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The problem I see with this kind of argument is that whether a health care provider provides abortion services has very little (nothing) to do with the care giv

by DSMan195276 5y ago

The problem I see with this kind of argument is that whether a health care provider provides abortion services has very little (nothing) to do with the care given to a medicaid or medicare patients. Where-as them being vaccinated for COVID does have a very clear impact on medicaid/medicare patients, especially since medicare patients are more likely to be in a high risk group (IE: old). It seems to me like you just don't think medicare or medicaid should be a thing to begin with. I think it's basic sense that if we're paying for medicare and medicaid we should require the healthcare providers receiving our tax dollars to meet some standard level of care, or else we're just wasting our money. We can argue over what that level of care should be, but I don't think it's all that debatable that requiring things like vaccines could fall into that level of care if not having them is particularly risky for patients.

bko 5y ago
> The problem I see with this kind of argument is that whether a health care provider provides abortion services has very little (nothing) to do with the care given to a medicaid or medicare patients. There's no mechanism to enforce this reasoning. It's whether the agency has the power to do it or not. For instance it could be argued that natural immunity is far superior to vaccines, so excluding healthcare workers with natural immunity from working is not about protecting patients. > It seems to me like you just don't think medicare or medicaid should be a thing to begin with. ???
- nickgros 5y ago
  > There's no mechanism to enforce this reasoning. The mechanism would be the judicial system, and in the case of restricting abortion services, the regulation would probably be subject to strict scrutiny. https://en.wikipedia.org/wiki/Strict_scrutiny https://en.wikipedia.org/wiki/Strict_scrutiny
- DSMan195276 5y ago
  > There's no mechanism to enforce this reasoning. It's whether the agency has the power to do it or not. For instance it could be argued that natural immunity is far superior to vaccines, so excluding healthcare workers with natural immunity from working is not about protecting patients. I'm not sure what you're getting at, Congress gave the agency the power to set guidelines for requirements for caring for medicaid/medicare patients, that's what they do. If a guideline would not actually impact medicaid/medicare patients, then they can't do it and it would rightfully get struck down in court when it is challenged for not falling within their powers. That's quite literally the same mechanism currently being used to challenge their power to require vaccines. Your point about natural immunity seems reasonable, it doesn't mean requiring vaccines for those without natural immunity wouldn't still make sense though so I don't think it really fits your point. Claiming that the particular way they went about this requirement is bad is different from saying they can't require a vaccine at all. I think your point makes some sense, but it could still be paired with a vaccine requirement making it effectively the same thing. > ??? I thought what I said was pretty self explanatory. If Medicare and Medicaid are going to be worth it then we have to have some standard level of care that we're paying for - we shouldn't be paying tons of money just for medicare/medicaid patients to receive bad care. Why should my tax dollars to go a healthcare provider who doesn't want to get the vaccine when that money can go to one who will? The medicare/medicaid patients that we're paying for will get better treatment from those healthcare providers who require vaccination, and if better care is not the goal than what is?
  - bko 5y ago
    >> It seems to me like you just don't think medicare or medicaid should be a thing to begin with. Please don't ascribe beliefs or intentions to me that I didn't explicitly state. > Why should my tax dollars to go a healthcare provider who doesn't want to get the vaccine when that money can go to one who will? Medicare and Medicaid should be fee for treatment. Why shouldn't I be allowed to choose what provider I want to visit for the same treatment? They can have different covid policies, much like schools do. I don't think it should be a federal issue. > The medicare/medicaid patients that we're paying for will get better treatment from those healthcare providers who require vaccination, and if better care is not the goal than what is? You're mistaking treatment for safety protocols. A health care provider can have a certain doctor to nurse ratio or a million other things and they may not all be "optimal" as defined by the powers that be. We should allow people to choose what health care provider is right for them based on their constraints and not restrict options.
    - kelnos 5y ago
      > We should allow people to choose what health care provider is right for them based on their constraints and not restrict options. Disagree. If I'm footing the bill for that care (as a taxpayer) I expect to have a say in what constitutes minimum quality of care. And allowing unvaccinated healthcare workers to treat patients is reckless, and falls well below that minimum quality bar. (I would also accept healthcare workers with natural immunity, assuming we can establish some sort of testable minimum antibody level that confers a similar level of protection as a vaccine.)
    - DSMan195276 5y ago
      > Why shouldn't I be allowed to choose what provider I want to visit for the same treatment? They can have different covid policies, much like schools do. I don't think it should be a federal issue. You can, by paying for it yourself :P > You're mistaking treatment for safety protocols. A health care provider can have a certain doctor to nurse ratio or a million other things and they may not all be "optimal" as defined by the powers that be. We should allow people to choose what health care provider is right for them based on their constraints and not restrict options. I see what you're saying but I think it's an odd distinction, treatment outcomes and safety protocols are clearly linked, why should tax dollars go to treatment provided with substandard safety protocols when the same can be spent for better treatment elsewhere? Functionally it would just end up costing us and the program more over time and lead to worse outcomes. The other issue here is that most patients aren't even going to know enough about the various things you listed to make an informed opinion about them.
- lukeschlather 5y ago
  "it could be argued" is not a substitute for the judgement of the regulatory body. The regulatory body hears arguments and makes a determination, I'm pretty sure that's the mechanism. (And it sounds like the court has decided to overrule it on shaky grounds.)
- zcw100 5y ago
  > it could be argued that natural immunity is far superior to vaccines It could be argued that we should wait for benevolent space aliens to come and cure it. Just because it could be argued doesn't mean it's a good argument.
  - sjwalter 5y ago
    Uh, wat? Every single study done on the topic shows that natural immunity (not innate immunity) is vastly superior and more durable and more robust than vaccine immunity. Here's a study from the prestigious publication Cell: https://www.cell.com/cell-reports-medicine/fulltext/S2666-3791(21)00203-2#relatedArticles https://www.cell.com/cell-reports-medicine/fulltext/S2666-37... What are you talking about?
  - UnFleshedOne 5y ago
    The problem here is not preferring vaccines to natural immunity for previously uninfected people -- it is mandating vaccinations for people already having natural immunity. Once that comes into play you can be sure health outcomes are not the intention of the policy.
- Beldin 5y ago
  > For instance it could be argued that natural immunity is far superior to vaccines Lots of things could be argued; some things shouldn't be argued without evidence. During a pandemic, statements that will be interpreted as suggesting that catching the disease beats vaccination fall squarely in that category.

bko 5y ago

> The problem I see with this kind of argument is that whether a health care provider provides abortion services has very little (nothing) to do with the care given to a medicaid or medicare patients. There's no mechanism to enforce this reasoning. It's whether the agency has the power to do it or not. For instance it could be argued that natural immunity is far superior to vaccines, so excluding healthcare workers with natural immunity from working is not about protecting patients. > It seems to me like you just don't think medicare or medicaid should be a thing to begin with. ???

nickgros 5y ago
> There's no mechanism to enforce this reasoning. The mechanism would be the judicial system, and in the case of restricting abortion services, the regulation would probably be subject to strict scrutiny. https://en.wikipedia.org/wiki/Strict_scrutiny https://en.wikipedia.org/wiki/Strict_scrutiny
DSMan195276 5y ago
> There's no mechanism to enforce this reasoning. It's whether the agency has the power to do it or not. For instance it could be argued that natural immunity is far superior to vaccines, so excluding healthcare workers with natural immunity from working is not about protecting patients. I'm not sure what you're getting at, Congress gave the agency the power to set guidelines for requirements for caring for medicaid/medicare patients, that's what they do. If a guideline would not actually impact medicaid/medicare patients, then they can't do it and it would rightfully get struck down in court when it is challenged for not falling within their powers. That's quite literally the same mechanism currently being used to challenge their power to require vaccines. Your point about natural immunity seems reasonable, it doesn't mean requiring vaccines for those without natural immunity wouldn't still make sense though so I don't think it really fits your point. Claiming that the particular way they went about this requirement is bad is different from saying they can't require a vaccine at all. I think your point makes some sense, but it could still be paired with a vaccine requirement making it effectively the same thing. > ??? I thought what I said was pretty self explanatory. If Medicare and Medicaid are going to be worth it then we have to have some standard level of care that we're paying for - we shouldn't be paying tons of money just for medicare/medicaid patients to receive bad care. Why should my tax dollars to go a healthcare provider who doesn't want to get the vaccine when that money can go to one who will? The medicare/medicaid patients that we're paying for will get better treatment from those healthcare providers who require vaccination, and if better care is not the goal than what is?
- bko 5y ago
  >> It seems to me like you just don't think medicare or medicaid should be a thing to begin with. Please don't ascribe beliefs or intentions to me that I didn't explicitly state. > Why should my tax dollars to go a healthcare provider who doesn't want to get the vaccine when that money can go to one who will? Medicare and Medicaid should be fee for treatment. Why shouldn't I be allowed to choose what provider I want to visit for the same treatment? They can have different covid policies, much like schools do. I don't think it should be a federal issue. > The medicare/medicaid patients that we're paying for will get better treatment from those healthcare providers who require vaccination, and if better care is not the goal than what is? You're mistaking treatment for safety protocols. A health care provider can have a certain doctor to nurse ratio or a million other things and they may not all be "optimal" as defined by the powers that be. We should allow people to choose what health care provider is right for them based on their constraints and not restrict options.
  - kelnos 5y ago
    > We should allow people to choose what health care provider is right for them based on their constraints and not restrict options. Disagree. If I'm footing the bill for that care (as a taxpayer) I expect to have a say in what constitutes minimum quality of care. And allowing unvaccinated healthcare workers to treat patients is reckless, and falls well below that minimum quality bar. (I would also accept healthcare workers with natural immunity, assuming we can establish some sort of testable minimum antibody level that confers a similar level of protection as a vaccine.)
  - DSMan195276 5y ago
    > Why shouldn't I be allowed to choose what provider I want to visit for the same treatment? They can have different covid policies, much like schools do. I don't think it should be a federal issue. You can, by paying for it yourself :P > You're mistaking treatment for safety protocols. A health care provider can have a certain doctor to nurse ratio or a million other things and they may not all be "optimal" as defined by the powers that be. We should allow people to choose what health care provider is right for them based on their constraints and not restrict options. I see what you're saying but I think it's an odd distinction, treatment outcomes and safety protocols are clearly linked, why should tax dollars go to treatment provided with substandard safety protocols when the same can be spent for better treatment elsewhere? Functionally it would just end up costing us and the program more over time and lead to worse outcomes. The other issue here is that most patients aren't even going to know enough about the various things you listed to make an informed opinion about them.
lukeschlather 5y ago
"it could be argued" is not a substitute for the judgement of the regulatory body. The regulatory body hears arguments and makes a determination, I'm pretty sure that's the mechanism. (And it sounds like the court has decided to overrule it on shaky grounds.)
zcw100 5y ago
> it could be argued that natural immunity is far superior to vaccines It could be argued that we should wait for benevolent space aliens to come and cure it. Just because it could be argued doesn't mean it's a good argument.
- sjwalter 5y ago
  Uh, wat? Every single study done on the topic shows that natural immunity (not innate immunity) is vastly superior and more durable and more robust than vaccine immunity. Here's a study from the prestigious publication Cell: https://www.cell.com/cell-reports-medicine/fulltext/S2666-3791(21)00203-2#relatedArticles https://www.cell.com/cell-reports-medicine/fulltext/S2666-37... What are you talking about?
- UnFleshedOne 5y ago
  The problem here is not preferring vaccines to natural immunity for previously uninfected people -- it is mandating vaccinations for people already having natural immunity. Once that comes into play you can be sure health outcomes are not the intention of the policy.
Beldin 5y ago
> For instance it could be argued that natural immunity is far superior to vaccines Lots of things could be argued; some things shouldn't be argued without evidence. During a pandemic, statements that will be interpreted as suggesting that catching the disease beats vaccination fall squarely in that category.