income inequality and abortion

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Nobody has suggested that. You are the one who was misusing the term, "primary care."

I have identified an abortion as primary care based not upon the provider, but upon the typical definition of "primary care" as that care which is provided to the patient at the first level of contact with the health care system.



You are allowing the term "primary care" to distract you. It's not in the least relevant to the questions of whether or not abortion services are generally available without restrictions, and whether publicly funded health insurance systems ought properly to pay for them. There are plenty of primary care situations that are not paid for by public insurance providers.

So, if we accept the fact that a physician and a patient can agree that a procedure is medically necessary, what are the bases that you would suggest are proper for the legislature to use when prejudging whether or not the publicly funded insurance system will pay for that service?

Can you conceive of a set of criteria that are objective, that will identify abortion as a non-insured service, and that will not be revealed for a complete sham by differential treatment of some other procedure?

In the Netherlands there are private insurance companies that operate from a Christian background. People who are against abortion can get insured there, and they won't have to pay for abortion.
Of course this way of thinking could lead to a complete loss of solidarity: older people that don't want to pay for pregnancies/repoductive medical procedures, men who don't want to pay for female health problems and vice versa. Hasn't happened as far as I know.

I dont think, that this will lead to an separation, because thats the way public health care always have been in our countries. Necessary medical costs get payed. Things you want extra beside basic necessary medical costs, you either need to pay yourself, or get an private insurance for it. When it comes to an abortion out of medical reasons, that are necessary to protect the womans life, there is no real choice, so its a necessary medical cost. While if you are free to choose, without any medical reason to do so, if you want to abort or not, this is your private stuff. As far as I know even medical costs for "after rape care" so pill afterward ... is included. But "Oh, my partner and I both forgot about protection." simply is no medical reason, that was forced on you, so that problem was created privately, and must as well taken care and payed privately.

This is not the case in the Netherlands. If a woman deliberately signs up for a Christian insurance company, the insurance will not pay for abortion. Though there is a lot of government money involved in healthcare, there is no real public healthcare option here.

Not really, it was you who raised it as a metric, I just tried to reason within your view and show you that it does not really hold up there either.



Well they sort of started things out that way in Britain, specially the law states that abortion can only be done for the life of the mother but over time that gap has been widened to the point where abortion on demand is pretty much the rule of the land. Given how that is pretty standard practice when pro-choice doctors meet a media and government that does not really want to look all that closely, solid regulation would seem to be called for.



Not sure why it would be any different from the relegation of health care as is, we have hundreds of mechanisms for looking at how doctors bill the system for treatment and the system I am offering is already in place elsewhere as other posters have pointed out. Also this seems like a tactic to shift the discussion away from the logical principle.



Probably through the same support system I used to grow up. There are hundreds of families out there who are waiting for a child to adopt.

Read back. You were the first to use the term, and you used it incorrectly, in this statement:

"I am happy to give some flexibility on that definition but it is too long of a bow to draw to insist that public funding for abortion on demand constitutes, in all cases, primary care."



But you are trying to accomplish regulation through the back door. If Parliament wants to prohibit abortion; or to prohibit it with a narrow range of policy exceptions, then it has the criminal law authority to do that (subject, of course, to constitutional limitations on that power).

But to leave the criminal law vacant, and to use the public purse as a means of curtailing abortion ("it's legal, but you can't have it if you can't afford to pay for it") offends at least two principles: first, that the government should not use spending powers to effect policy that would more properly be effected under a substantive policy jurisdiction; and second, that government policy should have equitable impact on all citizens. If we adopt, as a principle, that all citizens are entitled to medically necessary care, free at the point of delivery, funded through a public insurance scheme, then it is an affront to that policy to then start picking and choosing which forms of treatment we will fund.



Mechanisms for looking at how doctors bill does not interfere with the doctor-patient relationship. When I treat a patient, I submit my bills, and government is free to audit them to make sure that I have delivered the care that I claimed to have delivered; to make sure that I have retained the records that I am required to retain; and the like.

But government is not entitled to come in and question whether I made the correct medical decision about how to treat my patient. That jurisdiction belongs to the College, not to the Minister.

Now that's not to say that I have carte blanche. For example, medicare generally will not pay for experimental procedures. The policy justification is two-fold. First, government already supports research activities in which experimental procedures are subjected to clinical trial. Second, where established treatments exists, and have not been exhausted, these should be attempted first, before turning to experimental procedures.

So there, we have a rational, objective, policy based motive for refusing to pay for a procedure.

So what is the rational, objective, policy based motive for refusing to pay for abortions? I have yet to see one that does not rely on the subjective attitude of policy makers towards abortion.

Because its not the public job to pay for non necessary stuff? What next? Shall I pay someone a PS4? Because the one referring, his life gets destroyed, if he doesnt get one?

Getting a nose corrections is as well legal, but yes people need to be able to afford it. Do I now have to pay that as well?

I am totally willing as member of an community, everything life necessary for the members of the community. People should have a possibility for acceptable living, acceptable food, acceptable medical support. But abortions hardly can be something life necessary, if its not about babies without brain or without backspiral or whatever. Aborting a kid, that will die the moment it is born? Totally understandable for me. As well as kids out of rapes and all that. But when it comes to aborting perfect healthy children, whose existence have no negative cause, then people always demand about others not having the right to be involved in the desicion. And paying that involves me. Its need two people too stupid to protect themselves, additional two people too stupid to simply go to the pharmacy and get yourself the pill afterwards, and one person not caring for her regular menstruation coming, so that abortion by "simple" hormon pill still is possible to have the need to an standard abortion to get rid of your child. So two people absolutely not caring for becoming pregnant. And then suddenly all the others shall be caring about that?

Sorry, I am technically and logically out of necessity pro abortion (simply because out of experiences, forbidding abortion leads only to illegal abortions being done, and noone has a benefit from that), but if someone wants to pay me and support me, what I feel emotionally as the murdering of an innocent human being, that is additional medical not necessary, then I am sorry to be rude, but they can f**k off.

So all those patients who need nose corrections (rhinoplasty) because of the effects of skin cancer, trauma and congenital deformities (like Binder Syndrome and Cleft Lip and Palate) should not be covered by insurance and/or taxes?
Tough luck, I guess.

It is not back door regulation, if we say tax payers don't have to foot the bill. All it does is change the framework through which the policy is enacted. There is no prohibition element to it, rather it is the most morally neutral position that the subject can take on. If we banned abortion using criminal laws then it would follow that your decision support abortion or not had been made for you. If however, it is legal and can paid for by public health care under all circumstances then equally my decision to support abortion has been made for it. If the first places you in an untenable position, then equally so you should recognise that the latter places me in the same.



You need to explain your first reason a bit more, it is incomprehensible at present. The second is nonsense as there are almost no government policies that treat two people equally. I would also take issue with the term 'medically necessary care' abortion is many things but abortion on demand paid for by all taxpayers without condition covers a great deal more than 'medically necessary care'. All together, I just don't find your position all that tenable.



The doctor is free to proscribe whatever he wants but the government is not obliged to pay for it. I can get a proscription for medications and the government can chose only to pay for the generic one it choses to subsidise. Government's do this all the time. Government also determines what specialists I can see and what amounts of treatment they will cover. Public health care, at least where I live, is not and never has been a pay for everything service. If you want braces in Australia you pay for it and in my view, if you want an abortion go pay for it yourself.

Your saying so doesn't make it so. The use of spending power is insidious. What's next, refusing to fund schoolboards to provide curriculum to which policy makers object? The self-same reasoning could be applied to refusing to fund schools to teach evolution. Or to fund schoolboards to purchase library books that the government objects to.

And you are either lying or stupid if you think that withdrawal of funding is a "morally neutral" position.



I suggest you go back and reread, then.

And take note, I did not use the word, "equal." I used the word, "equitable." That's a very different thing.

Finally, it's not my decision that abortion is medically necessary. It's a decision made by an individual physician and patient in the context of their professional relationship. I have no place in those conversations. I give deference to another physician's decision about what is or is not medically necessary unless I have been asked to provide a second opinion on a subject in which I am competent to give that decision.



No, but when the government has determined, as a matter of public policy, that it will pay for medically necessary procedures, then it must enunciate a rational, objective, policy based rationale when it chooses not to fund a procedure that a physician and patient have decided is medically necessary.

When government only pays for generics, there is a rational, objective and policy based rationale for that--the same medical effect is available at a lower cost. A perfectly reasonable approach.

I can't speak to your system, but here government has absolutely no right to determine what specialists a patient may see--that's a matter to be determined by a primary care physician and the specialist concerned. As for amounts of treatment, again, government has no ability to ration services.

And I note that you have ducked my last question. So I will ask it again:

So what is the rational, objective, policy based motive for refusing to pay for abortions?

Do you have any answer?

The slippery slope you speak of already went too far one way and now its time to start hauling ourselves back up the hill to something more evenhanded. Abortion used to be illegal and then it became legal under certain circumstances and now is legal under almost all circumstances for any reason and I have to pay for it. You are correct, there is a slippery slope element here, just not the one that you personally prefer.



Then you have your objective framework. It appears you have answered your own question. If the doctor determine that it is life threatening, lets go with that. Unless of course you now want to turn your own position on its head and proclaim that this is some sort of an unreliable process.





You keep saying those words, 'medically necessary'. Doctors determine medical necessity all the time you are making a mountain out of a molehill.

You are not correct, at least for most of the US.
http://en.wikipedia.org/wiki/Hyde_Amendment

So, you admit that doctors, not laymen, are the ones qualified for determining what is medically necessary?

Umm... I am not an American and the Hyde Amendment only applies to Federal funding. 17 of the 50 states provide public funding for abortion services.



Sure.

Then why don't you defer to the medical establishment when determining the medical necessity of abortion?

Because it means they would have to concede their position. It's just like with the sex reassignment issue.