None of these alternative statues give Trump what he wants and what he used the IEEPA for, which is unlimited power to use tariffs to force specific countries to comply with his edicts and more importantly to stop laughing at him. The SCOTUS took that away leaving him with the only other kind of power that he knows how to use: missiles and war ships. The next few months may prove disastrous for the US and for the world.
America finally caught up to Canada and ditched the penny. That's a victory everyone can feel good about. Hopefully the nickel is on it's way out too, and we can get bigger bills back in circulation to catch up with inflation
As comedians say: the last few months have been disastrous, but the next few months will be disastrous, too. Just lots of ... disaster ... going around. (cue grim laughter) Sooo, as I was saying: giant meteor ...
I suspect that 122 was used for grift: numerous exemptions of specific companies were made, quite often after a company personally met with Trump or his family members.
We have been here before many times. Nutritional epidemiology studies have a terrible track record of establishing causal relationships (e.g., Beta-carotene and lung cancer, selenium and prostate cancer, etc all were not replicated when the definitive clinical trials were done). The problem is that statistical models with questionable and often untestable assumptions are used, but the results are reported as if these models were fault-less. The result is overly optimistic estimates of statistical significance and inflated confidence in study findings.
I would disagree with this. While we can always point to examples where epi did not align with RCTs, this doesn’t capture how discordant (or not) this relationship is in the aggregate.
Thing is, we actually have empirics on this, and in reality observational studies comparing intake to intake are concordant in over 90% of cases, so I think we actually have a very strong case for making causal inferences based on replicated epi findings:
This remains uncontrolled and unblinded experiment complicating the interpretation of the results. For instance, can you be sure that any changes you might see are not caused by (e.g., hormonal, behavioural) changes induced by your knowledge that you just received 10x the average amount of microplastics?
if 10x the average amount of microplastics are showing changes that are approximately equivalent to hormonal or behavioral changes, it's not a significant factor to be worried about.
There are many times where unblinded experiments are still valid. And unfortunately, n=1 means that you can't have controls. The question: "did this intervention, in one person, cause a greater-than-normal increase in epigenetic changes, above baseline?"
For a "little" speech, it is all people seem to talk about; e.g., it was mentioned few times in the comments above. And, yes, one can be on the board of a public company and still make valid and consequential analyses. Hell, one can be a convicted fraudster and at the same time become the president of a superpower. My point, you could belittle Canada, EU, China etc but it is going to solve the US's intractable problems.
Mark my words. Few years from now , all who had the power to stop the genocide will claim that they were the ones who were warning us about it but we were not interested. History will be rewritten to highlight how morally ambiguous the situation was and how the perpetrators had no choice but to kill everyone. War is peace. Genocide is love.
I experienced similar challenges writing a music engraver app. I ended up rewriting it in Go in fifth the time. I think Rust is trying to solve a really difficult problem (certifying total memory safety at compile time) by exposing faulty assumptions about our code. But the problem is that in real programs, the interplay between correctness, safety, ease of maintenance and performance considerations is not a mathematical equation that can be solved at once by fixing the values of certain parameters. Often, what is needed is the ability to quickly experiment and rule out all the dead-end designs and algorithms which is really hard to do when you are changing multiple parts of your program while wrestling with the borrow checker all the way.
As a physician, I can tell you that euthanasia has been always around in every society and at all times. MAID just made the arrangement formal. Before MAID, it was implemented by withdrawing life-saving treatments (usually due to side-effects), rising doses of narcotics (for painful conditions) or even "terminal sedation" (the most explicit form of euthanasia before MAID-like laws).(And of course, patients always had the option of taking their own lives). In any healthcare system, there has to come a point where patients (and their families) and their doctors decide to terminate efforts aimed at extending life. In most cases, MAID is just a way to shorten the unpleasant interval between that decision and death. Given all that, it is not that surprising that 5-7% of deaths are attributed to MAID. The debate about MAID is another example where a lot of otherwise rational people fall prey to misguided sloganeering.
Euthanasia is illegal in most countries and almost always has been. Terminal sedation and intentional rising doses of narcotics would be considered ACTUAL murder in 100% of those cases where euthanasia is illegal.
If you are a physician and don't know this you should be immediately investigated.
I don't think it's that misguided. The incentives are so perverse here that, if the government isn't abusing it, they are acting incompetently. it would almost be better if they just had the actuary provide an expected life and expected cost chart and we agreed to pay the potential MAID recipient's estate 10% of the savings remaining on the day the chose to go, if they choose MAID.
How are incentives perverse? Would it be better to have a system that only incentivizes life extension, no matter the suffering it causes, no matter that it will still ultimately end in death?
It's not about whether the person should live or die, it's that the Canadian government has vested responsibility to provide healthcare in itself while making other options illegal. I can't make my own choice to, for example, buy my own medical insurance to ensure I live for as long as possible with the most effective (and likely expensive) treatments. The government has said they got this and limited everyone's choice to government only.
They screwed this up via multiple mechanisms, because that's what government seems to do, and now there is a pretty decent shortage of healthcare up here. This makes the incentives highly perverse because the government can't provide the world class health care it promised even if it wanted to, which leads to political pressure to bring in MAID and chop tens to hundreds of thousands of dollars of medical liability off the end of many patient's lives (which I would actually support if the underlying incentive structure was different, or if the government was at least honest about what was happening and compensating the MAID recipient's estates for forgoing treatment the government is obligated to provide but would be better for said government if they didn't). The most concerning bit here is the lack of provision of other life improving services like joint replacement, the latest experimental drugs, etc. and the likelihood that that is funneling people into a situation where MAID is the obvious best choice sooner than it otherwise would be. This is certainly happening with cancer treatments (although probably not intentionally, just incompetently) as people get detections for cancer and then find a months long wait list instead of days to weeks long wait list to see someone who can progress their treatment.
> which leads to political pressure to bring in MAID and chop tens to hundreds of thousands of dollars of medical liability off the end of many patient's lives
So this is an assertion that requires some evidence. The political pressure was instead from a majority of Canadians (across political lines) who want there to an an end-of-life option in situations when life becomes intolerable. People do not want to be forced by the state to stay alive and suffering via extensive medical interventions. Nor do they want to have to suffer through the alternative of slow and debilitating conditions that science is powerless to stop. This is the where MAID came from. Thinking of it in purely economic terms is already acting in bad faith.
> compensating the MAID recipient's estates for forgoing treatment
If you paid for private medical insurance, would you expect the same from them? To compensate your estate if you choose to end your life early rather that receive invasive and expensive treatment to temporarily forgo the inevitable? Even if you did expect that, insurance companies would never go for it. An even by the widest stretch they did then you're back to the same economic incentive but now with private industry. This is even worse I would say, because now people would be given a cash bonus to commit suicide (either by the government or private insurance, the same applies if people were compensated for foregone treatments). People with families in financial trouble may even consider this a way out to help loved ones. That is a crazy perverse incentive if you ask me.
On the side of offering better services, you have my whole-hearted agreement. Even something as simple as mandating an increase in the number of available seats at medical schools that corresponds with the population growth would be a start. Lots more to that list.
The claim that the govt. not being able to provide option A leads to more people picking option B is such an obvious truism that the onus is on you to provide evidence it ISN'T happening.
The political pressure is budgetary and care related. Are you claiming MAID does not save money and decrease usage by ending expensive care earlier than it would otherwise be ended?
I would expect private care to uphold whatever I agreed to when buying insurance from them. You continue to miss the point that there is no other option in Canada because the government made the other options illegal, which is what creates the liability. They can't make care in any other form illegal and also not provide care. I am also talking about the specific case where the person is terminally ill, not the way more crazy version we have rolled out letting people with no impending doom opt for suicide. Limiting this to the defensible type of MAID limits the perverse incentive you are concerned about to almost nothing.
You trust the government to do the right thing when they have continually proven they will choose the wrong thing if it is convenient or the outcome most likely under incompetent management.
> Are you claiming MAID does not save money and decrease usage by ending expensive care earlier than it would otherwise be ended?
No, I'm saying it reduces suffering and it also saves money and resources. It's the first part that is the most important and where the political pressure came from. You seem to missing that point. That it reduces suffering and that people want suffering reduced!
End of life care is expensive regardless of whether it is publicly or privately funded. And in either cases there will be people in situations where extending life via medical means just isn't worth it because the extra time would just be an extension of torment. If private insurance was an option, then it would be the private company that would incentivized to get people to end life early. The private/public part is irrelevant to the discussion if you only look at it through a financial lens. Both ways would have the same incentive monetarily.
> You trust the government to do the right
In this case the right thing is to allow people to choose for themselves, and that it what's happening. I don't even know what you want instead, do you want MAID eliminated?
The part you seem to be missing is that suffering isn't reduced and may increase if proper care isn't administered. Hopefully you can now see the confluence of both factors leading to the question whether MAID is to some degree replacing proper care.
> suffering isn't reduced and may increase if proper care isn't administered
Of course this is true. And if care isn't administered because of a choice by the person, then that's the end of the discussion. But, if its a lack of resources by the gov, then 100% these should be increased and I've already said I fully support that.
Is MAID replacing proper care? This could be a harder question to answer because what would your control group be. It would have to be one for which health care resources were available to them, AND, they also had a MAID-like option that normalized (i.e. not scandalous or considered morally 'wrong'). And then compare current uptake in Canada to see if there is a difference that could be attributed solely to a lack of health care resources being a driver, rather than just the existence of MAID as an alternative.
> The debate about MAID is another example where a lot of otherwise rational people fall prey to misguided sloganeering.
This is the same level of argument as saying that people who vote for the other guys must have been tricked by FOX News / MSNBC / Russia / Tik Tok / transtrenders / tradwives, and if only they truly understood their actual self-interest they would agree with you on all things. It's a bad style of argumentation, albeit very popular in academia ('why do the poor keep voting wrong?').
There are legitimate reasons to oppose Canada's euthanasia program on its own terms, and it's not surprising the Canadian government has very carefully shielded MAID from any sort of public input or oversight, since it's deeply unlikely it would pass a majority vote in its current form. There is consistent public opposition to euthanasia being available to anyone but late-stage terminally-ill people (and even then, it's divisive at best). There is strong public opposition to euthanasia solely on the grounds of mental health.
More broadly, I think people are increasingly sick of the misuse of the term 'healthcare' (or 'public health') to sneak unpopular or controversial policies past the electorate, and the idea of 'death as healthcare' is probably the most extreme example of this trend. When people cannot express democratic opposition to policies they deeply oppose, don't be surprised if you get pushback and populism.
> Only 12.1% correctly answered ≥4 of 5 knowledge questions about the MAID law; only 19.2% knew terminal illness is not required and 20.2% knew treatment refusal is compatible with eligibility. 73.3% of participants expressed support for the MAID law in general, matching a nationally representative poll that used the same question. 40.4% of respondents supported MAID for mental illnesses. Support for MAID in the scenarios depicting refusal or lack of access to treatment ranged from 23.2% (lack of access in medical condition) to 32.0% (treatment refusal in medical illness)
Most Canadians express support for MAID but cannot correctly answer questions about it. When Canadians are actually told what's in MAID, they oppose it.
It's also worth noting that quite a lot of polling on this question is done by, or on behalf of, pro-euthanasia organisations; there is often a huge mismatch between the questions asked and the actual legislation proposed and passed (in a very motte-and-bailey kind of way).
People stated they supported the policy after reading a full description of the policy. If you don't trust the paper (whose researchers are anti-euthanasia), the Canadian government found the same results. https://researchco.ca/2023/05/05/maid-canada-2023/
Nobody ever correctly answers questions about legislation, to put it glibly. Any piece of legislation newer than 10 years and more complex than a sentence is not going to pass such a test with the general public. 19.2% knew that terminal illness is not required? I would be shocked if 19.2% could correctly answer a few basic questions about the definition of "terminal illness."
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