NOTE: While looking through my old essays, I found another 15 that struck me as particularly interesting. Some may seem a bit dated, as they discuss current events during the period 2008 to 2010, but the principles they discuss are still relevant.
I was a bit surprised to hear about Obama's decree concerning same-sex visitation at hospitals. The main problem, as I see it, is that there is no legally recognized gay marriage in most states, which means hospitals, if the patient is unable to declare who can visit (and if he or she can declare who can visit, then this a moot point), anyone can claim to be a partner and gain entry. Yes, my wife pointed out when she was at the hospital they accepted assertions that someone was a relative on faith, but in that case, if there was a doubt, the hospital could ask for proof, and such proof could be provided. Without gay marriage, there is no way to prove someone is or is not a gay spouse, making it possible for all manner of mischief to take place. (If you think this unlikely, recall all the Anna-Nicole Smith type marriages. Or, in more mundane matters, the fact that my wife caught a patient's wife trying to hold his hand and sign over insurance benefits. Or the fact that in one family I know, a step brother convinced his stroke-damaged father to sign over all the insurance to him instead of his biological daughter. With or without financial disputes, family spats, especially involving dying relatives, make for bizarre situations, and the gay visitor rule simply opens a new avenue for abuse.)
But, perhaps I should go back a bit. Before I describe what I find wrong with Obama's action, let me take a moment to look at the present situation.
It should surprise no one to hear me say the present situation is not ideal, though it probably will. Both liberals and many conservatives have a strange belief that conservatives must oppose anything that seems to advance gay marriage, even if opposing it increases the size of government. My own position is different. I see ethics as a personal, family and cultural issue (""The State and Morality", "A Bit More Explanation", "The Political Spectrum"), and so sexual matters, outside of those few cases where sex involves violation of rights (rape, child molestation), are outside of the interest of the state. Far from opposing gay marriage, or thinking we must do all we can to prevent it, I think marriage is a religious question and should be outside of the state's interest as well. ("Solving the Gay Marriage Debate", "Updating an Old Post", "Revisiting Gay Marriage", "Some Additional Thoughts on Gay Marriage", "A True Conservative Platform") I would not accept the state trying to tell me who or what to worship, what doctrines to follow, or deciding any other religious question, so why should it be involved in the religious question of marriage? Yes, parts of marriage (child support, custody, division of property mutually owned) could come to be of interest to the state, but they are also of interest to the state between two people who never married, so why does that make marriage a state matter? No, as with all religious doctrine, marriage is a private matter, and marriage, gay or straight, should be handled by the state as a contractual matter, and the public as a religious question which also involves contracts*.
On the other hand, just because I seem to side with some gay groups in asking that marriage be made a private matter, that does not mean I endorse the entire "gay agenda". For the most part, any movement seeking special privileges for a group, whether they say they seek "equal treatment" or admit they seek some form of redress, is not something I endorse. And, from their belief in the biological origins of homosexuality, to their belief that such origins have any legal significance ("Biology as Justification", "Cultural Rules", "Don't Liberals Notice the Contradictions?", "Myths of Homosexuality", "Follow Up", "Correlation and Causation Revisted", "A Question About Biological Theories of Sexual Identity", "Passing Thought on PET Scans"), to their attempts to be declared some form of protected, privileged minority, I am almost always opposed to the formal, organized gay rights movement.
But that does not mean what many think. From the paragraph above, many on the left would ask me if I think gays should be "forced back in the closet" or legally disadvantaged. To which I reply "no." My position is simple, though they may not like it. The state, in any form, should judge citizens equally, using only relevant criteria in making decisions. In short, the state should discriminate only in appropriate ways (eg. limiting prenatal care or mammograms to women). However, when dealing with private individuals, I believe in total freedom, the absolute right to individual agreements. ( "In Praise of Contracts ") And that means, much as it offends the left, that I believe people can freely discriminate if they wish. ("The Danger Inherent in Banning "Bad Ideas"", "In Defense of Discrimination", "A Statute of Limitations for Race", "How to Handle Idiots", "Back Again", "The Right Way", "The Danger Inherent in Banning "Bad Ideas"") I know that supposedly makes me anti-gay, but I disagree. Under my system, gay individuals have the same rights as anyone else, and can do as they wish. On the other hand, under their "anti-discrimination" system, some individuals have special rights, the ability to force others to act against their beliefs, and, to my mind, that is inconsistent with a free society. ("Negative and Positive Rights", "Symmetry and Asymmetry in Government", "My Vision of Government", "My Vision of Government Part II") And, when deciding between hurt feelings, or even outright discrimination, and the abrogation of individual rights, I still stand by individual rights. After all, if discrimination is unfounded, sooner or later it will harm those who practice it, and will eventually end ("Planning For Imperfection", "Fairness and the Free Market", "The Triumph of Good", "Greed Versus Evil"), it is only impatience, and an absurd utopianism, which makes us insist on forcibly solving every problem right now. ("Utopianism and Disaster", "Life Is Not Fair - And Trying To Make It So Makes Things Worse", "The Right Way", "Private Versus Public Racism", "The Inherent Disappointment of Authoritarianism", "Moral For Me, But Not For Thee", "Antibiotics, Automobiles and the Free Market", "Defending Freedom?")
Of course I have gone a bit far afield, but I did want to make clear my position before explaining why I think the present situation is a problem, but that Obama's solution is the wrong way to approach the situation. ("The Cycle of Compassion", "Inescapable Logic", "Recipe For Disaster", "The Endless Cycle of Intervention")
The problem, as I see it, is a simple one, and one easily solved, but for the state. No, I am not talking here about the exceptional problems, the unusual cases, where hospitals refuse to recognize power of attorney or similar issues. Those problems are more indicative of issues with how the state handles power of attorney than any problem with gay marriage. And, in any case, even most gay rights activists admit such problems, while mentioned often for their PR value, are uncommon at best. The real issue, the more common problem, is that hospitals simply are not responsive to consumer needs and wants. As I mentioned in "The Free Market?", certain circumstances make some types of businesses insulated from competitive pressures ("The Inevitability of Bureaucratic Management in Government Enterprises", "Bureaucracy Revisited"), and that makes them more likely to behave in ways displeasing to customers.
So, what does this have to do with allowing gay family members visit a sick patient? Everything.
Let us suppose you went to a hotel. The front desk refuses to let your friend come up to your room. What would you do? Check out, go elsewhere, and tell everyone you know to never go there. And that is why most hotels don't interfere in that way, fear of lost business. And also why no one complains about hotels preventing their gay partner from visiting, as they would instantly leave and go elsewhere.
So, why is it different for hospitals?
Well, there is a small problem with intrusive government regulation, such as HIPAA, but that truly is a very small part of the issue. For the most part, hospitals are less responsive to patients for the same reason doctors tend to control the relationship despite technically being the employees, thanks to government regulation and licensing, hospitals are part of a cartel. (("Professional Education", "Business Licensing and Regulation", "Another Thought on Regulation", "Insider Trading", "Gun Control, The FDA and Regulating the Law Abiding", "Medical Regulations", "Medical Regulation II") Worse still, as bizarre government dogma thinks having "too much competition" ("Bad Economics Part 2") will cause problems for hospitals ("Government Efficiency"), they actually keep the number of hospitals artificially low, meaning you would have trouble finding another hospital nearby with the same specialty care, unless you live in a large city. In short, unlike the hotel, you are stuck where you are, and they know it.
It sounds simple, too simplistic, but ask yourself when was the last time you saw any firm be anything but solicitous toward gay couples. Why? Because they want the business. Could you imagine a car dealer refusing to sell to gay men? Or a restaurant refusing to seat a gay couple? But hospitals, because of their monopoly situation, have no concern about patient satisfaction, and so, they can behave as they wish, even refusing to allow visitors against the patient's wishes.
The obvious solution, removing the licensing and barriers to entry which keep the hospital cartel alive, obviously was never considered. Despite the fact that it does no good ("Medical Regulations", "Medical Regulation II", "Bad Economics Part 2", "Bad Economics Part 3", "Bad Economics Part 5", "Bad Economics Part 6", "Bad Economics Part 12", "Bad Economics Part 18"), and not only harms customer service, but maintains inefficient firms ("Anti-Business Businesses), and even plays a part in our high medical costs ("High Cost of Medical Care", "Medical Reform, An Overview", "My Health Care Plan"), the government would never consider removing such regulations. ("Doing Something", ""Doing Something" Revisited", "Who Is To Blame?", "The Difficulty of Principle") Instead, as usual, the government has "solved" a problem it created, by adding a solution which makes things worse.
But that brings me back to my beginning, the problems I see with Obama's plan. Rather than making hospitals responsive to patients by removing regulations and making them compete for patients, his solution is to decree that hospitals honor a nebulous relationship, with no legal documentation and which is impossible to define, much less prove. Not only will there be endless abuse, but thanks to the vague nature of the decree, I can foresee countless lawsuits as well. As I have written before about uncertainty n the law ("The Problem With Evolving Standards", "In Praise of Slow Changes", "Predictability", "Conservatism, Incremental Change and Federalism", "Empathy" Threatens not "Justice" but Predictability", "Sotomayor and Empathy", "Interpretation and Activism", "Why Judicial Activism Hurts", "The Problem With Tort Reform" and "Red Herring", "The Fascination with Change"), poorly drafted laws introduce nothing but strife, fear and confusion.
Hardly the way to solve what was, in essence, the side effect of the last government "solution".
* There would be some changes. Taxes would have to revert to being entirely individual, provided we keep an income tax. Insurers would have to decide how to handle family insurance, under what conditions they would and would not cover others, and so on. On the other hand, it would involve fewer changes than some think. Even now, inheritance, child custody, support, bankruptcy and other questions are settled between non-married individuals, so the same principles could be applied if marriage were no longer recognized by the state. As I said elsewhere, we would need to change some of contract law to allow individuals to create a marriage-like partnership, and to allow them to assign custody, and willing take on support obligations, as well as handful of other modifications, but for the most part, very little would change if marriage were to be made completely outside the scope of government.
For those following my health travails, my hand is working for the first time since last Wednesday, but my wrist and forearm remain weak, making typing slow and painful. So, please forgive me a lack of lengthy posts and even a reduced number of shorter ones. I am trying to write, but it remains difficult.
Originally posted in Random Notes on 2010/04/19.