The consequences of gutting Obamacare

In 1940, when my mother was 13 years old, her mother had a hysterectomy at a hospital in Century, Fla. As was common in small Southern cities in those days, the hospital was owned by a group of doctors, and patients only received the care they could pay for. My grandmother was among the lucky ones. Though she and her husband were subsistence farmers, they had a little cash to pay for her surgery.
A man in a nearby room wasn’t so lucky. His leg had been crushed when he fell under the wheels of a moving locomotive as he attempted to hop aboard (another common practice in those days).
He needed an amputation, but his family didn’t have the money to pay for it, Mom said. The doctors refused to perform the operation without cash up front. So, for days, the patient screamed in pain before he succumbed — apparently to gangrene, my mother remembers.
Health care in America has come a long way since then, taking a journey toward fuller access, more emergency care and more provision for children, the elderly and the poor — in short, toward more compassion and generosity. But that journey has been a bridge too far for ultra-conservative Republicans, who want a meaner and less compassionate health care system.
You’ve no doubt heard that the GOP’s bill to “repeal and replace” the Affordable Care Act is struggling to find enough votes to become law. What you may not know is that the bill’s biggest hurdle is not opposition from Republican moderates, who fear that it’s too stingy, but, rather, opposition from GOP right-wingers, who say it’s too generous.
Their complaints come despite the fact that the original bill would hack Medicaid to pieces and push 24 million people off the health care rolls in the next decade — 14 million of those in the next year, according to the Congressional Budget Office. It would hit the poor and the elderly especially hard while granting tax breaks to the wealthy. But that’s not callous enough. The ultra-conservatives want it stingier still.
They are Darwinian conservatives who are indifferent to the suffering of the poor, the pain of the addicted, the helplessness of children. They pretend to believe that all Americans could buy their own insurance if they worked a little harder and stopped buying iPhones.
They know better than that, of course; they just don’t care. (Members of Congress, by the way, have one of the best health insurance plans available, courtesy of the taxpayers.) Many of them, like House Speaker Paul Ryan, wear their Christian beliefs like an armband, but it’s not a Christianity that I recognize.
Still, many conservatives do genuinely believe that it’s not the responsibility of government to provide a generous social safety net. Many also believe that such benefits merely make able-bodied people dependent on handouts and resistant to hard work. I have some sympathy with the argument about dependency.
But if you genuinely believe that people should work to support themselves, you’d want them to be healthy, wouldn’t you? How can you make a decent living if you cannot get treatment for diabetes and high blood pressure? How can you get off the dole if you cannot get rehab for your addiction to opioids?
And what about your child, who keeps missing school because her asthma goes untreated? The working-class parent who misses work frequently with a sick child is likely to lose his or her job.
Of course, the GOP has spent the last eight years vowing to repeal Obamacare, often promising to replace it with something better. Indeed, that’s exactly what President Donald Trump said he would do.
As he told 60 Minutes last fall, “I am going to take care of everybody. I don’t care if it costs me votes or not. Everybody’s going to be taken care of much better than they’re taken care of now.”
That turned out to be just another of the president’s outrageous lies.