71 thoughts on “Sandpit

  1. I see doctors want to have the authority to recommend that asylum seekers be admitted to Australia irrespective of the immigration Minister’s wishes. In a related vein, doctors have, for many years, wanted to have the final say on people who abuse addictive drugs – a common view is that legalizing them would make the “drug problem” more manageable through harm-minimization. In both of these cases doctors are making policy judgements on key issues of social concern by focusing on the immediate medical needs of the “patient”. Often the basis for both viewpoints is a shrilly-voiced “compassion” for those immediately affected by some policy.

    This can be a poor basis for policy. Political scientists and economists have a more sophisticated view of policy issues that accounts not just for the immediate benefits for a relatively narrow group of individuals but for society-wide effects of a particular policy. Economists use social cost-benefit analysis to look at all the effects of a policy move not only on the direct effects on a small group.

    If doctors have the ability to admit asylum seekers to Australia will they exercise this judgement responsibly or will they gradually identify medical problems in all asylum seekers that justify the entry of all. Some might agree that all should, in fact, be relocated to Australia but that is not the policy of either major political party in Australia and certainly not the viewpoint of a majority of Australians. Will there be effects of this policy on the incentive to seek the asylum-seeker route to settling in Australia rather than working through official channels and the refugee/humanitarian program? When Kevin Rudd relaxed the Howard policies a little numbers of so-called asylum seekers surged from close to zero to 1000 per week and 1200 drowned at sea. With the institution of “turn-back” policies asylum seeker numbers reverted to zero as have drownings.

    With respect to drug users the legalization of drugs to addicts (or the introduction of safe injecting rooms) reduces the comprehensively-assessed costs of accessing drugs and the cost consequences of becoming addicted to drugs. If it is agreed that “demand curves slope downwards” – that people will indulge less in activities that are more expensive – then the gains in terms of reduced overdose deaths from providing drugs legally need to be traded off against the fact that more drugs will be used and that more will use drugs. Again it might be objected: So what? But the fact is that most politicians and Australian citizens would prefer that fewer people use currently illicit drugs rather than more.

    Doctors do have a role in presenting their views on both asylum-seeker and illicit drug issues. But it is not the only reasonable view and is not the most comprehensive view. From a broader social viewpoint compassion for a particular group needs to be supplemented by consideration of the interests of the broader community. Occasionally the “direct effects” of a policy will be large enough to dominate unsought-for indirect effects. But not always and the “compassion” of doctors can be a poor basis for devising policy. .

  2. I have to admit I had no idea Mathew Guy was relying on ‘sophisticated economic and political science analysis’ to draw up his law and order policies, instead of being a transparently crooked politician with the most notorious drug dealers in Victoria firmly up his backside.

    I’d like to see the evidence that a) safe injecting rooms cause more people to become drug users, and b) a significant number of doctors want to see hard drugs legalised.

    The idea that Peter Dutton based any of his decisions on the medical treatment of asylum seekers upon ‘sophisticated economic and political science analysis’ is not even worth pretending to take seriously.

  3. a) The argument is that making drugs safrv reduces their user costs and thereby encourages use. b) Many doctors do e.g. Alex Wodak. I didn’t make the claim that Peter Dutton had used sophisticated economics and political science so your views too probably do not need to be taken seriously, at least in terms of my argument.

  4. harryclarke

    “If it is agreed that “demand curves slope downwards” – that people will indulge less in activities that are more expensive”

    Holy Mother of Jesus. Not the rational addiction model of substance abuse. It was comprehensively debunked (by economists!) decades ago. Time to update your knowledge of the literature. You can start with the 1999 Productivity Commission Report into gambling.

  5. In both of these cases doctors are making policy judgements on key issues of social concern by focusing on the immediate medical needs of the “patient”.

    I am reminded of the episode of Yes, Prime Minister in which the Health Minister proposes a major package of anti-smoking initiatives. Sir Humphrey Appleby suggests that because the Health Minister (in this particular instance) is a doctor, he has a biassed perspective: all he bothers to think about is keeping people alive.

    Often the basis for both viewpoints is a shrilly-voiced “compassion” for those immediately affected by some policy.

    ‘Shrilly-voiced’? Okay, now you’re just making stuff up out of nothing. Why?

    A hypothetical person who was opposed to being compassionate but reluctant to admit it might very well describe it as ‘shrilly-voiced compassion’.

    Another thing that might be done by a hypothetical person who was antagonistic to compassion but reluctant to admit it would be surrounding the word with needless but rhetorically deceptive scare-quotes.

  6. smith9, There is no dependence on the rational addiction model which calls for forward-looking behaviour. The demand for heroin is known to be relatively price elastic. Are you saying that individuals will use more heroin as the price rises?

    J-D. You ridicule but don’t read carefully or fairly. I stated that doctors do have a role but that there are other incentive issues that do, as a matter of fact, drive policy views. Levels of drug use as well as overdose deaths are a policy concern and if there are increasing levels of use there may be more deaths. Both political parties in Australia are concerned with asylum-seeker numbers not only with the welfare of asylum seekers on Manus.

  7. smith 9. Price elasticities of demand for heroin have been estimated to lie between -1.8 and -1.6. Demand curves do slope downwards. The authors of this famous study do not use the rational addiction model.

    Click to access w5238.pdf

  8. harryclarke

    Did you even read the paper? The price elasticity is assumed to be twice the participation elasticity. The participation elasticity is chosen among different specifications where a key criteria is that “the price coefficient should be negative and significant”.

    In other words, they assumed their answer. And what’s more their various specifications explained hardly any of the variance of heroin participation.

    This is supporting evidence?

    And in the published version of this paper, in Economic Inquiry in 2007 , the price elasticity of heroin was revised down to -0.9. It took them 12 years to publish their results and only then in a withered form.

    Hmmm….

  9. Smith9, Yes I have read the 1995 study. The data used was dichotomous and participation elasticities were estimated – all were negative and four out of 5 were significant, this was not an assumption as you claim. Then using results from the single prior study along these lines which found price elasticities were 2.5X participation elasticities – very plausible intuitively – they conservatively set usage elasticities at twice participation elasticities. I do not have access to the Economc Inquiry article and have only read the abstract. I assume in it that the participation elasticity is taken to be about the demand level elasticity. It is still -0.9 so nothing at all changes. Demand depends negatively and significantly on price. I have never read any other study – even those claiming inelastic demands of around -0.4 that do not confirm this.

    Demand curves for a wide range of illicit drugs do slope downwards and to argue the opposite is both non-intuitive and inconsistent with the evidence both in the original 1995 Saffer/Chauoupa article and the subsequent publication – as well as every study I have encountered on the issue.

    Do you have contrary evidence or are you simply trying to snark?

  10. harryclarke

    nobody says that heroin users buy more when the price goes up. The question is how much less they buy. I suggest to you that heroin addicts (not recreational users), the kind of people who will use injecting rooms, will find a way to pay the going price for the fix they need.

    You know it makes sense.

  11. Former drug policy person here. First – not all drugs are the same. Second, for the most harmful categories of drugs (heroin, ice), use and harm are concentrated among a small number of heavy users, who are not responsive to price. Which is why the price of these drugs is not responsive to supply (the main users have fixed incomes and spend nearly all of it on drugs – they can’t pay more). What is responsive is demand – the casual users drop out, then some main users seek treatment because they can’t find the drug.

    Injecting rooms are aimed at these heavy users, and try to keep them alive and doing less damage.

  12. harryclarke started by asserting that ‘doctors want to have the authority to recommend that asylum seekers be admitted to Australia irrespective of the immigration Minister’s wishes’. Maybe there are doctors who do.

    But the measure passed by the Senate clearly doesn’t allow doctors an override of the Minister. And even a further reference to a larger panel produces nothing that overrides the Minister. The doctors put a treatment need to the Minister: the Minister decides and cannot be compelled by the doctors’ views of treatment need.

    Now, whose views on who needs what treatment, other than those of doctors, does harryclarke think should be preferred? Bearing in mind, of course, that questions other than need for treatment are matters for the Minister, whose views will decide after the doctors have asserted a treatment need?

  13. chrishod, No my understanding is that the Senate decision is that doctors can force the issue on medical grounds. The Minister can only object on national security grounds. The difficulty lies in the ambiguity of “medical grounds” which the Minister (in my view rightly) believes could become a free-for-all.

  14. Harry Clark. Just curious. Have you ever known a heroin user? Ice user? Pot. Alcohol? Benzos. Prescription (read: same)?
    For how long?
    Met a person who has lost a loved one to heroin or ice or alcohol?
    I have.
    I updated my priors. Yours are based on fear as evidenced by your belief; “the Minister (in my view rightly) believes could become a free-for-all.”

    And please, Do you have any data later than yhe 1990’s.

  15. Let me add to the pile-on on. Harry, it really is bad form to imply your opponents are all arguing in bad faith by putting terms like compassion in quotes. I don’t agree with your arguments about either asylum seekers or drug legalisation, but, yes, you can legitimately point out that doctors have a deformation professionelle that is not the only possible perspective on these issues. But instead those quote marks make your post offensive and untrue.

  16. Harryclarke now says the measure passed in the Senate would allow doctors to override the Minister unless the Minister called on national security grounds. Feel free to identify what is wording in the measure that you think creates this; and feel free to identify how a power in the Minister to override without reasons, not requiring the statement of any particular national security grounds, leaves the Minister unable to disagree with medical opinion. I recommend the Parliament House – Senate website for the actual text. For myself, I can’t find anything in the measure that restricts the Minister’s power to reject the views of the (initial) two doctors or of the (reference panel of) seven more.

    That, of course, is if you can identify any basis on which the medical views of the Minister could have any medical credibility against the initial two doctors, and if disagreed the larger panel of doctors. I understand that you have asserted that doctors might make non-medical determinations despite their ethical obligations and despite the exclusively medical question on which they must advise.

    Certainly I must concede that a Minister might make determinations not actually informed by any issue of national security. Many Ministers do. But they are neither ethically supervised externally nor controlled by any ethical standards subject to open testing. (The opinion of the Prime Minister or the PM’s amanuensis is notoriously not driven by any standard other than political cost and benefit.)

  17. @derridaderider

    I think Harry’s use of quotation marks around the work “compassion” is open to more than one interpretation. You say it means he is questioning the genuineness of the compassion of those who disagree with him. I disagree and I interpret it differently. I see it as an expression of frustration and annoyance because, for Harry, our view of what is compassionate should be the product of the cold hard calculations we expect from economists.

    I surmise Harry is the type of guy would never seriously contemplate walking away from Omelas: ###www.thoughtco.com/ones-who-walk-away-omelas-analysis-2990473

  18. I think you are being disingenuous Harry.

    Doctors have argued that drugs should be viewed as a public health issue and that drug related illnesses are better treated by the medical profession rather than by incarceration in a prison.

    Similarly with asylum seekers, whose health issues are not being properly addressed by border protection authorities.

    This is a failure of governance by the government.

  19. You can talk about “cold and hard calculations” or you can talk about taking a comprehensive view of the welfare issues. I prefer the latter way of thinking about it. Doctors focus on the issues concerned with the immediate individuals involved without considering broader issues that are important in addition. Providing asylum seekers with an entry mechanism or allowing free access to drugs (or safe injecting rooms) have incentive effects on other agents that can determine, in the case of asylum seekers, numbers attempting unofficial entry (and drownings at sea) or, in the case of drugs, usage participation rates. These indirect effects also have costs that are the basis for substantial community opposition to these views.

    It is easy to collapse complex policy issues that involve difficult tradeoffs to one-sided views based on myopic, emotional overcharge. That’s what I am trying to point out. The responses are revealing. One line of counterattack might be to say that these secondary effects are negligible but the evidence from Kevin Rudd asylum seeker policies with 1000 asylum seekers arriving each week and 1200 dying at sea does not convince me. Nor do claims that drug users have very inelastic demands for drugs = the evidence is not consistent with this. And policies should be based on evidence where it is available.

  20. Despite there being only two safe injecting rooms in Australia the evidence would indicate that they have had no adverse effects.

    Other evidence, ie from Portugal, points to a substantial improvement in public health with a reduction in drug related disease and drug related crime.

    The ongoing effects of mass incarceration, both on the individual and society, also need to be examined.

  21. J-D. You ridicule …

    It’s not clear to me what your purpose is in stating this. Were you under the impression that I didn’t understand what I was doing and needed to have it explained to me, or what?

    I stated that doctors do have a role but that there are other incentive issues that do, as a matter of fact, drive policy views.

    Again, I don’t know why you think you needed to explain this to me, because I noted exactly this point as being like the position of Sir Humphrey Appleby, that we can’t consider only saving lives but have to take other factors into consideration as well.

    In particular you argue that if drug use were safer fewer people would die, but on the other hand we might have to deal with the consequence of increased drug use, which would be a bad thing because some people wouldn’t like it. It’s absolutely true that if drug users were persecuted less some people wouldn’t like it, but strangely enough I don’t care.

  22. Harry Clark. Please stop shouting at clouds. Amanda Vanstone in 1998 I think, boasted of “the biggest heroin bust ever” (worldwide). But you are still saying the same thing I saw on Doug Domicus’ backside “Don’t do drugs”.

    I presented a system dynamics model in 1993 (-ish! It was a long time ago) on ‘the effect of busting heroin addicts’ the the big wigs in The Office of Strategic Crime Australia, now subsumed below Peter Dutton. 

    Basically Harry, busting heroin addicts leads to less dealers, users back EVERY day (after 180 days addict has a private dealer and 3-5 day supply) , users detained returned to market within 20 days after release, less supply, price up, other dealers exploit high price and offer any and every other drug (heroin addicts will use alcohol benzos if heroin unavailable ) and finally more heroin more drugs more busts more price hikes and on and on… and not to mention costs of policing, deaths, family and public health. AIDS?  (Paper on my dead eMac!) And see below re start ups and entrepreneurs. 

    Try this;
    US citizens benefited 15 cents per dollar spent on the first, and 32 and 52 cents, respectively for the second and third. But the benefit of the last measure, that is, treatment rather than law enforcement was US$7.46 for each dollar spent.”
    http://theconversation.com/what-works-best-in-the-war-on-drugs-31015

    Harry, i believe your priors are not letting you update your data and assumptions. And I think your time step (in your perceived data) is a bit big; “As the timestep becomes larger, the accuracy of the simulation model falls.”

    But Harry, what would you do about this;
    “Politicians who believe implicitly in the unseen, unstoppable power of the market are consistently shocked that the $321 billion global drug trade attracts start-ups and entrepreneurs. That river of money is an unstoppable torrent. It always flows to the point of least resistance – the poorly-paid cop, the law student out to make a quick buck, the young mother willing to stuff herself full of poison for a chance at a better life. It builds and builds until it threatens to wash away entire nations.

    And no country has been able to hold it back. Australia spends more than a billion a year on the war on drugs. The US spends many multiples of that. In Mexico, where the war is actually being fought, 100,000 people have paid with their lives in the last decade alone.”
    abc.net.au/news/2015-12-01/mcclintock-drugs-are-destructive-but-criminalisation-is-worse/6991076

    Now Harry, can you spot the word in this link which is BAD?
    https://www.hrlc.org.au/news/un-finds-australias-treatment-of-asylum-seekers-violates-the-convention-against-torture
    The T word. That is what you sound like you are endorsing. Are you endorsing torture? 

    Harry, how many Australian / Indonesian navy and air force vehicles are patrolling and returning the potential drowners? 2016-17; “That figure included $1.57bn for onshore compliance and detention, $1.08bn for the “offshore management” of “irregular maritime arrivals”, and $1.06bn on border enforcement.”

    Because of people allow compassion to be overridden by priors and FEAR, we basically dump money on places in need of capital and use this as an excuse to stop people drowning. We soend ridicylous amounts because if fear. A billion or more on boats planes people which could be used to COMPASSIONATELY process these people,  AND provide medical care to boot.
    https://www.theguardian.com/australia-news/2018/jan/05/australias-border-protection-policies-cost-taxpayers-4bn-last-year

    I’m scared too Harry. But I am more scared of this;
    “Peter Dutton says he has always seen ‘parliament as a disadvantage for sitting governments’,” and no, i won’t link quote. Dutton said this yesterday.

  23. @ Harry Clarke

    I did not use the expression “cold hard calculations” pejoratively. In regards to asylum seekers we are in broad agreement; a strong deterrent condemns a few to misery but saves the lives of many and is thus more compassionate.

    For that reason I wouldn’t give doctors responsibility for transfers off Nauru as a “medical reason” will undoubtedly be found in almost every case and the deterrent will be lost.

    Another part of my cold hard calculus is that if Oz opened itself up the way Europe has, the centre-left would be smashed and the reactionary right would be invigorated.

    My ancestry is Swedish; I look on with horror at the fall of the Social Democrats and the rise of the Sweden Democrats. The bleeding hearts would have the same thing happen in Oz.

  24. For that reason I wouldn’t give doctors responsibility for transfers off Nauru as a “medical reason” will undoubtedly be found in almost every case …

    Apparently you think that doctors are all liars who are motivated only by a desire to defeat government policy.

  25. The Portugal example is, as we should expect from any serious attempt to deal with the drug problem by means other than criminal sanction, not so simple as “legalising drug use”, but it does provide an example of a different, health focused approach. Recreational drug use did not explode and there is evidence of reduced take-up of drug use by young people as well as more drug users giving it up. Less HIV infections, lower drug death rates. We will have to wait to see how US States and Canada legalising cannabis play out but early signs are not consistent with a surge in new users.

    As for refugees – if Australia’s border security is so fragile that just the suggestion that people who have been in detention for years might get residency in Australia will wreck it there is something seriously wrong with border security. Myself, I don’t see even tens of thousands of refugees as any kind of grave security threat to Australia – other nations, much poorer than Australia, have to deal with hundreds of thousands at a time and appear to survive it – but I appear to be in the minority. Lots of people do appear to think they present some kind of danger to Australia – I think simply because they are being told that they are – but irrespective of that, I still don’t see that camps in Nauru and Manus can really be considered the cornerstone of a rational and humane border security policy.

    The whole “saving refugees from drowning” framing looks to me like pure bullshit of convenience; how many denied transport to Australia are being condemned to die in refugee camps? More or less than by drowning? If we don’t know that, we can’t say we are saving lives. In any case, stopping the boats needs to be about actually stopping and forcing back boats, not blanket refusals to settle refugees who they failed to force back or who lacked prior permissions.

  26. @ J-D: “Apparently you think that doctors are all liars who are motivated only by a desire to defeat government policy.”

    This is a typically petulant and unlettered response from you. A doctor doesn’t need to lie; all they need do is accept that a patient is faithfully reporting their symptoms. My 20 plus years medico-legal work experience is that doctors usually assume faithful reporting of symptoms unless there is an obvious reason not to do so. Indeed, under cross-examination, doctors tend to be candid in that regard.

  27. @Ken Fabian

    The whole “saving refugees from drowning” framing looks to me like pure bullshit of convenience; how many denied transport to Australia are being condemned to die in refugee camps? More or less than by drowning? If we don’t know that, we can’t say we are saving lives.

    According to Asylum Inasight- Facts and Analysis, 37 people have died in immigration detention facilities since 2010, twelve of whom died on Manus Island and Nauru. According to The Conversation’s ‘Fact Check’, approximately 1200 asylum seekers drowned en route to Australia between 2007 and 2013.

  28. @J-D

    “J-D. You ridicule …
    It’s not clear to me what your purpose is in stating this. Were you under the impression that I didn’t understand what I was doing and needed to have it explained to me, or what?”

    If you did understand that you were setting out to ridicule that is useful information. My purpose was to try to get you to think a bit more carefully about what you write and to try to encourage you to express your views in a less obnoxious way. We can then, perhaps, have a discussion rather than just having me respond to snarky unpleasantness.

  29. From wiki:

    Estimates of the number of Vietnamese boat people who died at sea can only be guessed. According to the United Nations High Commission for Refugees, between 200,000 and 400,000 boat people died at sea. Other wide-ranging estimates are that 10 to 70 percent of Vietnamese boat people died at sea

  30. More reason to ensure safe passage. Refugees seeking asylum do so out of fear.

    There was a time in Australia when immigration was unfettered allowing criminal elements easy access. These criminal types were from many nations and of many religions and skin tones.

  31. I look forward to discussion with harryclarke ‘rather than just having me respond to snarky unpleasantness’, as he says of another commenter above.

    There is nothing in the measures passed in the Senate that allows doctors to override the Minister, for the reasons I have twice set out. So Clarke’s discussion lacks the founding assumption with which he began.

    I am intrigued by Tim Macnay’s refusal to address Ken Fabian’s question. How many refugees, whether ‘convention’ refugees or not, die in holding camps after years without a life? That question cannot be answered by referring only to those who died after a voyage to Australia followed by on or offshore Australian detention. It requires reference to the various holding camps and administrative detentions in all the other jurisdictions too, and certainly in Thailand, Malaysia and Indonesia at least. It’s a large number though not certain – and it’s not within two orders of magnitude of the ’37’ Macnay quotes. Similarly, when Hugo talks of as many as 70% of Vietnamese refugees by boat dying ‘at sea’ – that is, in transit, including at the hands of privateers and pirates – the comparison required is to the numbers dying in detained lives in Vietnam and in holding camps and administrative detention in intermediate stops. (And the percentage is slippery because the denominator, the number of Vietnamese refugees by boat, is rather uncertain itself.)

    Various anti-refugee rhetoric has in common the idea that there are numbers beyond Australia’s capacity to accept. Uganda has taken two and half million refugees in less than five years. It has admitted them fully to education and given them land and (Ugandan) services. We have never had any numbers arriving in Australia that present a problem; the much larger current processing load of asylum seekers arriving by air annually than ever arrived by boat in any year presents no real difficulties, beyond the reluctance of Dutton and his agencies actually to assess their claims quickly, and the reluctance of our security agencies to clear people fleeing the secret police who are members of their joint clubs (like those of Sri Lanka).

  32. @chrishod

    I am intrigued by Tim Macnay’s [sic] refusal to address Ken Fabian’s question.

    Why do you say I “refuse to address Ken Fabian’s question”? I think you need to take a deep breath, calm down, and don’t make so many assumptions about other people’s intentions.

  33. We can then, perhaps, have a discussion rather than just having me respond to snarky unpleasantness.

    If you didn’t want snarky unpleasantness then you shouldn’t have started it. I am, however, ready at any time to accept your apology and look forward to find you doing better in future.

    If you have, perhaps, lost track of what your original snarky unpleasantness consisted of, you can check back to my first response to you; or I can just repeat the point for you: it was the condescending use of the word ‘shrilly’ and of scare-quotes.

  34. @chrishod

    This from the ABC website:

    https://www.abc.net.au/news/2018-12-11/refugee-medical-evacuation-nauru-manus-island-analysis/10605212

    “Let’s turn to the bill, which refers to a person in Nauru or Manus as a “transitory person”.

    Under section 198E of the proposed, if two or more “treating doctors” for a transitory person notify the Home Affairs secretary that the person needs medical or psychiatric assessment and, in their opinion, is not receiving appropriate care, the Home Affairs Minister must approve or refuse transfer to Australia within 24 hours.

    They may be refused transfer if the minister either reasonably believes it not necessary or if the minister believes bringing them to Australia would be “prejudicial to security” within the meaning of the Australian Security Intelligence Organisation Act, including because the person is subject to an adverse security assessment under the ASIO Act.

    The Government argues that this significantly narrows the existing unfettered ministerial discretion, precluding him or her from even making assessment of the person’s character when deciding whether to allow a transfer on medical or psychiatric grounds

    ….Under section 198F, if the minister does refuse a transfer on the basis he or she deems it unnecessary, the decision is referred to an independent panel which, within 24 hours, must conduct a further clinical assessment of the person and then inform the minister.

    The proposed Independent Health Advice Panel would be a high-powered bunch, comprising the chief medical officer of Home Affairs, the surgeon-general of the Australian Border Force, the Commonwealth’s chief medical officer plus no fewer than six other health professionals, including nominations from the Australian Medical Association, the Royal Australian and New Zealand College of Psychiatrists and the Royal Australasian College of Physicians.

    *******A medical opinion from such an eminent panel would, you’d think, carry significance, but even at this stage the minister would be able to defy the advice, but not on medical grounds*******.

    The minister would be given another 24 hours to reconsider the matter and either accept the panel’s recommendation or again refuse the transfer to the Australian mainland, if the minister reasonably believes that the transfer of the person to Australia would be prejudicial to security, as defined under the ASIO Act.

    It all sounds a bit circular, but the process foreshadowed by the bill effectively stops the minister being the final arbiter of whether evacuation to the mainland is reasonable on medical or psychiatric grounds.

    However, the bill does not stop the minister refusing transfer on security grounds, even if the majority of the expert panel agrees with the two treating doctors that evacuation is necessary.

    Which means the definition of “security” becomes central.”

    This is the basis for my claims – the crucial line is indicated with a *******. My reading is that the Minister cannot overrule on medical grounds but can overrule on national security grounds. That’s what I claimed earlier.

  35. Tim, I was actually thinking of the refugee deaths amongst those that are turned back or denied any opportunity to reach Australia, rather than the ones who did make it and died in Australian camps. I suspect for those Vietnamese refugees the death rates for those who did not take to boats was also very high.

    In any case it looks like my views are not widely held and preventing boat arrivals is widely supported. That I think the level of fear and loathing of refugees desperate enough to take to leaky boats is artificially inflated – all that pressing those buttons and whistling those dogs – won’t diminish it’s popularity.

    I still think the preventing boat arrivals is the fundamental action in border protection terms; denying any opportunity for settlement for the “crime” of seeking to enter Australia by boat is not. The boats not getting through is the deterrence, not indefinite detention.

  36. Ken, I belatedly realised that’s what you meant after I’d posted my comment. You’re clearly correct that the drowning figures are frequently deployed cynically, typically by Liberal politicians to bash the Labor party and by Labor to creat a humanitarian veneer to justify policy designed for more Macchiavellian ends (I.e. to avoid being wedged).

    I do think, though, that the drownings are a salient fact when considering asylum seeker policy. Personally I only became aware of the extent of the drownings quite recently, and I was quite shocked at the numbers. It now seems to me that a policy needs to be developed that does away with both inhumane detention and irregular maritime journeys. I’m not entirely sure what such a policy would look like, but it might resemble the concept recently put forward by Andrew Wilkie that entailed UN-supervised processing centres followed by resettlement to a number of locations, including Australia. Such a policy might be difficult to set up but it seems to me the sort of thing we should be aiming for.

  37. @ Tim Macknay,

    Thanks for avoiding snark and adding light to a debate that is overheated.

    I don’t think the Andrew Wilkie as outlined by you is a solution either. The problem is that far too many people would seek access to these UN-supervised processing centres if they offered a guarantee of resettlement. It would be a massive pull-factor. Unfortunately far too many folk live in oppressive countries and the number who would like to get to the West is huge, so I believe you would have hundreds of millions of people trying to get to such centres.

    The only real long term solution as I see, is to turn off the asylum seeker tap- or at least reduce it to a trickle- by making oppressive and impoverished countries better places to live. That however is a massive task and I think it would require a massive paradigm shift, creative thinking, a long term commitment and a fully developed and funded plan by the wealthy countries. It would be like the Marshall Plan only ten time bigger.

    The cost of what I envision would be a few trillion dollars. Those who think that is too much might want to compare it with this: *****www.nationalpriorities.org/cost-of/

  38. I agree with Ken in that indefinite detention is not the best way to maintain border protection. Asylum seekers claim that the turn back the boats policy is the most effective deterrent and the evidence to date would concur with this.

    Indefinite detention is cruel, unjust and unwarranted and should not be govt policy.

  39. ‘Turn back the boats” is dangerous, ineffective, costly, dishonest and runs counter to international law.

    A 2015 Amnesty International report”By Hook Or By Crook: Australia’s Abuse Of Asylum Seekers At Sea”, provided, according to an AI representative “compelling evidence that boat “turn backs” (or “push backs”) not only violate international law, but put people in danger, are accompanied by human rights abuses such as unlawful detention and denial of medical care, and – in at least one apparent case – involve the payment of money to boat crews, which would qualify as a crime under Australian and international law.”

    The policy is conducted in secrecy, without public scrutiny and accountability. Claims that it is not causing deaths or problems for returned people are not credible without evidence. Evidence is impossible to obtain because of the secrecy. Outside of (relatively) legitimate requirements for war and espionage, government secrecy is adopted only to protect government actions from proper scrutiny. Secrecy is close to a guarantee that inhumane and illegal actions are being perpetrated.

    How can we provisionally assess and reject asylum and refugee claims on the high seas away from proper process and legal representation? Indeed, that gives the clear clue as to why it done; expressly so it can be done away from all scrutiny, proper process and legal representation.

    All refugees and asylum seekers should be permitted to arrive in Australia and THEN be processed promptly according to international law and UN agreements. Those not qualifying should then be promptly repatriated. Such a process is more humane AND more cost effective.

    Click to access Offshore-Processing-Mythbuster_August-20132.pdf

    Proper refugee and asylum seeker processing is easily made compatible with any population policy setting. Voluntary migration places can be reduced by the number of places granted to refugees and asylum seekers.

    Proper processing will weed out most of those attempting to exploit the process without just claim or with nefarious intent. The presumption of innocence, honesty and good faith should apply to refugees and asylum seekers. It should be up to our legal processes to prove when they are not bona fide.

  40. @ Ikonoclast

    Your plan would precipitate a mass exodus of bona fide and economic refugees from poor and oppressive countries as they attempt to make it to Oz to take advantage of your proposed “presumption of innocence”.

    The UN estimates 200,000 to 400,000 Vietnamese boat people died at sea. The plight of the Vietnamese was rape, robbery and cut throats at the hands of pirates, unseaworthy boats death from thirst and drownings.

    Your plan would make the Vietnamese boat people experience look like an episode of the Mickey Mouse Club. Fortunately no Australian government would be so callous and depraved as to adopt it.

  41. The UN estimates 200,000 to 400,000 Vietnamese boat people died at sea. The plight of the Vietnamese was rape, robbery and cut throats at the hands of pirates, unseaworthy boats death from thirst and drownings.

    What would have happened to them if they had not taken to the boats?

  42. Harryclarke cites the ABC analysis as establishing that, if two treating doctors have found clinical need to bring someone to Australia for medical action that is not being given where they are held, and the Minister disagrees with this clinical view, the medical question can then be taken out of the Minister’s hands. The question is referred to a high-powered group of medicos ‘comprising the chief medical officer of Home Affairs, the surgeon-general of the Australian Border Force, the Commonwealth’s chief medical officer plus no fewer than six other health professionals, including nominations from the Australian Medical Association, the Royal Australian and New Zealand College of Psychiatrists and the Royal Australasian College of Physicians’. They make a further clinical assessment.
    I think, now, that s198F does require reference to the high-powered group of medicos if the Minister disagrees with the clinical assessment. (The Senate website daily journal for 6 December gives the text of the various amendments proposed and passed or rejected.) In that case, harryclarke is right to say that the Minister can no longer decide to refuse to bring someone to Australia on medical grounds, if the group of medicos makes a clinical need determination that the person should come. The Minister can then refuse to bring them here only on security grounds.
    It’s in that case that harryclarke believes the high-powered group of medicos will ‘gradually identify medical problems in all asylum seekers that justify the entry of all’.
    I think there’s no reason to believe anything like that. The group of medicos comprises, after all, the Home Affairs medical officer; the Border Force surgeon-general; the Commonwealth chief medical officer; and nominees of major medical colleges. The group has to carry out a clinical assessment identifying what medical action is needed and that it is unavailable where the person is held.
    So what would be required, for harryclarke’s concern to come to pass, is that medical problems have to be identified that have available treatment in Australia, require treatment, and do not have that treatment available where someone is held, only so as to justify the entry of anyone held offshore.
    If the group of medicos would really decide the clinical position, they would be much less likely to do so contrary to good medical knowledge than, say, a medically unqualified Minister concerned about political presentation.
    And, as the ABC analysis on which harryclarke depends says, ‘But can the Government reasonably argue, as Home Affairs Minister Peter Dutton has, that the Bill would “trash” offshore processing? No, not reasonably.’

  43. The thing is, boat turnbacks are plainly unlawful: anybody who’s sufficiently under australian authority to be told where they have to sail their ship is sufficiently under australian authority to file an asylum claim. I mean, no claim here on the practical or moral merits of turnbacks, but legally it’s a shitpile.

  44. @chishod. For clarity your view:

    “There is nothing in the measures passed in the Senate that allows doctors to override the Minister, for the reasons I have twice set out. So Clarke’s discussion lacks the founding assumption with which he began.”

    Is incorrect. Doctors can override the Minister on medical grounds. The Minister can only override a decision made by doctors on national security grounds as I stated.

    This kind of gets lost in the long response you make which deals mainly with whether or not doctors would abuse this. This later point has already been addressed by Hugo and I concur:

    “A doctor doesn’t need to lie; all they need do is accept that a patient is faithfully reporting their symptoms. “

  45. Hugo,

    Analysis provides no support for pull theories of immigration based on boat turn back deterrent policies or lack thereof.

    https://blogs.crikey.com.au/pollytics/2009/10/19/push-vs-pull-asylum-seeker-numbers-and-statistics/

    To maintain a theory against obvious contrary empirical evidence and with no supporting empirical evidence seems Mickey Mouse to me.

    As J-D correctly infers, it takes an horrendously strong push factor to make hundreds of thousands of people take to the seas in very un-seaworthy boats. With a push factor like that, pull factors are irrelevant. People are thinking only of escaping the intolerable, not about where they are escaping to.

  46. Collin Street trots out a plainly false claim when he says “boat turnbacks are plainly unlawful”.

    According to an ABC Fact Check from 2013:

    [T]urning around boats in international waters is illegal, but there is more to the story. If the Government replicates the Howard-era policy, it will not be turning boats back in international waters.

    The Government can legally turn back asylum seeker boats provided it is safe to do so and they are intercepted within 24 nautical miles of the Australian coastline. It is clear that Australia cannot steer the boats into Indonesian waters, but exactly how close they can legally get to Indonesia is up for debate.

    24 nautical miles is 44.4 kilometres.

  47. @iconoclast. Are you contending that “push” factors accounted for the surge in asylum seeker numbers following the weakening of Howard’s strong border protection measures by Kevin Rudd: From almost zero arrivals to 1000 per week. Numbers again reverting to zero when the strong border protection measures were introduced by the second Rudd government and then by Abbott. To assess recent asylum seeker experience in terms of push factors alone seems really inconsistent with basic observation.

  48. The Government can legally turn back asylum seeker boats provided it is safe to do so and they are intercepted within 24 nautical miles of the Australian coastline.

    Sure, because australian territorial waters are under australian juristiction. But if the boat is under australian juristiction then the people on it can file asylum claims.

    And if the boat isn’t under australian juristiction then the people can’t file asylum claims… but it can’t be ordered to turn back, either.

    Which I set out t

  49. As I set out in the post you’re responding to:
    anybody who’s sufficiently under australian authority to be told where they have to sail their ship is sufficiently under australian authority to file an asylum claim.

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