Every health system in the world makes decisions that result in deaths that could have been avoided had other decisions been made. I don't like many of the decisions our shambolic health system makes. But none of it is "murder".
An insurer having an auto-deny policy for care claims (procedure/medication/etc) and then fighting a physician’s explanation/reason for their recommendation to the extent the patient expires while this battle plays out, is evil and premeditated and arguably meets the legal criteria of murder in many jurisdictions.
Arguably was the key word you missed. I don’t think anyone has made this argument before but I personally believe it could be made successfully to a jury.
1) denial of care resulting in death has already has case law for murder, it’s typically geared towards people with a legal responsibility like a grossly negligent parent and does typically get treated as manslaughter but there have been extreme cases where murder was charged. This is where I think an attorney could sway a jury that insurers have a legal obligation to their insured. And particularly where the insurer is objecting to a medical practitioners recommendation/diagnosis/etc.
2) premeditation can be determined because the auto-deny decision has been made and programmed into their business systems.
There are jurisdictions where that’s basically all you need
No, that is obviously not also true of the Holocaust. Again: pretzels! It's really easy to look up why we invented new categories of crime for the Holocaust.
It is entirely true. The Holocaust was a sovereign nation committing actions that were legal within its judicial system at the time.
> The drafters of [the Nuremberg Charter] were faced with the problem of how to charge the men at the Nuremberg Trial with committing the Holocaust and other state-sanctioned atrocities committed in Germany and German-allied states by the Nazi regime. As far as German law was concerned the men had committed no crime, but only followed orders. Not following orders however, in Nazi Germany, was a horribly punished crime. The problem in trying the individuals responsible for the German atrocities lay in the fact that, like in World War I, a traditional understanding of war crimes gave no provision for atrocities committed by a state on its own citizens or its allies. Therefore, to solve this problem and close the loophole, Article 6 of the Charter was drafted to include not only traditional war crimes and crimes against peace, but also crimes against humanity…
You're misunderstanding the issue. As far as German law was concerned, ordering the deaths of millions of people wasn't a crime because of uniquely awful German law dehumanizing those people. International law was required, in part, because there was no other way to apply the obvious murder statutes to the case (you'd need to do that under German law, which was warped by the Nazis) and in part because the crimes were themselves more horrible than just murder. It was not because there was some weird bank-shot way in which knowingly operating death camps was alien to ordinary notions of criminal law.
Also: stop comparing things to the Holocaust. Still more pretzel twists. All you have to do is not pursue this dumb rhetorical strategy of depicting policy you don't like as "murder".
> As far as German law was concerned, ordering the deaths of millions of people wasn't a crime because of uniquely awful German law dehumanizing those people.
As far as American law is concerned, causing the deaths of many people isn’t a crime because of uniquely awful regulatory regime dehumanizing those people.
> Also: stop comparing things to the Holocaust.
It illustrates well the point that “just because a killing is lawful doesn’t necessarily mean it shouldn’t be considered murder”.
Because you're intent on framing a policy decision you dislike as "murder" you've found yourself arguing that running a death camp wouldn't be prosecutable without a "crimes against humanity" law, and comparing the administration of health care systems to the Holocaust. This is what I mean by saying you've twisted yourself into a pretzel. You made a bad argument. It's not the end of the world; I do it all the time. Let it go.
I want to highlight your point because you're correct and this is something that a lot of people don't understand about economic systems. We exist in a resource constrained system. There are finite medical workers, finite time, finite medicine, finite medical facilities, finite medical equipment, and just finite resources in general. There will always be shortages and surpluses in such a system as resource allocation is never perfect. If you have a shortage you must ration supply through some mechanism. It can be by prices, by queue, by need, by lot, by status, or countless other mechanisms or combinations of mechanisms but you must ration regardless. This will lead to people dying under certain conditions who may not have died if some other rationing mechanism was used, but if a different rationing mechanism was used then a different set of people would have died. The only thing that can be done is to select the system that allocates resources more efficiently than other systems to minimize this failure mode. This whole idea of "statistical murder" would just lead to the banning of medical care entirely as no system has perfect allocation at all times, although some are certainly worse than others.
Plus I have no idea what the word "statistical" even means in this context...
Our system isn't this resource constrained though. Our system has evolved unintentionally to allocate things this way, but our system does in fact have the resources. In fact, we have so much resources/efficiency/excess we have all kinds of labs/practices doing all kind of optional procedures across the entire country. So many that wait times are really really low for those elective procedures.
Example. I live in a mountain town. Our ER takes hours. I can go to one of the multiple nearby doc in a boxes and get seen in 15 minutes. My town HAS the resources to see those people waiting in the ER. We just don't allocated the resources that way.
My town is a ski town. We have WAY more orthopedic surgeons than we need, but it's extra profitable for them here and living rich in a remote ski town is nice.
My tiny town has multiple beauty skincare facilities with licensed doctors on staff.
It's not a 'we don't have resources' it's a 'we don't prioritize these lives'.
Which is fine. But don't lie to us and say there aren't medical resources.
You also have way more orthopedic surgeons because the AMA lobbied to require primary care physicians to go through the same rigorous residency track as specialists do, where before they could begin practice after a year, and so there's almost no incentive to enter primary care medicine directly anymore; it's the same cost and effort as becoming a cardiologist, but less pay.
One twist in your pretzel (or 38, if you want to break it out using the OECD) is that you've essentially indicted every health system in the world for murder.
Point to the spot in that table where private practices began merging with hospital systems and tell me why things were better in the instant before that spot. I took the time to assemble and present the data, you can at least engage with it.
> Point to the spot in that table where private practices began merging with hospital systems and tell me why things were better in the instant before that spot.
That's a strawman. No one asserted they all merged at the same time in a way that this sort of 30,000 foot overview would illustrate, nor that the effects would be instantaneous.
> I took the time to assemble and present the data
I mean, as a bit of feedback on that work, it'd be substantially more useful if the site said whether or not it's at least inflation adjusted. Population adjustment would be handy, too.
I think you want take that up with Medicare; this is just an NHE XLS put up on a web page. I don't know how any of that would change your argument, because you didn't actually make an argument here.
Every health system in the world makes decisions that result in deaths that could have been avoided had other decisions been made. I don't like many of the decisions our shambolic health system makes. But none of it is "murder".
An insurer having an auto-deny policy for care claims (procedure/medication/etc) and then fighting a physician’s explanation/reason for their recommendation to the extent the patient expires while this battle plays out, is evil and premeditated and arguably meets the legal criteria of murder in many jurisdictions.
It meets the legal criteria of murder in literally no jurisdiction anywhere.
Arguably was the key word you missed. I don’t think anyone has made this argument before but I personally believe it could be made successfully to a jury.
1) denial of care resulting in death has already has case law for murder, it’s typically geared towards people with a legal responsibility like a grossly negligent parent and does typically get treated as manslaughter but there have been extreme cases where murder was charged. This is where I think an attorney could sway a jury that insurers have a legal obligation to their insured. And particularly where the insurer is objecting to a medical practitioners recommendation/diagnosis/etc.
2) premeditation can be determined because the auto-deny decision has been made and programmed into their business systems.
There are jurisdictions where that’s basically all you need
The same is true for the Holocaust in 1944.
We had to invent new crimes “against humanity” to cover it.
No, that is obviously not also true of the Holocaust. Again: pretzels! It's really easy to look up why we invented new categories of crime for the Holocaust.
It is entirely true. The Holocaust was a sovereign nation committing actions that were legal within its judicial system at the time.
> The drafters of [the Nuremberg Charter] were faced with the problem of how to charge the men at the Nuremberg Trial with committing the Holocaust and other state-sanctioned atrocities committed in Germany and German-allied states by the Nazi regime. As far as German law was concerned the men had committed no crime, but only followed orders. Not following orders however, in Nazi Germany, was a horribly punished crime. The problem in trying the individuals responsible for the German atrocities lay in the fact that, like in World War I, a traditional understanding of war crimes gave no provision for atrocities committed by a state on its own citizens or its allies. Therefore, to solve this problem and close the loophole, Article 6 of the Charter was drafted to include not only traditional war crimes and crimes against peace, but also crimes against humanity…
You're misunderstanding the issue. As far as German law was concerned, ordering the deaths of millions of people wasn't a crime because of uniquely awful German law dehumanizing those people. International law was required, in part, because there was no other way to apply the obvious murder statutes to the case (you'd need to do that under German law, which was warped by the Nazis) and in part because the crimes were themselves more horrible than just murder. It was not because there was some weird bank-shot way in which knowingly operating death camps was alien to ordinary notions of criminal law.
Also: stop comparing things to the Holocaust. Still more pretzel twists. All you have to do is not pursue this dumb rhetorical strategy of depicting policy you don't like as "murder".
> As far as German law was concerned, ordering the deaths of millions of people wasn't a crime because of uniquely awful German law dehumanizing those people.
As far as American law is concerned, causing the deaths of many people isn’t a crime because of uniquely awful regulatory regime dehumanizing those people.
> Also: stop comparing things to the Holocaust.
It illustrates well the point that “just because a killing is lawful doesn’t necessarily mean it shouldn’t be considered murder”.
Because you're intent on framing a policy decision you dislike as "murder" you've found yourself arguing that running a death camp wouldn't be prosecutable without a "crimes against humanity" law, and comparing the administration of health care systems to the Holocaust. This is what I mean by saying you've twisted yourself into a pretzel. You made a bad argument. It's not the end of the world; I do it all the time. Let it go.
> you've found yourself arguing that running a death camp wouldn't be prosecutable without a "crimes against humanity" law
I have cited how we did, indeed, have to do exactly that.
> comparing the administration of health care systems to the Holocaust
Yes. Both involve causing megadeaths in a way existing law is entirely unprepared for.
I want to highlight your point because you're correct and this is something that a lot of people don't understand about economic systems. We exist in a resource constrained system. There are finite medical workers, finite time, finite medicine, finite medical facilities, finite medical equipment, and just finite resources in general. There will always be shortages and surpluses in such a system as resource allocation is never perfect. If you have a shortage you must ration supply through some mechanism. It can be by prices, by queue, by need, by lot, by status, or countless other mechanisms or combinations of mechanisms but you must ration regardless. This will lead to people dying under certain conditions who may not have died if some other rationing mechanism was used, but if a different rationing mechanism was used then a different set of people would have died. The only thing that can be done is to select the system that allocates resources more efficiently than other systems to minimize this failure mode. This whole idea of "statistical murder" would just lead to the banning of medical care entirely as no system has perfect allocation at all times, although some are certainly worse than others.
Plus I have no idea what the word "statistical" even means in this context...
Our system isn't this resource constrained though. Our system has evolved unintentionally to allocate things this way, but our system does in fact have the resources. In fact, we have so much resources/efficiency/excess we have all kinds of labs/practices doing all kind of optional procedures across the entire country. So many that wait times are really really low for those elective procedures.
Example. I live in a mountain town. Our ER takes hours. I can go to one of the multiple nearby doc in a boxes and get seen in 15 minutes. My town HAS the resources to see those people waiting in the ER. We just don't allocated the resources that way.
My town is a ski town. We have WAY more orthopedic surgeons than we need, but it's extra profitable for them here and living rich in a remote ski town is nice.
My tiny town has multiple beauty skincare facilities with licensed doctors on staff.
It's not a 'we don't have resources' it's a 'we don't prioritize these lives'.
Which is fine. But don't lie to us and say there aren't medical resources.
You also have way more orthopedic surgeons because the AMA lobbied to require primary care physicians to go through the same rigorous residency track as specialists do, where before they could begin practice after a year, and so there's almost no incentive to enter primary care medicine directly anymore; it's the same cost and effort as becoming a cardiologist, but less pay.
> Every health system in the world makes decisions that result in deaths that could have been avoided had other decisions been made.
And some of those decisions are, shall we say, justifiable homicide.
Intent and motive makes murder. “I will let these people die so I can be richer” is different than a bureaucrat who gets paid the same either way.
None of them are homicide. Look at the pretzel you've twisted yourself into trying to defend your use of the term "murder".
Look at the pretzel that’s forming from trying to avoid the “decisions to let people die for profit” aren’t homicide.
One twist in your pretzel (or 38, if you want to break it out using the OECD) is that you've essentially indicted every health system in the world for murder.
The US is uniquely and aberrantly expensive amongst the OECD.
Yes! For reasons having very little to do with your argument!
https://nationalhealthspending.org/
Perhaps you could elaborate on what argument that link is supposed to support?
“We spend a lot” and “people make profit off denying and inflating cost of care which results in needless deaths” are not exclusive scenarios.
Point to the spot in that table where private practices began merging with hospital systems and tell me why things were better in the instant before that spot. I took the time to assemble and present the data, you can at least engage with it.
> Point to the spot in that table where private practices began merging with hospital systems and tell me why things were better in the instant before that spot.
That's a strawman. No one asserted they all merged at the same time in a way that this sort of 30,000 foot overview would illustrate, nor that the effects would be instantaneous.
> I took the time to assemble and present the data
I mean, as a bit of feedback on that work, it'd be substantially more useful if the site said whether or not it's at least inflation adjusted. Population adjustment would be handy, too.
I think you want take that up with Medicare; this is just an NHE XLS put up on a web page. I don't know how any of that would change your argument, because you didn't actually make an argument here.