearing and middle fingers in my direction; so I thanked them for their seats.

We can disagree but I don't appreciate the suggestion I didn't take your articles seriously. I read the article it just states they are separate issues when I've offered plenty of EU data to the contrary. So the article is demonstrably wrong and doesn't take the effect of legalisation into account because it simply assumes no relationship exists.

I had you pegged more intelligent than this.

Neither of those articles take into account the possible effects on human trafficking so I don't find them persuasive at all. It's curious after highlighting this obvious link between legalisation and human trafficking in at least one case doesn't inspire you to be more critical.

A fair point, but not a rebuttal to to my statement. Is your argument that because it takes time that we should just throw the “johns” under the bus? With limited resources choices must be made, priorities serviced. In the multitude of things to put resources towards there is room for both if anyone actually cared, but they dont. — DingoJones

I'd like an approach that creates the least victims as a result of (un)intended consequences. It's a weighing of interests to me. A John paying a fine doing something he doesn't necessarily have to, to avoid victims of human trafficking seems a reasonable trade off to me. As I've said and I'll repeat, it's not ideal and I agree with the principle and I even used to unequivocally argue in favour of it until I was confronted with the real life consequences of it by people working in the field. For now I consider the Nordic model a better alternative than full legalisation of sex work with respect to the Netherlands.

What you say "seems" right only in a vacuum, not so much in many other recent historical and national contexts. According to Human Rights Watch (contra the "Nordic Model" used in The Netherlands and elsewhere) ... https://www.hrw.org/news/2019/08/07/why-sex-work-should-be-decriminalized# . Also consider this recent article. — 180 Proof

What I say isn't in a vacuum and I find the suggestion kind of weird. It's you who starts from a principle and then conclude things must be a certain way. I agree with the principle but know what it costs in the real world to just legalise. It's a well known issue for anyone working for the police or public prosecution in the Netherlands, where many of my peers from university ended up working - which is how I know.

The Netherlands isn't using the Nordic Model. I don't understand where you get that from. It's been legal for both prostitutes and buyers since 2000 with devastating effect for human trafficking victims. It's no coincidence that the UN Office of Drug and Crime consistently lists the Netherlands as a top destination (and regularly as the top destination) for victims of human trafficking. That's disproportionate if you consider size and population of the Netherlands compared to Germany and the UK.

60% of all European human trafficking is for sex exploitation but if looking only at women, it's 92%. See: https://ec.europa.eu/home-affairs/what-we-do/policies/organised-crime-human-trafficking/trafficking-human-beings_en

The question is what do you want to prioritise? Sex worker rights or saving/avoiding human trafficking victims? I'm choosing the latter because most sex worker rights are protected under the Nordic model - even if it's not perfect from a principle-based point of view. And since, even in the Netherlands where sex work has been legal for over 20 years, there is only a very small group who fully willingly work as prostitutes instead of as a result of circumstances (mental health, debts, poverty) or at worst as victim of human trafficking, fixing the circumstances surrounding sex work is a much bigger problem in terms of number of victims and seriousness of the breach of human rights of trafficking victims. Or in other words unwilling sex workers far exceed willing sex workers and the human rights abuse suffered by trafficking victims are much worse than the limited infringements suffered by willing sex workers.

Only once you have the human trafficking under control and a good social safety net with respect to mental health and debt management, should you take the next step and fully legalise. It should be a goal not a principle.

Why can’t you do both though?
It seems like a bad idea to let criminals dictate policy.
Like, “Whoa whoa whoa fella. We can’t make that legal cuz the criminals will act up and we can’t have that”. Criminals will be criminals, the answer for me is to combat the criminal behaviours, not placate them. I mean, your plan is to punish the people (the johns) who participate in something you just made legal (for sex workers to sex work) instead of punishing the people who A) were the problem in the first place and B) are committing more crime and inflicting more suffering that they were before. (The human traffickers).
That seems pretty assbackwards to me. Is that justice? — DingoJones

Criminals don't dictate policy, limited resources do. That said, it took over 15 years before local and national governments changed focus to dismantling networks of human trafficking instead of closing "windows" where victims worked. But it requires a lot of international cooperation too, which has steadily been improving since 2012 thanks to EU legislation (specifically EU directive on combatting human trafficking.

In an ideal world sure. But we live in a world where criminals are perfectly capable of getting away with it and have been getting away with it for ages even when prostitution was illegal.

So given the reality of the situation, even if I support the theoretical point that adults should be free to contract for sex in practice I've learned to oppose it but in such a way as to not oppress sex workers (who are generally already victims). So I support legalising the prostitute and allowing them to unionise but criminalise those who buy the service. It's an incongruent position but the best option on the table where it concerns the Netherlands.

with criminalized prostitution as it is so the prevalence of trafficking is an independent factor and not increased by 'decriminalizing' prostitution; otherwise, I don't think 'sex workers' (former & current) in North America, Australia, Europe, etc would (pre-2020 at least) be politicking to legalize, even unionize, — 180 Proof

It's not independent, it's related. Which is why human trafficking increased in the a Netherlands when prostitution was legalised. And while it makes sense for those who chose to become sex workers, or even those who were initially forced into it, for their own sake to pursue legalisation and unions that doesn't mean they understand the wider repercussions of such policies.

You can't just legalise and not expect demand to go up.

sale^ of consensual sex acts – victimless ... — 180 Proof

Theoretically true but by decontextualising it from the criminal background from which legal prostitution arose, the legalisation of prostitution led to a huge increase in human trafficking of sex workers. We've seen it happen in the Netherlands. So unfortunately this isn't true in practice.

Israeli geopolitics — Tzeentch

What's this?

I think a viability test on whether something qualifies as abortion or not is problematic because medicinal developments may result in the right to abortion to disappear altogether. I think a reasonable period of reflection (a month?) upon becoming aware of the pregnancy should be the deciding factor. I think it's more important that children arrive in families that want them to be there than being unwanted. Moreover, why are we considering forcing women to carry to term against their will?

You are responding to me, not the other way around. — Tzeentch

You've repeatedly initiated discussions towards me. So this is another stupid remark.

The rest of your post, as usual, doesn't contain an argument. I'll ignore you from now on.

This will take us maybe too far afield because I don't want to turn this into a debate over the virtues of capitalism versus socialism, but, suffice it to say that even in a purely profit driven environment, a business entity must remain focused upon supplying services based upon the demand if it wants to realize profit. That is, an insurer can't expect to have subscribers if it excludes benefits for expected illnesses. — Hanover

It's not a debate about the virtues of capitalism or socialism but a debate between privatised and universal healthcare. Under the first, you're definitely screwed if you have a rare disease. At least universal healthcare is subject to public debate, instead of board room decisions. Moreover, due to the fact universal healthcare includes more people, the risk mutualisation is spread over a greater number of people. In theory it should be more affordable to also cover rarer diseases. In practice this is proved time and again by the fact both coverage is greater and costs are lower in countries with universal healthcare as opposed to the US, while quality of care is, on average, better too.

Of course, the US has extreme outliers in both directions and the best care available in the world most likely would be in the US. That's the only upside of the profit driven mechanism in the US I can think of.

As I said, universal healthcare makes economic sense.

Ought we afford them less care than others? — Hanover

Are you asking whether prisoners should be afforded less care than others? Then no.

It's only relevant if other triage considerations have already been exhausted (such as, acuteness of the care needed, beneficence and maleficence) and if the information is available whether such a person has contributed to the hospitalisation themselves, then I would use that information and I think it would be ethical to do so.

First of all, if you're not interested in argumentation, get the fuck out of here. My "beliefs" are at least well-founded. I've not read arguments from you on this thread just repetitive inane talking point or "oooh you're a bad person".

Second, you're so stuck in wanting to disagree with me it creates a spontaneous inability to read on your part. I've not argued might makes right anywhere nor does it logically follow from my arguments. I've merely demonstrated that there can be no theft because the right to pre-tax income is morally and legally incoherent.

In other words, your statement doesn't logically hold and therefore is a false belief.

I believe I actually have an argument where you dodge questions and just like to repeat yourself.

Excellent. You totally didn't understand the argument as expected. I dismissed the legal argument for a right to pre-tax income in one sentence. Obviously, I don't find it important.

What's the moral basis for claiming you have a moral right to pre-tax income if moral considerations are entirely absent from market functioning? There isn't one. When's the last time a discount on bread was given for the hungry? That the best and most capable, and therefore most deserving, person gets paid the most is the exception to the rule. There's so many reasons why this is the case and why the market mechanism doesn't result in moral outcomes that this should be obvious. Please let me know if your imagination is so stunted that this needs an exposition for your educational benefit.

The right to income arises within the framework and context of existing social systems as embedded in society which cannot be separated from its legal framework because that supports and upholds the socio-economic framework through various laws such as enforcing the terms and conditions of agreements through courts, policing frauds, setting standards etc. etc. That same system requires you to pay taxes; you cannot claim a right provided by society on the one hand and deny the obligations that come with it.

You can frame it any way you like - it doesn't change what taxation is. — Tzeentch

Yawn.

For taxation to be theft, there must be a right to pre-tax income. Legally, this is clearly not the case.

A moral right to pre-tax income can only be said to exist if earned income results in a fair and equitable payment for labour rendered. This too is false. Market circumstances are not concerned with the moral worth of labour or who needs the job the most or who is most deserving of fulfilling the assignment. So a moral right to pre-tax income is incoherent.

Since no rights are infringed, there's no theft.

In other words, your statement is laden with so many unspoken assumptions it can be dismissed as the opinion of an uneducated layman who simply doesn't like paying taxes.

Great post, thank you. I'm swayed to some extent but want to look at some points you raise further.

When the US was debating universal public healthcare, one of the things that derailed it was the Republican argument that there would be "death committees" that would be charged with determining who was provided care and who wasn't. The Democrats responded that was hyperbolic and inaccurate. As you've stated it though, you seem to accept that some government accounting committee would in fact intervene in the decision of who gets what health care and who does not. That is, you seem to be generally agreeing there will be and should be such death committees. That seems to me a hard strike against public health care ever coming to exist in the US if it were to move forward in the way you've suggested. — Hanover

It is obviously hyperbolic. Care is, at all times, rationed. There's decisions on how many beds, how many doctors, how many nurses, how many vents, CAT-scans, etc. etc. made all the time. Should we spend 2 million EUR per dose of Zolgensma?

And let's not pretend the private insurance companies treat this any differently. How many US insurance companies cover Zolgensma? And if they do, how much does the premium go up making it unavailable for most? (I'd say there is another issue here where a lot of public research and development goes into what is eventually privately patented so we should be wondering about the whole pharmaceutical setup to begin with, but totally different discussion).

The important difference with universal healthcare and private healthcare insurance is that the decisions on what to cover isn't a cost-benefit analysis with respect to profit for private companies but instead about an efficient distribution of cost and effective care.

So if we must use the hyperbole, I'd rather have a death committee I can vote about and politically influence than one that will randomly change my coverage as its shareholders require to make a profit that I cannot influence.

What we should be forbidden to consider are factors surrounding the ethical worth of the two individuals, where the good hearted humanitarian gets the heart but Ebenezer Scrooge is left to die or where the prostitute is overlooked, but the community leader gets the nod, or, more pointedly, where the vaccinated gets care and the unvaccinated gets denied. — Hanover

This is a misrepresentation of my argument. I'm not arguing about the moral worth of a person, I'm arguing about taking into account culpable behaviour that contributes to the hospitalization. In a car accident where there's a victim and a speedster and only one operating room available and operating one means the other dies, I'd save the victim first. Why? Because the perpetrator has culpably contributed to his own hospitalisation. That lowers the responsibility on others to save him. I don't find this an ethically difficult position to hold.

To stick with the Wild West theme, you can always shoot a few judges while there's a democratic majority.

Apart from the problematic framing resulting from such a narrow individualistic and capitalist worldview that isn't shared by most here (certainly not me), you're not forced to go to the hospital either. You're paying for the option to use healthcare at a cost far below what you can actually afford because other people are effectively paying for it. In other words, you effectively pay for insurance and by mandating this type of insurance, costs of healthcare are kept lower. Universal healthcare makes economic sense.

I think you've misunderstood how discussion works. Either the matter of it's wrongness can be established (or at least furthered) dialectically, in which case you need to answer the points I've raised, or it can't, in which case this is little more than an opinion poll and you've already had your go. — Isaac

I've given enough arguments and given real life examples of what the Dutch healthcare system is already struggling with that have laid bare that this approach cannot continue. It's not sustainable so they are looking at it differently. The prevailing position will go the way of the dinosaurs.

Should people who misbehave in a restaurant be served even though they paid? The other customers paid too and to ensure they can get the service they paid for, the misbehaving customer is asked to leave instead of causing all other customers to suffer the misbehaviour.

Payment is not the only requirement for access to a privilege. Meanwhile, in the real world, its actually those people that don't need care who effectively pay for the people who do need care. Otherwise the system wouldn't be affordable.

On another note, I must say it is a bit disheartening to see grand ideals of healthcare for all be dismissed at the first sign of trouble. — Tzeentch

Total mischaracterisation of other people's positions.

So, applying the same logic, I would not demand you lose priority for the vent based upon your bad behavior of vaccine refusal, but I could certainly see insurance refusals, hospital surcharges, or other penalties short of having your medical care altered. — Hanover

But it's not the same logic because there's nothing barring you to return home and get the shoes. In the examples I give, a decision has to be made. Both patients need care equally. Justice isn't the first consideration in triage but it certainly is one of them. Other things being equal, I think the decision not to get vaccinated and requiring a scarce resource like an IC bed or a vent as a result of that decision and when other people need it just as badly can and should be taken into account.

And while we're at it. In the Netherlands we have universal healthcare and there are serious debates about whether to treat certain patients due to limited resources. The anesthesiologists I mentioned recently took a minority position to treat a 90-year old woman for heart surgery. Everybody else argued not to do it, too old, much too likely to develop complications from the procedure and likely not to fully recover. He argued differently because in her particular case she had never had need for extended care or other operations.

In retrospect she did develop complications and kept an IC bed occupied for 5 weeks.

Do we provide care or not? She did take up resources that could've been used by others. At what point has a person lived a full life that, as part of our decision to ration care, we say we don't treat you for heart issues anymore? These are serious ethical questions that have been an issue here for a decade now because it's becoming increasing clear, with an aging population, our healthcare system cannot indefinitely provide all care needed. These questions don't involve a "first come, first serve" solution or "who has the most acute need".

It's the same about whether to insure extremely expensive drugs for very rare diseases. Both these issues put the system under stress.

And that brings me back to the point I've made before: healthcare is a privilege not a right and we can and should establish requirements as to when you get that privilege. This is not an issue when the system isn't under stress, then everybody gets care and we can prioritise based on need but if the healthcare system is under stress other considerations can and should be taken into account.