Fox/Trump Immoral Handling of covid19

Author: ebuc

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#121
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@bmdrocks21
Ah, so we're finally back to this. Alright, let's cover it.

First off, it's not just about staffing the border. Israel has a far greater number of troops per its size, as well as a greater capacity to staff its borders. I agree that there are limits to their effectiveness in the latter capacity (though we probably would not agree on the numbers you're using), though not in the former, so even if we mobilized every person in the military reserves, I don't think it's possible to match or even come close to Israel's deterrence resulting from sheer force of numbers. 

Second, the amount of our GDP is really besides the point. Saying that we have more money to throw at the problem is technically accurate, but much of that money is already being used towards other ends. It would have to be stripped out from those and continually used to upkeep the wall. Also, you say it's "only a little over 13x larger", but that's not inconsequential. We aren't copying their wall design (in fact, we're spending about two times what they did to build theirs) and our maintenance costs are similarly quite a bit higher, with our cost per mile being $77,000. We're talking about roughly 2000 miles, so roughly $150,000,000 a year. We may have the GDP to cover it, but it's not small. https://www.washingtonexaminer.com/copying-israels-wall-would-cut-trumps-price-nearly-in-half

Third, yes, it's not impossible to construct a border on this terrain. So, let's see how well we're doing:
If wind alone is a problem for it right now, that means this will require reassessing and rebuilding, increasing costs still further. As for solving for every bit of terrain, it seems issues like floodplains and wildlife habitats aren't so easily solved, nor are issues of lost commerce across the border (much of which takes place entirely legally). I'd say it's impossible to both address the issues with building such a wall and see to it that building said wall doesn't cause any harm to the surrounding environment or dramatically increase costs.

Fourth, I'd like to see you point out what laws among those in our immigration statutes address the same issues as the legal responses from Israel, though that's really besides the point. If those legal avenues alone have been effective, then why would a wall be more effective? That's what I was getting at here. You're the one saying that it's "an indispensable part" of any effort, so for me, the fundamental question is: why are other measures insufficient, and how would a wall bolster them further? I'm not seeing much in the way of response to that. 
#122
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@bmdrocks21
Watch this clip. It's pretty good.

#123
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@bmdrocks21
What you said, and I'll quote you here, is that Republicans "are mostly blameless" despite their attempts to get a huge amount of money that they and only they controlled with no oversight. That was your point, and from the sound of it, the only reasons you see that as less problematic than what the Democrats were adding was a) because it is a Republican President and you simply trust him to use that money well, and b) that the targets the Democrats selected were problematic in your estimation (despite the fact that these are all organizations with employees who are clearly harmed by these circumstances, but let's not get into that). The former point is, as you say, bias-driven. The latter point is just frustrating to me because it says that you're more upset with a party that designates targets that you disagree with than one that allows full and unencumbered use of a very large amount of money to prop up any business or set of businesses they wish. Yes, that money could be used for good purposes, but it seems you're putting a lot of stake in a could, not to mention relying on a small set of actors to make choices with regards to its distribution. Some businesses will inevitably be left with less than they need, while others will get more than they need. I'd rather not have one party making those decisions alone. As for your other point, I disagree that this would have been easy to rectify if the bill was passed; it required amendment before it was passed, as actually happened. Modifying the terms of the bill would have been much more difficult after it was signed into law.
#124
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@whiteflame
Did you literally post that fake clip from CNN about a small wall section under construction falling over because it wasn't set in the concrete foundation yet as an example about how fucked up the border wall overall is? As a clear example as to how you cannot make a wall on terrain?

Shameless.

"I get the urge to dunk on the border wall, but this is misleading. The panels that fell over in the wind were not anchored yet. You can clearly see that in the photo. And adjacent sections did NOT fall, likely because the concrete base had time to harden," Washington Post reporter Nick Miroff said on Twitter Thursday.

This is from WAPO....
#125
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@Greyparrot
...It's not fake. Yes, there were ways to handle it, like a concrete foundation. Funny, then, that they waited so long to put in the foundation and allowed that section to fall as it did, again delaying the project and increasing its cost in the process. It has work-arounds, but they're not employing them. That's my point: even where easy solutions exist, they're not being employed.

#126
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@whiteflame
"I get the urge to dunk on the border wall, but this is misleading. The panels that fell over in the wind were not anchored yet. You can clearly see that in the photo. And adjacent sections did NOT fall, likely because the concrete base had time to harden," Washington Post reporter Nick Miroff said on Twitter Thursday.


#127
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@whiteflame
That's fine but to cherry-pick one questionable incident over the thousands of days of construction and suggest it as pervasive reeks of bullshit.
 CNN gets a few things right, but this aint one of them.
#128
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@whiteflame
They are "mostly blameless", though. Not completely blameless, as it was sneaky and it wasn't a good idea. But I don't understand why you don't agree that adding provisions that have absolutely nothing in any way, shape, or form to do with helping alleviate the economic issues Americans are facing, such as ridiculous voter ID law changes, is much worse than a sketchy, yet completely relevant and necessary portion of the bill. That part has nothing to do with bias. That is just an objective fact. My bias makes me care a little less about their $500 billion addition, but if Republicans put oil tax credits in the bill, I would be pissed about that as well. The additions from the Democrats weren't bi-partisan, they showed no intention of having the bill passed, and they were completely politically-driven hogwash. 
#129
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@Greyparrot
It's... not questionable (there are pictures and footage, whether you believe it or not), nor is it cherry-picking. I'm pointing out that this is a problem, not that it's happening everywhere. You're putting words in my mouth.


#130
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@bmdrocks21
I disagree that pushing for a $500 billion slush fund that they can dip into at their leisure and use to prop up any company of their choice is "mostly blameless" for stalling an agreement that should have very easily gone through. I did not say that adding those provisions was a good choice, nor have I argued that the Democrats have behaved well in these negotiations. I've argued, and will continue to argue, that Republican efforts to create this slush fund without any kind of oversight were just as bad if not worse, simply because they could have used it for anything. You're essentially treating them as mostly blameless because you believe they would have spent that money well, despite having no clue how it would have been doled out. The slush fund certainly is not a bipartisan addition and could have been used to prop up companies Republicans and only Republicans selected with no oversight and no controls, yet you seem happy to go to town on Democrats for inserting their own choice applications into the bill. If that's not biased analysis, then I don't know what is.

#131
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@whiteflame
This is exactly what you said.

So, let's see how well we're doing:

You cherrypicked one incident to describe how we were doing overall. That's exactly what you did. It's a myopic discussion and not helpful.

An incident mind you that was widely circulated by celebrities and debunked by left sources from WAPO and others as omitting key contextual facts. I get you might have an agenda to support, but this is the worst way to go about it.
#132
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@Greyparrot
I pointed out an instance of failure. I said that that instance of failure reflects some clear issues in the construction of the wall. I did not say the entire wall is suffering from these same failures, I did not say this was a systemic problem that's happening all along the border, and I did not say that it describes how we are doing overall, as you put it. I pointed out a failure. One. It's your choice if you want to see it as some broader claim about how the entire border construction is going, but it was neither my intent nor my words.
#133
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@whiteflame
Fair enough, but I wholeheartedly disagree with you if your intent was to suggest that we are having serious problems on a daily basis constructing the wall during unexpected high winds, or building a wall that can sustain high winds after the concrete has set in as the article you posted clearly did.

#134
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@Greyparrot
I'd say the bigger problem is the very next link in that post: building on terrain like floodplains. It's a manageable problem, but it makes building and maintenance a lot more expensive. Wind is likely a minor issue and will only affect some construction if they don't manage it properly. 
#135
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@whiteflame
Fair enough. 
#136
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@whiteflame
First off, it's not just about staffing the border. Israel has a far greater number of troops per its size, as well as a greater capacity to staff its borders. I agree that there are limits to their effectiveness in the latter capacity (though we probably would not agree on the numbers you're using), though not in the former, so even if we mobilized every person in the military reserves, I don't think it's possible to match or even come close to Israel's deterrence resulting from sheer force of numbers. 


We don't disagree that Israel has the ability to have a more strongly staffed border. However, they aren't employing every troop of theirs to that area, obviously, and they have no need to. If we use all army reserves and border patrol agents for the 2,000 mile border, we could have 154 individuals per mile. Let us say you just line these people up to make a human wall..... If you are saying that having one person per 34.29 feet isn't enough, then I don't know what is.
Based on : 288,725 army reserve and 19,437 border patrol agents.

While it may not be very fiscally conservative of me to say so... $150,000,000 per year, when we are throwing trillions into the stock market via repo agreements like it is nothing, is really pocket change for the federal government.

I'll have to agree with GreyParrot regarding the wall falling over. I am not unaccustomed to seeing government incompetence. But I hardly see how giving up and having de facto open borders by not securing the border would be a better option. All in all, the government could stand to do a much better job.

I didn't really get the point of The Monitor article. It just said Trump allocated $1.6 billion to the wall and that CBP is asking opinions and getting rights of entry to the Hidalgo area.

Legal commerce doesn't have to be entirely ended. The administration can add ports of entry in economic hot spots. As for "any harm to the surrounding environment or dramatically increase costs." I'd have to see specific cost estimates related to ecologically-sound wall construction to make a judgement on that. 

Fourth, I'd like to see you point out what laws among those in our immigration statutes address the same issues as the legal responses from Israel, though that's really besides the point. If those legal avenues alone have been effective, then why would a wall be more effective? That's what I was getting at here. You're the one saying that it's "an indispensable part" of any effort, so for me, the fundamental question is: why are other measures insufficient, and how would a wall bolster them further? I'm not seeing much in the way of response to that. 

But the fact is Israel didn't merely pursue the legal avenues. They built a wall, manned the wall, added sensors/other electronics to it, and they passed new laws to address illegal immigration. That is exactly what I want. We need all of those. A wall is a physical obstruction to entry. It slows down and deters potential entrants. When these individuals are slowed down, it gives agents more time to react and apprehend these illegal immigrants. 

According to commissioner of Customs and Border Protection, Mark Morgan, El Paso has seen an 80% decrease in apprehensions since the new wall has been erected there.

#137
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@bmdrocks21
Realistically, we're not going to deploy every member of our military to the US border, but I think you're missing my point. There's a deterrent effect just from having so many members of the military per such a small population that the US simply cannot hope to match. The effect is seen regardless of whether the wall exists, hence my point about proportions. That is not an effect the US can hope to match.

$150,000,000 is a baseline cost. It's the cost for upkeep if and only if the type of wall we build is functionally the same across the board and there are no additional costs. I don't view it as pocket change, but I guess that's just a difference of opinion. It's true that the government spends a lot more in other places, though I don't think that minimizes the importance of those finances.

The issue is that dealing with terrain like floodplains and riverbanks will inherently be more difficult, time consuming and expensive than it is elsewhere. It's not just a financial cost, though, as this also disrupts ecosystems in the area. Those can't be solved by throwing money at the problem.

I suppose legal commerce could persist in one form or another. Then come the questions: where will these "ports of entry" be placed? How many will there be? What kind of traffic will be allowed? Who will decide these factors and will the people on these borders to be able to influence those choices? It's possible that all of this will be decided in a way that affords most people access to the same commerce, but I have my doubts.
#138
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@whiteflame
I would argue that at the worst, a $500 billion dollar "slush fund" would have less terrible effects than the dozens of random, unrelated laws included in the bill. Economic effects aren't the only consideration in this bill now. When you completely alter the voting process and push unprecedented collective bargaining laws into place, you are going to reap much more drastic impacts to the overall economy and future of the country.

Now, the reason why I am not entirely pessimistic about the $500 billion is that Trump's main shtick has been bragging about how well the economy is doing. So, they are under a lot of pressure to wisely use that money to actually help the economy get back on track so that he can continue to tout his economic savvy for the election in less than a year. He needs the economy to do well. Would some of it be used corruptly? There is a decent chance, yes, and I oppose that. In fact I support amendments to improve transparency because I strongly support government transparency. 

Don't know how much is left to discuss on this matter. Neither of us like what Republicans and Democrats did. There isn't really much to gain by pointing the finger more at one side than the other. I think a ridiculous 1100+ page bill with dozens of insane and unrelated additions is worse compared to one, potentially quite bad amendment that just needs a touch-up to be palatable. That is how I see it: which bill will more quickly bring aid to Americans? I would argue the one that at least semi-coherently attempts to remedy the issues at hand.
#139
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@whiteflame
Realistically, we're not going to deploy every member of our military to the US border, but I think you're missing my point. There's a deterrent effect just from having so many members of the military per such a small population that the US simply cannot hope to match. The effect is seen regardless of whether the wall exists, hence my point about proportions. That is not an effect the US can hope to match.

So just to clear up your point, you are arguing that having a large military force per capita is what will deter the illegal immigration, not having troops patrolling the border?

$150,000,000 is a baseline cost. It's the cost for upkeep if and only if the type of wall we build is functionally the same across the board and there are no additional costs. I don't view it as pocket change, but I guess that's just a difference of opinion. It's true that the government spends a lot more in other places, though I don't think that minimizes the importance of those finances.

Finances are incredibly important, but we overspend in a lot of different sectors and that money can be carved out or added through additional taxes quite easily.

The issue is that dealing with terrain like floodplains and riverbanks will inherently be more difficult, time consuming and expensive than it is elsewhere. It's not just a financial cost, though, as this also disrupts ecosystems in the area. Those can't be solved by throwing money at the problem.

I don't necessarily know that an ecosystem simply existing makes it important. If its destruction would have wide-reaching negative effects, then I could see where you are coming from on this. However, that also needs to be weighed against the economic and national security issues related to illegal immigration.

I suppose legal commerce could persist in one form or another. Then come the questions: where will these "ports of entry" be placed? How many will there be? What kind of traffic will be allowed? Who will decide these factors and will the people on these borders to be able to influence those choices? It's possible that all of this will be decided in a way that affords most people access to the same commerce, but I have my doubts.

This would extend beyond the view of the discussion. I could look up specific roads and where most commerce occurs, but that would take hours and would serve little purpose. It would have to be left up to the experts and politicians to weigh those costs.
#140
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@bmdrocks21
It really does sound like we're on the same page about transparency being essential to this, but that's why I'm so confounded by your response. The lack of transparency inherent to this addition is just staggering. That's one thing the Democrats aren't guilty of in this case; at least they listed their pet projects, however ridiculous they might be. I completely agree that the Democrats did wrong here, but recall that it was your statement about how terribly the Democrats were doing that started this discussion. For the record, I think both sides have a lot of reason to pursue legislation that rights the economy at this point, though some may believe that the Democrats want to use this as some kind of leverage for the election. In that regard, I'd trust both sides to at least believe that what they're doing is to bring the economy back in order. I don't think that makes either party good decision-makers in this regard, especially given that this is largely uncharted territory. Maybe Trump would have used that money correctly. Maybe he wouldn't. It's entirely possible that, despite oversight and restrictions, they will still fail to use it correctly. I'm hopeful, but these are dark times, and much as I would have liked something passed as soon as possible, I feel like a better bill is necessary when you're dealing in this much money. We can't afford to make huge mistakes at this point just because we want to rush something through.
#141
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@bmdrocks21
I'm arguing that having more troops on the border is part of the benefit that Israel has over us in this regard due to their draft. I'm also arguing that simply having more troops serves as a deterrence.

A year ago, I might have agreed with you that the financial issue is less important. Now, I'm not so sure.

We may simply disagree about the importance of maintaining ecosystems. You might think that it's the bleeding heart liberal in me that sees them as important, but it's actually the scientist. I know what disrupting ecosystems does to a region, and the effects can be wide-reaching very easily. If you want, we can get into them, though my impression is that you perceive them as less important than the potential benefits to economic and national security.

Agreed that there's a lot involved in how commerce would proceed with a wall in place and that we can't get into specifics without experts on the topic. That being said, I'm not convinced anyone really "knows" how this would go down, and I suspect our efforts to encourage commerce across the border after the wall is built will face a number of problems, especially if we're prioritizing national security in our efforts. To me, that uncertainty is among the biggest problems I have with such a wide-reaching project. It should be one of the first things we consider, yet I haven't seen much evidence that it is being considered.

#142
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@ebuc
MSM immoral handling of reporting:
The Guardian
Title:
The article states that he took fish tank cleaner chloroquine phosphate, not the drug that Trump was talking about. Based on the headline, it looks like they are saying he died for doing what Trump actually said.

Furthermore, he didn't say it actually was a cure, nor did he say people should self-medicate.

#143
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@bmdrocks21
They also said the drug was not approved when people have been using it for 70 years.

The fake news is very real when it comes to spinning the Orangemanbad narrative.

Usually, they try to be sneaky and crafty like CNN by omitting key contextual facts, but this is straight-up deception.
#144
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@whiteflame
It really does sound like we're on the same page about transparency being essential to this, but that's why I'm so confounded by your response. The lack of transparency inherent to this addition is just staggering. That's one thing the Democrats aren't guilty of in this case; at least they listed their pet projects, however ridiculous they might be. I completely agree that the Democrats did wrong here, but recall that it was your statement about how terribly the Democrats were doing that started this discussion. For the record, I think both sides have a lot of reason to pursue legislation that rights the economy at this point, though some may believe that the Democrats want to use this as some kind of leverage for the election. In that regard, I'd trust both sides to at least believe that what they're doing is to bring the economy back in order. I don't think that makes either party good decision-makers in this regard, especially given that this is largely uncharted territory. Maybe Trump would have used that money correctly. Maybe he wouldn't. It's entirely possible that, despite oversight and restrictions, they will still fail to use it correctly. I'm hopeful, but these are dark times, and much as I would have liked something passed as soon as possible, I feel like a better bill is necessary when you're dealing in this much money. We can't afford to make huge mistakes at this point just because we want to rush something through.

I feel like we are mostly in agreement based on this. My point was that Democrat additions made the bill impossible to salvage- many things they added were non-starters and needed to be taken out before negotiations could even start. Republicans offered a bill that likely couldn't be passed, but it was very close to what we needed, as we saw with its passage.


I'm arguing that having more troops on the border is part of the benefit that Israel has over us in this regard due to their draft. I'm also arguing that simply having more troops serves as a deterrence.

I don't think that simply having troops deters illegal immigration if they are not being used for this purpose. If America had 100 million soldiers, it wouldn't deter illegal immigration if we only had 1,000 of them on the border. Now I looked it up, and this says that Israel has roughly 6,000 border guards. https://en.wikipedia.org/wiki/Israel_Border_Police Even if we assume that they are all on that 150 mile stretch, that is still only 40 troops per mile. I showed that based on reserves and border patrol agents, we can afford to have 154 per mile. So, the fact that they have more troops doesn't have any meaning because they are in no way related to the prevention of immigration. 


A year ago, I might have agreed with you that the financial issue is less important. Now, I'm not so sure.

We may simply disagree about the importance of maintaining ecosystems. You might think that it's the bleeding heart liberal in me that sees them as important, but it's actually the scientist. I know what disrupting ecosystems does to a region, and the effects can be wide-reaching very easily. If you want, we can get into them, though my impression is that you perceive them as less important than the potential benefits to economic and national security.
I don't think you're being a bleeding heart liberal for the ecosystems. I do believe that if construction would have vast negative effects, that may be something that has to be worked around. I could be talking out of my rear end, but desert ecosystems in particular seem less important than other types like marshlands. I don't think that killing cacti is something that is likely worth risking security for, but it might be.

Agreed that there's a lot involved in how commerce would proceed with a wall in place and that we can't get into specifics without experts on the topic. That being said, I'm not convinced anyone really "knows" how this would go down, and I suspect our efforts to encourage commerce across the border after the wall is built will face a number of problems, especially if we're prioritizing national security in our efforts. To me, that uncertainty is among the biggest problems I have with such a wide-reaching project. It should be one of the first things we consider, yet I haven't seen much evidence that it is being considered.

I am not really certain how much consideration is being given to the commerce aspect on the government-end. I believe Trump likely isn't doing a lot of thinking in that regard simply because this was one of his biggest campaign promises, and it is something that really has to be accomplished, even if it means brushing over some of these considerations. I think that a wall is necessary and that it has potential to be very beneficial. That doesn't necessarily mean that I trust this administration or any other administration to do it faultlessly. 

#145
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@bmdrocks21
I don't think either case was impossible to salvage. The Democrats removed most of the things they were pursuing, hence there was room to negotiate over those issues. The Republicans modified the fund that they were setting aside to provide oversight. Both sides had to modify the things they chose to include in order to get the other side to come to the table, and both sides did.

I have a hard time believing that Israeli troops generally aren't being used to address issues related to illegal immigration, given that it's a near-existential threat for them. Just because they aren't stationed on the border doesn't mean that they aren't functioning in anything related to immigration or anti-terrorism, which are inherently linked in their case. I agree, America having more soldiers wouldn't put most of them on the border. That's part of the difference between Israel and America in this regard. 

We're not just talking about desert ecosystems, hence I'm talking about floodplains and river banks (though to be clear, we do prize some desert ecosystems, hence Death Valley, Joshua Tree, the Mojave National Preserve, Red Rock Canyon and others). They do have much broader effects. We could cover those, though I do think it's somewhat tangential to dig into those too deeply.

I guess my perspective is that this "full steam ahead" approach to the wall is inherently damaging if it brushes over considerations of commerce and ecosystems. I agree, the Trump administration is likely a lot more focused on getting it built than on the logistics regarding passage through it. That's generally what I find so problematic in this regard. I understand that they don't feel that another administration would take building the wall seriously (they're probably right), but I don't think these are issues that we can realistically paper over. From my perspective, if Republicans want to show that the wall is a necessity for future administrations to continue building and maintaining, then they should be focused on ensuring that it doesn't cause undue harms that their opponents can continually cite against it. Preparing for these problems makes their positions far less assailable, though I guess that's not the point.


#146
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@bmdrocks21
MSM immoral handling of reporting:
The Guardian
Title:
The article states that he took fish tank cleaner chloroquine phosphate, not the drug that Trump was talking about. Based on the headline, it looks like they are saying he died for doing what Trump actually said.

Furthermore, he didn't say it actually was a cure, nor did he say people should self-medicate.
Before I say anything else, I will be clear that the blame aimed at Trump in this case is overblown. The person who did this clearly wasn't thinking about the choice they made to take the chloroquine phosphate, and Trump clearly did not tell them to do that.

That being said, in a situation where everyone's terrified, it's all the more important for our leaders to present information clearly and correctly. Trump did say that the FDA had approved the use of chloroquine to treat patients infected with COVID-19, which is blatantly false. That sends the message that this is a safe and effective treatment for this infection, which it is not. This treatment has only been tested in vitro, which is insufficient evidence to show that patients should be taking this medication. Trump's statement in no way reflected this, and he can at least partly be blamed for shortages of these drugs across the country, though admittedly, many of these people may have decided to buy these meds based solely on the preliminary scientific evidence. Even if I assume that's entirely the result of people making dumb decisions, though, Trump shouldn't be feeding into those mentalities by bolstering a false narrative about this medication. That in and of itself is dangerous.
#147
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@whiteflame
Trump did say that the FDA had approved the use of chloroquine to treat patients infected with COVID-19, which is blatantly false.
Are you even sure this is what Trump said or is this media hearsay?

FDA has approved the use of chloroquine for 70+ years.

What you are claiming is equivalent to saying the FDA hasn't approved Tylenol for Coronavirus. FDA has cleared Chloroquine for use by doctors for 70 years and the doctors know the side effects. No matter what it's used for. Maybe it will help, maybe it won't help, but it's as likely to worsen symptoms as Tylenol. Most doctors need options like these because, for many of the critically ill people, death is almost certain anyway with NO treatment.

I get how bad you want to prove Trump is too stupid to care about people, but you are wrong on every aspect of this, and Dr. Fauci backed Trump up.

#148
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Fine, I'll quote him:

"It's shown very encouraging -- very, very encouraging early results. And we're going to be able to make that drug available almost immediately. And that's where the FDA has been so great. They -- they've gone through the approval process; it's been approved. And they did it -- they took it down from many, many months to immediate. So we're going to be able to make that drug available by prescription or states."


The FDA has approved the use of chloroquine for specific applications, like lupus and malaria. Every time the FDA approves a drug for a new use, it has to go through more clinical trials to prove that it is both efficacious and safe at given concentrations. We don't know what concentration of chloroquine is necessary to see any beneficial effects against COVID-19 in vivo because no tests have been conducted to show that. We don't know what concentrations of chloroquine are safe in patients with COVID-19 because any clinical trials done with the drug did not occur during the time in which this disease has existed. Those are both big problems. Doctors that decide to prescribe these medications for off-label uses like this can face severe punishments for that very reason: they're essentially prescribing in the dark without any clue regarding dosage requirements.
#149
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Okay fine. You go out on your crusade and tell Doctors to stop giving Tylenol to critically ill patients because the FDA has not cleared Tylenol for the Coronavirus. You do that.

#150
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...Tylenol is used to treat pain and bring down fever symptoms, both of which are associated with COVID-19. It's also available over the counter, which means doctors don't have to prescribe it. Patients can just go get it if they wish, for any reason they wish.