Hmmmm. I mean, yes, but doctors will still save your life even if you declined to buy any insurance all life long or pay taxes or whatever. I'm not sure I want the same "protect at all costs" attitude extended to buildings, but fire can definitely spread and even if they don't care about your property they might care about other places.
Number one priority on any emergency scene. Life safety... my crew comes first, but I have taken some serious risk to save people. Once the humans and animals are safe, everything else is less concerning. Risk a lot to save a lot. Most "things" can be replaced. My crew takes great pride in saving homeowners animals these days as we now have some tools to help post smoke/heat exposure (Cyanokit and O2).
Adding a second reply with same sentiment. I am also a firefighter, and my main “assignment” over the years has been search/rescue.
We’ll always risk to reward. But more and more the phase after life saving is trending toward “surround and drown” - not that I want to fight like detroit in the 2010’s, but yes we do make a call sometimes to stop risking when lives are all confirmed safe.
There’s also a point where a structure is a total loss even if the “damage doesn’t look so bad from out here” at which point letting it burn as long as other buildings aren’t in danger may be the safest thing to do.
> I thought that taxes were supposed to pay for basic neighborhood services
Neighbourhood is the operative word here. In some parts of the rural United States, homes are far away and far between. Public services of the kind expected in populated areas are impractical, particularly for protection of property rather than life.
With that as a baseline, some "rural" areas maintain this peculiar, low-cost characteristic even as they become more populated. There's a degree of self-sorting behaviour as well, since some residents become attracted to the area specifically for its vanishingly small local tax burden.
I suspect you would find services limited in the middle of the Arabian desert as well.
The United States is enormous and many parts of it are incredibly sparsely populated. For example, Niobrara County in Wyoming has a population of 2,467 and an area of 6,810 km^2, or a population density of 0.36/km^2.
For comparison, the Northern Borders province, the least dense province in Saudi Arabia, has as population density of 3.4/km^2, almost ten times more people per square kilometer.
People outside of the US really have no idea how empty much of the country is. I think there's an assumption that just because much of the land is livable (i.e. not desert, bare rock, etc.), it must occupied. But that's simply not the case here.
Then perhaps the core issue is zoning land properly and making sure people don't spread out too thin.
That being said, the locality in question sounds very much like the low density suburban locale that I'm currently living in. It costs a pretty penny for the government to maintain services here, since there are only about 100 homes in an area at the edge of the desert (which at a rate of 75 per home per month as stated in the article wouldn't be able to cover a basic firefighting service). Of course, that does not bother the government in providing funds for everything from a local police station, hospital (yes, not a clinic), fire station, municipality, garbage collection, etc. The only thing missing (for the local Arabs mostly) is a government school, but then folks with families don't bother with it.
I could draw a similar example of my place in India, which has similar low density characteristics, and to make matters worse, is located in a hilly part of the district, but that doesn't stop the govt. from providing a local police force and fire fighting service complete with a helicopter.
Some amenities are basic needs that if you don't receive, then what the hell are you paying taxes for? Freedoms per second?
And no, I'm not a stranger to America's vast landscape. The fact stands that there should have been better zoning - or don't expect any facility at all, but don't make news out of it.
On a side note, the main link of this thread quotes the example of insurance companies in London in the 1830s, who would compensate each other in case their firefighters took action on fires not in their jurisdiction. If our forebears had such sensible foresight and collective responsibility, then why not America today?
Or you could just let people live where they want to live and make sure they are aware of and agree to the consequences of that choice, which it sounds like they were in this case.
> If our forebears had such sensible foresight and collective responsibility, then why not America today?
Seems like you're generalizing an awful lot from one random news article that is news largely by virtue of the fact that what it describes is unusual.
I think there is a difference between a remote place that is difficult to access and a place that is not entitled to use public firefighters' service. IMHO the former has no bearing on the latter.
I am not judging the way things work in the US, just commenting that I don't think that population density is relevant here as the issue is one of right.
Now, of course, if you live 100 miles from the nearest town it may well take hours for the police or firefighters to show up when you call them. That's another issue.
Edit: I must have written something offensive without realising it...
> I don't think that population density is relevant here as the issue is one of right.
It is absolutely relevant because services can only be logistically and economically viable at certain levels of density. Fire services aren't very useful if it takes them a two-hour drive to reach the fire. So they have a maximum radius where they are useful. They only provide value to the people within that radius. If the density is too low, then there aren't enough people in there to afford supporting fire services.
Public services are not expected to be 'economically viable' on their own. Moreover, whether there are enough people to support service is also a purely administrative and political issue.
You're not addressing my point, either, which is that there is a big difference between getting a crap service because you're hard to reach (which does happen including here in Europe) and having no right to call for help in the first place.
Again, I am not criticising, I am just thinking that there are different, separate issues here.
> Public services are not expected to be 'economically viable' on their own.
They inherently are. If these neighborhoods have fire coverage equivalent to that of a metropolis, but they would be paid for via taxation at the rate of $50K per year per household, that's not economically viable.
Public services are socialised. This means that every single person is not expected to pay as much in tax as necessary to pay for all the services they use. The aim is only that this be the case on average.
So in general people who live is more isolated houses end up being effectively subsidised by everyone else.
In your example the 'problem' stems from a tax base that is too narrow because of administrative and political choices.
In any case, that is NOT the point of my previous comments.
Much of the Midwest is sparsely populated but not unpopulated - you’re never more than a half mile from a house but never much closer than that. It can cause weird servicing issues.
State and local governments aren't exempt from tort laws, etc. If they commit to service a location 100 miles away, and can't practically do so, or someone gets hurt in trying to make heroic efforts to do so, they can and will get sued. And in such a suit, making that sort of unrealistic commitment can and will be held against them.
I don't think that this is how it works (paying taxes doesn't entitle to a level of service) but I admit I don't know US law.
As a side note, in this very case the issue wasn't remoteness since they could have had access to firefighters for a small annual fee. Rather it was a legal and administrative issue. But I would indeed be curious if voluntarily paying a fee rather then being taxed can have an impact on any enforceable expectation of service.
By living on unincorporated land, they wouldn't have been subject to the tax that pays for the fire department (which would be county level or city level I'm guessing?)
Some states like Virginia have city and county both at the top local level. Richmond City is completely separate from the extremely rural Richmond county located more than an hour away.
Virginia is also technically a Commonwealth and not a state as well.
> Hmmmm. I mean, yes, but doctors will still save your life even if you declined to buy any insurance all life long or pay taxes or whatever.
ERs in the US are required to provide stabilizing care to patients who come in, even if the patient can't pay, by law. It's a law because otherwise some of them wouldn't.
Eh, kinda, but it's not like you can walk into an ER with just any condition and get treated for free. You've got to be having pretty serious problems before they're required to do anything about it, and even then they're not required to fully treat you, just get you stable.
The municipal fire department's insurer told them that they would not cover injuries sustained while fighting fires on uninsured homes, which was the final straw for the fire department.
The FD had tried for years to find a workable solution and failed because the people in the unincorporated part of the county just didn't want to pay for fire services. IIRC, the county had tried three times in the previous decade to pass taxes to either fund the municipal FD or set up their own; three times the residents of the unincorporated part voted against it. The FD had tried retroactively charging owners, and spent more on collections than they'd earn.
They will save your life. They won't treat your trick knee, erectile dysfunction, or failing vision. And they eventually put it out to prevent it spreading. Just not with the same fervor of preventing property damage.
Funny, we get called for much less than a hurt knee and failing vision via 911 every day. I don't have a choice other to send them to the ER if that is what they want. I recently went to a call where the young man thought he took too much "extenze"... Long story short, we checked vitals and asked if he wanted to be seen at ER for further evaluation. "Nah man, I got work to do now... just thought I was gonna die for a second." Anxiety and Panic... number one call type.
My wife called for me because I accidentally drank my mouthwash. I couldn't speak and technically couldn't breath for a minute. And I would have been fine, but the bottle said to call poison control (or something - this was 10 years back) if ingested. So my wife called while I was wheezing. By the time the ambulance arrived I was totally fine... sorry about that too
> They will save your life. They won't treat your trick knee, erectile dysfunction, or failing vision.
I thought in the US, hospitals were only required to stabilize, not treat, non-paying patients. For example, if someone has cancer, they are not required to perform surgery or chemotherapy, just stabilize their symptoms at the moment.
> And they eventually put it out to prevent it spreading.
Reading the article, that's not true.
They watered down the fence line to protect someone else's land.
> Firefighters did eventually show up, but only to fight the fire on the neighboring property, whose owner had paid the fee.
> "They put water out on the fence line out here. They never said nothing to me. Never acknowledged. They stood out here and watched it burn," Cranick said.
So to your examples...
> They will save your life. They won't treat your trick knee, erectile dysfunction, or failing vision.
It would be closer to the story if it was "they won't save you, but they'll spray down everyone else with a disinfectant to protect them from your disease."
They will evaluate you and give you a ride home if you are indigent. There are places where it's not uncommon to call 911 for a runny nose or whatever, request ER care, and get the medicab home.
Not true. An emergency department in the US is obligated to provide life-saving care, as are EMS services and hospital doctors if the ER doc thinks you have an immediately life threatening condition . But a random oncologist has no obligation to treat you if you have a life-threatening cancer, unless you go to an ER and they determine that your condition is immediately life-threatening (say, a perforated bowel). Then the surgeon will treat you enough that you are not inmediately dying, but they are not obligated to say, remove an underlying cancer if it’s not causing immediately life threatening problems
But people complain about this too. No one seriously talks about not treating people in the ER with gun wounds, but Obamacare explicitly introduced the mandate that you get insurance or pay a penalty to address this very issue. Everyone is entitled to a basic level of care, but the mandate says that you should have to pay for it.
This mandate makes sense from a moral point of view, especially for true emergency situations. However, the act didn't take care of the cost of care, which was placed on hospitals and ultimately passed on to other patients and the government. Obamacare attempted to address this issue.
EMTALA also distorted US healthcare be redirecting poorer people to expensive emergency care rather than preventive or primary care, which might well serve many of their needs better. That's also something that Obamacare was designed to fix.
The Obamacare penalty for not buying insurance was eliminated by Trump, because reintroducing the free rider problem is a cornerstone of GOP health policy.
Reinstating the penalty is going to cost political goodwill, which is why the Dems aren't doing it.
Regardless of whether the penalty is or is not in place, I wouldn't recommend being poor and sick, regardless of whether you are insured, or are freeloading.
It wasn’t the Trump administration but the 5th Circuit Court of Appeals which struck down the mandate as unconstitutional and being liberal and a supporter of health care reform I think they had a point. I can’t see in the constitution where the federal government has the power to force me to buy health insurance. I like my constitutional rights being protected even when the thing being compelled (me having insurance) is a good idea. It means that things which are not quite so good of ideas have less chance of being forced on me later.
The plaintiffs in the case were several gop attorney generals. Related cases were also carried out by the Trump admin. And several courts had previously upheld that the ACA was constitutional because it does not force you to buy health insurance. It actually just imposed a fine if you didn't and that fine was considered a tax, which Congress has constitutional authority to levy. The GOP forum shopped to get in front of a rubber stamp republican judge.
Additionally, the whole point of these cases was not simply to get rid of the penalty. The idea was to get rid of the penalty so they could go back to the supreme court and again claim that the mandate is unconstitutional because now there is no "tax" associated with it.
I don't know where things are at now, but it seems unlikely to go anywhere now because it would be difficult to argue that buying insurance is required at all at this point. So we are left with the backup gop strategy of hoping that disarming the mandate will simply bankrupt the program. At least until republican voters wake up and realize that the program is miles better than what we had before.
I likewise do not approve of the Feds expanding their powers arbitrarily by declaring the punishment for whatever they wouldn’t otherwise be allowed to enforce “a tax”. Calling the insurance mandate constitutional because the punishment was a “tax” was abusing the intent of the law.
It's pointless to try to draw a distinction here, because you can re-frame the exact same behavior several different ways, some of which are already common, so it doesn't represent any expansion of power. Like, raise taxes by that much and give people with insurance a credit for it, but not those without insurance. Done. No "worse" than e.g. child tax credits, as far as constitutionality. Insisting that the law do some particular word-dance to get to the exact same place isn't productive and doesn't defend liberty.
If you worried about fines being used to deter activities society doesn’t want, and that fine money being collected as tax revenue, you are at least 200 years too late.
Trump's government repealed the individual mandate penalty, and then the court ruled ruled that in it's new form, it no longer qualified as a tax and was unconstitutional. (Not that this meant anything, since the legality of a fee of $0 doesn't matter.)
The court case as a whole argued that because the GOP changed the ACA in a manner that made part of it (the $0 fee) illegal, the entirety of the ACA should be made illegal.
The fifth circuit agreed with some of the arguments in the case (the fee one), but did not practically change anything about the ACA.
And then SCOTUS, surprising ~everyone, ruled that actually the whole of the ACA is constitutional.
Look at this timeline, and you tell me - who spent years trying to re-introduce the free rider problem, and to break the ACA? Congress, the president, and the plaintiff states... or the fifth circuit, which when presented with a singular, narrow question, ruled that a $0 fee (whatever that is) isn't a tax?
Now, as of 2022, we are in a world where the ACA has been thoroughly litigated, and is still here, with the free rider problem hanging like a millstone over its neck.
calling insurance a tax is about as strong an indication of regulatory capture as I can think of.
It should have never been a tax specifically because it's an unconstitutional act. Calling it a tax is the letter vs the spirit of the constitution.
If you and others like yourself want to ensure everyone has health insurance then __make it mandatory for the state to pay for it__. Anything else and you're just taxing the poor for being poor.
That is an interesting opinion, but at this point, both a conservative, and then a super-conservative, packed-with-federalist-society SCOTUS has disagreed with you twice on this issue (5-4) and then (7-2). It's about as written-in-stone as you can get in the United States.
The courts think this is above-board, the executive thinks this is above-board, most of the public thinks its above-board, it's safe to say its above-board.
As I recall, the whole "call the penalty a tax" thing was Roberts' tortured justification for allowing it in the 5-4 vote. Nobody ever really believed it was a tax.
> Slavery was also considered above-board at one point, so...
It was also perfectly constitutional[0], hence the need for that 13th amendment. And that civil war thing. As it turns out, the constitution kind of sucks[0], it has a lot of problems with it. Fewer than it did in the past, but we aren't quite at the end of history just yet.
You're going to need a better complaint than 'it's unconstitutional', as this is pretty verifiably constitutional. The people who have been empowered[1] by the founding fathers to determine what is, and what is not constitutional have determined that this is constitutional. It's not a matter of opinion at this point.
> carrying private service X is required for you to exist in the united states.
And that's nothing new. Government can compel all sorts of things from you. Showing up to contribute your labour to a jury duty. Involuntary servitude in the military. Taxing the land you live on. Following emergency orders. Not heading a communist political movement. Every society - even this society - provides you with privileges, and requires obligations from you.
This obligation has been ruled to be well within the legal framework of this society, and if you think it should be outside that legal framework, you should look into passing a constitutional amendment on the subject.
Or, you could believe that this obligation is a constitutional, but bad idea, and have the legislature repeal it. Either way, it's currently constitutional. [0]
[0] You're confusing 'constitutional' with 'just'. They are not the same thing.
[1] Actually, SCOTUS' powers in this sphere are what's unconstitutional[2], but we all close our eyes, and collectively pretend that they are.
[2] You're not going to find anything in either the constitution, or passed legislature granting SCOTUS the incredibly broad powers it currently enjoys. These powers were invented out of thin air, and are backed by neither fiat, nor democratic will. All that the constitution says on the subject is 'We should, like, probably have courts. That should do stuff, maybe.'
the question is whether or not the government can force you to pay for a __PRIVATE__ service just for __EXISTING__ within the borders of the US.
There is __NO PRECEDENT__ for this. The closest you can get are things like car insurance where you're required to carry insurance in order to drive on US roads. You can choose not to drive, you cannot choose to "not exist".
That puts this into an entirely different category. The fact that it originally got rationalized as a tax opens a whole different can of worms. Good luck refusing to pay taxes.
I'm entirely willing to accept that it's a bad law (It is, for multiple reasons - unfortunately, the situation without it is even worse), I'm simply drawing the line at claims that it's an illegal law (It's not, it's been pretty thoroughly litigated).
Elimination of pre-existing condition exclusions, and restrictions on which factors can be used to set pricing for policies—both wildly popular—create a free rider problem.
Well, right, because most other advanced-economy states require you to carry insurance (more-or-less the solution we were going for, before the penalty for failing to have insurance was eliminated) or cover everyone under a government-provided healthcare scheme of one sort or another.
If your point is just that the US healthcare system is far more-broken than most, and in some unique ways, all for no good reason—sure, yeah, of course that's true.
"Gun wound" as in a wound caused by (actively) using a gun, or a bullet wound, typically caused by someone else using a gun? I could understand the former (like excluding accidents while skiing, skydiving, whatever), but excluding the latter seem pretty cynical.
The vast majority of gun wounds in the US are purposeful crimes or suicides
For deaths, there's maybe 300 accidental deaths, 10,000 - 15,000 homicides, and like 60,000 suicides. Non-death injuries scale similarly, with the caveat that like 6,000 ish people per year try to kill themselves with a gun and fail, but still injure themselves.
Saving burning buildings with no people in them is still a risk to the firefighters’ lives. Why go through that when the owners explicitly declined the protection repeatedly?
In fact Hospitals were not required to treat you until 1986, which was part of the COBRA act.
Prior to that there was a large practice of "Patient Dumping" where a hospital would kick you out if they found out they you couldn't pay for your treatment. Hospitals in the US would literally let you die out side the ER doors.
Then you protect the insured buildings, not really sure why it's an issue?
The same logic could apply to police... what if all the crime is coming from an unincorporated part of town? Do you just go and start policing it (kind of like an invading army occupying)? Or do you erect borders / station patrol cars near key locations?
You call the county sheriff. Sheriffs and courts were the original reason why counties exist, and why there aren't any parts of the country that exist outside of a county, while there are quite a lot of people living outside of any incorporated city.
They will save you from an acute emergency, stabilize you, then dump you into a care home with inadequate care or to the street as appropriate, where you play the long game of succumbing to whatever ails you.
No. Hospitals will do what they have to *against immediate threats*. They will not do what's needed in the bigger picture if they are not paid. You don't get the chemotherapy etc if you can't pay.
