[PASSED] Patient Travel Freedoms

[Cretox State]

OOC: I think this is basically at the point it needs to be. I'm moving it to Last Call, and planning to submit in a week or so.

[Cretox State]

OOC: Tentatively changing the category to Health | Healthcare, since the proposal has a clause pertaining to medical care for incarcerated populations, and would place an additional burden on the healthcare systems of member nations (due to greater numbers of foreigners seeking specialized care that may not be available in their home countries). If there are objections, I'll just revert it to Civil Rights | Mild.

[Cretox State]

OOC: I'm going to submit this a bit earlier than planned, since there have been no comments for over a week.

[Bananaistan]

OOC: I'm struggling to see that the category is appropriate. Healthcare "improves nation's health at government expense." The impact that the prisoners clause has on healthcare seems to be trivial or speculative.

[Cretox State]

OOC: I'm struggling to see that the category is appropriate. Healthcare "improves nation's health at government expense." The impact that the prisoners clause has on healthcare seems to be trivial or speculative.

OOC: I could just pull it; no harm done. My logic was that yes, the prisoners clause would impact the healthcare system in some way, but generally speaking, people would mostly travel to seek care that is simply not available in their home country, thereby increasing the burden on healthcare systems that do offer that care.

[Graintfjall]

OOC: I have a vague memory of a pre-Pink Power Ranger ruling, or at least opinion, that anything in Healthcare needed to be the equivalent of "Significant" in another category. And a couple of non-mandatory clauses wouldn't cut it for that.

[Cretox State]

OOC: Pulled. Will not resubmit until there's clarity as to the category. Leaning CR | Mild right now.

[Cretox State]

OOC: Bumping this after expanding to include additional protections for foreigners seeking medical care and adding a new exception in the form of 2c. I feel that the proposal is now in a more complete state, and I changed the category back to Health | Healthcare to reflect the changes made.

Edit: Non-member nations are now completely excluded from this.

[Araraukar]

OOC: The phrase "citizens or permanent residents" is repeated ad nauseatum (2.c. alone uses it twice). Can't you define them as patients or something? Also, doesn't 2.c. bugger up the purpose entirely with "a compelling public policy interest similar in nature to the above"? A nation could have a public policy of not letting their residents to travel to "less advanced" nations, for example, to seek (in that nation's opinion) "voodoo treatments" or "faith healers" or whatever derogatory term you want to use, and then deeming themselves as the most advanced around (whether it was true, it might be true in terms of "where people can travel freely").

In IC this would likely be the general stance of Araraukar, as their citizens' only option was to try to travel to the hivemind's island, but they couldn't, because there's an active volcano erupting and thus it wouldn't be safe... Araraukarian diplomatic staff are the only ones allowed to travel through the "portal" to reach WAHQ. The general public doesn't even know the portal exists, nor would they have the means to reach it.

How exactly is clause 4 going to work out? How can any nation provide "foreign medical care", when no other member state is required to provide said medical care?

Same for 5.a. and 5.b. for treatments that their home nation simply cannot provide. Like, say, they manage to travel from a MT nation to a FT one, where their condition gets treated with medical nanobots, but their home nation hasn't yet developed the tech for those, so how are they going to manage to continue to give the appropriate care?

5.d. - person travels to another nation to have an operation, they're given approx length of operation and the costs calculated to that, but during operation there are complications and both the length of operation and the costs involved go way beyond the estimates. Are you requiring perfect knowledge of future with this clause?

5.e. - how is a doctor on one planet in solar system A supposed to know what medications are called on another planet that they have nothing to do with in solar system B, because their people haven't yet developed interstellar travel and didn't know about the planet B the patient comes from even existing, not to mention having life or intelligent life? Or any side effects any given medication might have for an alien species individual?

5.f. - what are "work constraints"?

5.g. - is "none" an acceptable answer? Especially if the patient is required to write a total release of responsibility before receiving the treatment (for, say, one of the abovementioned reasons)?

Clause 7, how does medical care not include medical treatment in your opinion?

OOC: I have a vague memory of a pre-Pink Power Ranger ruling, or at least opinion, that anything in Healthcare needed to be the equivalent of "Significant" in another category.

OOC: Strong effect (for all AoE ones aside from Environmental: All Businesses Mild), actually, but since Pink Power, Significant has been accepted a few times at least, I think. Draft has some mandates now, though, even if they were impossible to follow for the nations in question, so it probably works for the rule.

[Kelssek]

not be discriminated against in terms of quality or cost of care solely due to their status as a foreign citizen or permanent resident;

A citizen or resident of Kelssek contributes to the cost of the healthcare system through their taxes. Why should a visitor who has not contributed to financing the system be entitled to benefit from it at the same cost as people who live here? If you are not demanding that our people subsidize free healthcare for anyone who cares to get on an airplane then please clarify this provision.

[Cretox State]

OOC: I have a vague memory of a pre-Pink Power Ranger ruling, or at least opinion, that anything in Healthcare needed to be the equivalent of "Significant" in another category.

OOC: Strong effect (for all AoE ones aside from Environmental: All Businesses Mild), actually, but since Pink Power, Significant has been accepted a few times at least, I think. Draft has some mandates now, though, even if they were impossible to follow for the nations in question, so it probably works for the rule.

OOC: Significant. It's significant. Regarding clause 7, medical care and medical treatment have slightly different meanings, so I thought it prudent to clarify.

not be discriminated against in terms of quality or cost of care solely due to their status as a foreign citizen or permanent resident;

A citizen or resident of Kelssek contributes to the cost of the healthcare system through their taxes. Why should a visitor who has not contributed to financing the system be entitled to benefit from it at the same cost as people who live here? If you are not demanding that our people subsidize free healthcare for anyone who cares to get on an airplane then please clarify this provision.

OOC: Changed that, and some other stuff to hopefully address Araraukar's concerns.

[Maowi]

OOC: I think much of clause 6 is covered or mentioned in some way or other in PRA. I can look through it in more detail later but it might be useful to check for instances of slight contradiction where there may be some overlap.

[Kenmoria]

“I think that clause 4 should also mention clause 3c as a valid reason for member nations to retaliate against foreign citizens for seeking treatment abroad.”

[Cretox State]

“I think that clause 4 should also mention clause 3c as a valid reason for member nations to retaliate against foreign citizens for seeking treatment abroad.”

"That was an oversight on our part. It should have been 3, not 2."

[Cretox State]

OOC: I think much of clause 6 is covered or mentioned in some way or other in PRA. I can look through it in more detail later but it might be useful to check for instances of slight contradiction where there may be some overlap.

OOC: I think I removed all these instances of overlap, except for the one about information regarding prescriptions.

[Araraukar]

OOC post (too tired to do IC, sorry).

Defines a "patient" as a citizen or permanent resident of a member nation seeking medical care within the territory of a foreign member nation;

Maybe "...as inhabitant of one member nation seeking medical care in another member nation" instead? Using "inhabitant" includes both citizens and permanent residents - even CoCR uses it. If you're wanting to include WA nationals living in non-member nations, then maybe "citizen or inhabitant". Using the "one - another" form makes including the ones living in non-members or even having dual citizenship with a member and non-member nations easier, because the member state you're citizen of, would be a "foreign" nation, if you were a permanent resident in a non-member nation. Also, "in (a nation)" includes the "within the territory of (a nation)", so no need to make it more complex for no reason.

Declares that, subject to this and extant World Assembly resolutions, member nations shall not prohibit or obstructively interfere with the ability of their patients to seek medical care within the territory of a foreign member nation;

How can you prohibit travel without at the same time obstructively interfering? Meaning, "prohibit" might be unnecessary there. Also, given your definition of patient already includes "seeking medical care in another member nation" (if you use my wording suggestion), so there's really no need to repeat it everywhere. So, howabout "shall not obstructively interfere with patients traveling to other member nations"?

Clarifies that a member nations may implement reasonable restrictions on the ability of their patients a patient wanting to leave the nation to seek medical care, within the territory of a foreign member nation to address circumstances where:

Some streamlining and reducing the repetition same way as above.

seeking medical care within the territory of said nation would present there exists a severe threat to the safety of citizens or permanent residents the patient, excepting potential direct complications of caused by the medical care being sought;

A bit more rewrittal here, but again reducing extraneous fluff. Also, throughout this entire clause making it "a patient", not the plural (same for "a member nation"), because that way there's no "but the proposal has plural form so if only one person wants to go, this doesn't apply" kind of loophole available.

the patients in question are is legally unable to make the decision to seek medical care in the territory of said nation leave the nation due to incarceration, ongoing legal proceedings, mental incompetence, or being below the age of majority or lacking legal competence; or

There may be other reasons for lacking legal competence than those two (coma patients, anyone? coma is a physical condition, not mental), but there exists a resolution that requires such non-competent persons to be assigned a guardian of some kind (relative or court-assigned other), so using the wording from that one makes most sense.

preventing said patients from seeking medical care within the territory of said nation serves there exists a compelling public policy interest of similar in nature to the above, which clearly and demonstrably restrict warrants restricting the ability of those patients a patient's ability to seek medical care within the territory of said nation and definitely outweighs the need to protect the right to seek medical care abroad benefits from allowing them to travel;

Lots of rewrittal, to simplify and reduce repetition and also to close a loophole (taking out the "policy", as that's a more specific thing than public interest). Also, as you have not actually made it a right to do this seeking of medical care, it would make no sense to refer to it as such.

Prohibits member nations from in any way retaliating or taking legal action or retaliating against their patients for seeking medical care in the territory of a foreign member nation a patient, except as necessary to enforce the restrictions implemented pursuant to defined in clause 3 of this resolution;

Changing the order of retaliation and legal action since when I added the "in any way" to it the way they were, it sounded wrong. Also, "taking legal action against" just sounds more professional. The rest takes away repetition and simplifies things - like for example, there's no reason to specify "of this resolution", as referring to any other resolution's clause 3 would be a House of Cards violation.

Subject to extant World Assembly resolutions, mandates that member nations implement a reasonable and thoroughly developed policies clear policy for providing medical care to their incarcerated populations, for situations in which such care should be required;

Your clause 2 already specifies the extant resolutions thing, and "thoroughly developed (policy)" sounds like weasel words, and you don't provide medical care when it's not needed, so the last strikeout is just taking out some more fluff/circular reasoning.

Declares that patients within the territory of a foreign member nation have the right to:

Given that the first of the subclauses refers to their home nation, the strikeout is necessary for not making this self-contradictory.

receive appropriate continuing or follow-up medical care upon returning to their home nation member nation of origin, should when such care be is reasonably available there;

Home nation might be a non-member nation, especially for permanent residents who are not WA citizens. But for them to count for this, they either need to have citizenship in a member nation or permanently live in one, so they do have a "member nation of origin" by necessity.

receive, to the extent that such can reasonably be provided, accurate information concerning about all prescribed medications prescribed to them, including their names and alternate names as commonly known in said patients' nation of residence, their normal actions, active and inactive ingredients and applicable known side effects and their probablity;

Information about ALL medications is less relevant than what has been prescribed to them. And brand names are even more irrelevant, but the ingredients are not (active ingredient is the one that has the treatment effect, inactive ones are everything else, but they should be made known to the patient in case they're allergic to it), and "applicable" makes it sound like you needed to know in advance what side effects someone might have, so I changed it to what at least all of my meds have in the information slip that comes in the package.

receive reasonable accommodation concerning the scheduling of medical care when bound by travel constraints; and

What does this mean? Shouldn't the patient arrange their own accommodations in advance? Though you don't call them that, they are medical tourists in the nation they travel to. Tourists need to sort out their own accommodations.

be reasonably informed of available resources for resolving disputes arising from the medical care in question, including applicable domestic and foreign legal representatives, and to have potential disputes resolved thoroughly and in a timely manner, and to be sufficiently informed of their outcome when possible, and be made aware of the decision;

Requiring possible court cases to not be delayed by other court cases is another road to insanity, and "sufficiently informed" sounds like a loophole (sufficiently in whose opinion?), while "made aware of" means you need to actually make sure the person gets the actual information of the decision.

Subject to the other provisions of this resolution, requires member nations to collect and compile accurate and actionable data concerning their patients' reasons for seeking medical care in a foreign member nation, and to use said data to identify and address weaknesses in their domestic healthcare systems;

This likely would violate PRA. I know you have the "in accordance to extant resolutions" thing, but this WOULD be a stumbling block in vote, because many people likely are not aware of PRA even existing. The rest is unnecessary since...

Urges member nations to further improve domestic access to medical care; and

...you have this clause.

Clarifies that "medical care" as used in this resolution also includes medical treatment.

My previous objection to this being unnecessary still stands.

[Cretox State]

OOC: Bumping this; might submit later this week.

Maybe "...as inhabitant of one member nation seeking medical care in another member nation" instead? Using "inhabitant" includes both citizens and permanent residents - even CoCR uses it. If you're wanting to include WA nationals living in non-member nations, then maybe "citizen or inhabitant". Using the "one - another" form makes including the ones living in non-members or even having dual citizenship with a member and non-member nations easier, because the member state you're citizen of, would be a "foreign" nation, if you were a permanent resident in a non-member nation. Also, "in (a nation)" includes the "within the territory of (a nation)", so no need to make it more complex for no reason.

OOC: My problem with "inhabitant" is that it would include foreigners that have living arrangements. This works in CoCR, but might not work so well here, since this proposal covers more than just "you may leave a country."

[Eluney]

3. Clarifies that member nations may implement reasonable restrictions on the ability of their patients to seek medical care within the territory of a foreign member nation to address circumstances where:
a. seeking medical care within the territory of said nation would present a severe threat to the safety of the patient, excepting potential complications caused by the medical care being sought;

OOC: I generally agree with the proposal and its wording. My only doubt is the following: if a person of legal age, duly informed and with full physical and mental capacity, wanted to seek medical treatment in a country where, for example, there is a state of war, would it not fit within the individual autonomy of that person? Why would the State be empowered to prevent it?

[Fre Cruth]

Why wouldn't we just work as a nation to change the way healthcare is ran so that patients don't feel the need to travel outside of the area for more affordable healthcare?

[Cretox State]

Why wouldn't we just work as a nation to change the way healthcare is ran so that patients don't feel the need to travel outside of the area for more affordable healthcare?

OOC: Because many nations can't or won't provide such healthcare? Because healthcare is a right that all people deserve to have?

[Imperium Anglorum]

In section 2 don't use 'their patients'. Be more specific as to who has this right.

'Reasonable regulations' under what criteria? It doesn't actually help to say that member nations must not be vague; member nations too are an abstraction we cannot really observe. Getting to the later portions, the word 'reasonable' is massively overused.

[Western Kidora]

"The people of this world must have the right to take care of their personal health by any means necessary. Should the citizens home state be incapable or unwilling to provide the necessary medical services then it is the responsibility of the states with more advanced healthcare systems to provide assistance. We, the people of Western Kidora, understand that money is both the root of all evils and, in this world, the fixer of most problems. Perhaps a system where states whose people must travel abroad for treatment are then required to pay any fees the citizen cannot pay out of their own pocket? Otherwise, we agree that the health of one individual is more important than any barriers that might separate us politically."

[Cretox State]

Bump. Made some edits to cut down on "reasonable" overuse, and will look to submit later this week unless issues come up.

[Bananaistan]

OOC: The original was a RL hot topic issue du jour, unsuitable for WA legislation. This remains the case. Particularly so considering the existing legislation on healthcare that utilises WA funding to assist below par health services. Why is this even necessary?

[Honeydewistania]

What is a ‘clear and compelling public policy interest’