‘Poor people will die just because they are poor’

That’s a feature, not a bug. It’s a boast, not an accusation. It is, the speaker says, a “principle” that must be “accepted,” not an injustice that must be corrected.

It sounds like an accusation — “You people think we should just accept that poor people will die just because they are poor.”

That sounds like a really nasty thing to accuse someone of. Jonathan Chait is reluctant to accuse Republicans of anything that viciously cruel. His argument stops short of that, making the case, instead, that Republicans believe in “Health Care as a Privilege“:

Opponents of the law have endlessly invoked “socialism.” Nothing in the Affordable Care Act or any part of President Obama’s challenges the basic dynamics of market capitalism. All sides accept that some of us should continue to enjoy vastly greater comforts and pleasures than others. If you don’t work as hard as Mitt Romney has, or were born less smart, or to worse parents, or enjoyed worse schools, or invested your skills in an industry that collapsed, or suffered any other misfortune, then you will be punished for this. Your television may be low-definition, or you might not be able to heat or cool your home as comfortably as you would like; you may clothe your children in discarded garments from the Salvation Army.

This is not in dispute. What is being disputed is whether the punishments to the losers in the market system should include, in addition to these other things, a denial of access to non-emergency medical treatment. The Republican position is that it should. They may not want a woman to have to suffer an untreated broken ankle for lack of affordable treatment. Likewise, I don’t want people to be denied nice televisions or other luxuries. I just don’t think high-definition television or nice clothing are goods that society owes to one and all. That is how Republicans think about health care.

This is why it’s vital to bring yourself face-to face with the implications of mass uninsurance — not as emotional manipulation, but to force you to decide what forms of material deprivation ought to be morally acceptable. This question has become, at least at the moment, the primary philosophical divide between the parties. Democrats will confine the unfortunate to many forms of deprivation, but not deprivation of basic medical care. Republicans will. The GOP is the only mainstream political party in the advanced world to hold this stance.

The full title of Chait’s column is “Health Care as a Privilege: What the GOP Won’t Admit,” and he writes that, “The maddening thing is that Republicans refuse to advocate the position openly.”

Libertarian economist Tyler Cowen takes up that challenge — admitting everything Chait alleges and then some. Here is a Republican proudly and openly advocating the position Chait describes. Health care, Cowen says, is indeed a privilege — even life-saving health care:

A rejection of health care egalitarianism, namely a recognition that the wealthy will purchase more and better health care than the poor. Trying to equalize health care consumption hurts the poor, since most feasible policies to do this take away cash from the poor, either directly or through the operation of tax incidence. We need to accept the principle that sometimes poor people will die just because they are poor. Some of you don’t like the sound of that, but we already let the wealthy enjoy all sorts of other goods — most importantly status — which lengthen their lives and which the poor enjoy to a much lesser degree.

And here is another Republican, American Family Association culture warrior Bryan Fischer also freely admitting that he believes health care should be a privilege only afforded to those who can afford it. Fischer fully embraces Cowen’s “principle” that “sometimes poor people will die just because they are poor,” and argues that it ought to happen more often than it already does:

If we want to bring down the cost of health care, it’s easy. What we lack is not the way but the will.

The way is simple.

First, eliminate the federal requirement that hospitals have to treat any patient who shows up. That’s the place to begin. Get government out of telling hospitals who they have to do business with. There is simply no way to control the cost of health care if hospitals are obligated to provide healthcare to all regardless of their ability to pay.

And (via Adventus) yet another Republican happily admitting that, yes, health care is a privilege only for the deserving who can afford it:

Opponents of the federal health care law see the problem of the uninsured very differently. They object not just to the price tag of expanding coverage to millions more people, but to the whole philosophy behind it.

Texans are individualistic and value their freedoms and responsibilities, said Lucy Nashed, spokeswoman for Gov. Rick Perry, who notes  Medicaid spending is a big part of Texas’ budget.

“Individual responsibility is about making healthy choices and taking ownership of your lifestyle — not just about buying health insurance,” Nashed said. “And you can’t legislate a healthy lifestyle.”

As Karoli wrote in response to Cowen’s column:

This is what a sociopath looks like. In the 19th century, the same principle was expressed when Dickens wrote “Let them die, and decrease the surplus population.” Yes, people still believe this, especially those who also claim to be Christians.

Stay in touch with the Slacktivist on Facebook:

The gun undermines the badge
A servant for good
Rewriting evangelicals' past to preserve our mistakes
Culture warriors have weird ideas about how courts work
  • EnopoletusHarding

    If I remember correctly, Cowen is neither a Republican nor a Christian. However, I know of economically-well educated non-Republican Christians far more libertarian (i.e., anti-government) than Cowen. 

  • Tonio

    Trying to equalize health care consumption hurts the poor, since most
    feasible policies to do this take away cash from the poor, either
    directly or through the operation of tax incidence.

    If I were in the mood to be charitable, I would interpret “operation of tax incidence” as the stance that it’s impossible to tax the wealthy more without penalizing the poor. As opposed to, say, misguided concern that billionaires will have to sell five of their 10 vacation homes to pay their tax bills.

  • http://www.facebook.com/profile.php?id=507398586 Tim Fargus

    Are they saying that the wealthy will find a way to pass all of their taxes along to their customers, and all the way on down until the taxes ultimately fall on the people who can afford to pay them least?

  • PJ Evans

    misguided concern that billionaires will have to sell five of their 10 vacation homes to pay their tax bills

    Yeah, Ellison might have to sell Lanai. Poooor Baaaaaybee.

    Someone who can afford more than one vacation home is in a position where they ought to be able to afford to pay income tax up to at least a 75% top marginal rate, instead of whining about being overtaxed at half that.

  • Matt

    The wonderful thing about Fischer’s article is that on the same page, there is an ad for the upcoming film “October Baby,” the tagline of which is, “every life is beautiful.”

    Apparently that tagline only applies BEFORE someone is born, though – after they’re born, we don’t need to care if they die…

  • Nequam

    Apparently that tagline only applies BEFORE someone is born, though – after they’re born, we don’t need to care if they die…

    Well, of course not– after birth they’re just dripping with Original Sin, the filthy little parasitic beasts.

    [That should have hurt to type.]

  • Tonio

    most importantly status

    Wrong, a thousand times wrong. There shouldn’t be any such thing as status based on income. That’s simply “some are more equal than others.” Being wealthy doesn’t mean that one deserves preferential treatment, legal or otherwise. Infuriating to hear people like Cowen defending privilege as a good thing.

  • Ladyevenstar120

    Bryan Fischer just boggles the mind – any one who advocates that no hospital should be forced to give care even in emergencies cannot be rightly called “pro-life”.  So it’s not okay to have a first trimester abortion, but is perfectly okay to allow the possibility of a woman and child dying in labor if a hospital doesn’t want to treat them. 

    I read the rest of the Fischer article because stunned me that anyone could be so heartless, and Fischer goes on to say how he firmly believes that because Americans are generous and hospitals are often religiously based they would never let anyone go untreated.  Really? Clearly Fischer has refused to read the many incidences in which not-for-profit hospitals have sued, used collection agencies, and basically behaved as aggressively towards patients unable to pay as any for-profit corporation.  Fischer also seems to discount the rise of for-profit corporations in the healthcare industry. 

  • shadsieblue

     
    I haven’t read all of the commentary yet, but I read up through this one and it struck me.
     
    Two years ago, I fell down a starwell at the ranch I worked at. I cracked a bone in my arm and because I’d bumped my head on solid concrete, an ambulance was called and I was rushed to one of the local hospitals. I chose the one nearest my residence for conveinience-sake, even though I am not Catholic.  All was pretty well fine, minor treatment for my arm, spent a month off work, but three days after the incident my guy drove me to the hospital with abdominal pains.  I spent a few days in the hospital getting my apparently bruised kidneys back in order.  When I experienced the stabbing pain in my middle, I was thinking it was “nothing” just being bumped and bruised from the fall and did not want to go to the hospital because I was afraid of the bill. My guy convinced me we should go by rattling off the names of famous creative people we admire who died thinking “it was nothing.”    

    Yeah, it turns out that I basically had to be argued with to save my life just I knew I couldn’t afford to be sick.  It turns out that my boss paid for things, even though I was classed as an agricultural worker and she wasn’t bound by law.  (Tip: If you get an agricultural job in Pennsylvania, the only thing a farm is required to do is to post a little sign somewhere stating that if you work with large animals, you take on your own risk.  I’m serious).  That said, two years later, guess what comes up?  A seven-thousand dollar bill for the ambulance ride that I thought was already paid for.  I’ve gone to my boss about it multiple times and she thought she’d paid for it already, too.  And now, I cannot go to her anymore because I lost the job.  I made a simple mistake that just about everyone at the farm has made at one time or another but her husband (who’s hardly ever there) decided he hated me and I had to go.   I am still getting harassment over the phone for this bill and things in the mail. 

    From a Catholic hospital. 

    I cannot pay it at this time.  I might be able to pay it when the Disability I won back in March finally comes in, but for now, I’m steadfastly ignoring the bill and am tempted to drive up to the hospital and just drop my pants and moon everyone or something.  I’m also reluctant to pay at all, even when I’ll be able to because I’ve heard that sometimes, people run scams out of hospitals – double-charging for things that were already paid for and I have my suspicious about this mysterious bill that showed up out of nowhere two years after the fact.  We know it’s for a specific action because it lists a specific date. 

    There is my story. And I’m wondering if some people would have rather I died in horrible agony by staying home over the kidney-thing.  You’d think if people were interested in ridding the world of a surplus population that they’d at least be humane about it and put up stop-and-drop suicide booths like in Futurama.  Nah… people would probably see these politicians for what they are if they proposed doing that.   
     

  • http://twitter.com/FearlessSon FearlessSon

    There is my story. And I’m wondering if some people would have rather I died in horrible agony by staying home over the kidney-thing.

    No, they do not want you to die.  If you died, they would not get paid.  They want your payment, and if that means you have to get high-interest loans you will never pay off or bind yourself into crushing poverty, well that is your problem, in their eyes.  

  • shadsieblue

    In the case of the kidney-thing, they did get paid – by my excessively wealthy and nice former bosss who gets her money from old military weapons patents. (I just took care of horses and didn’t as questions).  However, the ambulance ride bill is a ghost that will not die… which makes me wonder if it’s a scam somehow tied into the hospital wanting more money than they’re owed.  I continue to respect EMTs, though. They have a hard job.

    I’m supposed to be getting Disability here sometime soon, when the state decides to stop dragging its ass. (Unlreated condtion). It makes me wonder, if I’d died two years ago, would people be glad not to have another drone on the dole?  I only put in my bid for Disability (seven years ago) because my condition makes work difficult and, as a result – poor, poor, poor.  I mean, if I were from a rich family and had my debilitating condition, I wouldn’t have bothered because I wouldn’t have had the need.  

     

     

  • Sgt. Pepper’s Bleeding Heart

    The ambulance bill is seven thousand dollars?

    O O

  • http://reshapingreality.wordpress.com/ Aidan Bird

     @880483e0216a63aed0a2de621439a5b0:disqus , to add to your point, there has been numerous incidents were hospitals have refused to treat trans* people and/or LGB people. One incident in particular is a good example of the sort of world Fischer seems to be advocating for: A transwoman in a car accident – she was a passenger – and the paramedics refused to treat her. She died because of it.  (Link: http://en.wikipedia.org/wiki/Tyra_Hunter  ).

    I suppose that is the sort of world Fischer would love to see. 

  • Sorbus

     Fortunately I’ve never been refused care because of my trans* status, but my insurance company has essentially refused to pay for a hospitalization (for severe depression; if my therapist hadn’t argued me into committing myself I would be dead) because the hospital miscoded the reason for my stay as “Gender Identity Disorder” (and refuses to recode it, choosing to send debt collectors after me for a hefty debt I shouldn’t even owe). It makes me wonder what would happen if I had gone to nearly any other psychiatric hospital in the country—this one was specifically pointed out by my therapist as one of the most LGBT+ friendly psych hospitals in the nation. And this is how they treat their LGBT patients.

    tl;dr Healthcare isn’t just an economic issue, it’s an LGBT issue as well (as well as being related to race and feminism and of course disability and nearly everything else under the sun). And I think this often goes unrecognized.

  • Tricksterson

    He’s also apparently ingnored the Catholic Bishops campaign to cut off women from important aspects of health care.

  • Twig

    The thematic cohesion between this post and the ‘Satan’ post directly beneath it is just marvelous.

    “There shouldn’t be any such thing as status based on income.”

    I doubt this will ever change.  I can’t even imagine a useful way to consider changing it that would both ever work to begin with and work over the long-term.   It seems far more feasible to find a way to raise up the lowest standard of living to something comfortable.

  • Tonio

     To clarify, I’m not talking about flattening everyone’s income, although I definitely support your goal of raising the lowest standard of living. My point was that income shouldn’t connote status or privilege. Our institutions shouldn’t treat Bill Gates as having more rights than, say, a nighttime custodian. That’s the premise behind health care being a right.

  • Tonio

    Obama gave me some hope when he endorsed the legality of same-sex marriage, even though it appeared that the statements by Biden and others in his administration forced his hand. (It’s likely that these were deliberately crafted trial balloons.) If the Court rejects the individual mandate, my political fantasy is to see the President almost immediately declare support for “Medicare for All.”

  • Nirrti

     It’s so pitiful we can only hope that Obama just might throw us poor folks and gays a bone. I feel like a mutt sitting by the dinner table hoping just maybe someone will throw a couple of table scraps my way.

    Is that all we Americans are to these rich guys, dogs they give the occasional Beggin’ Strip to if we be good?

  • Tonio

     Yeah, I had wanted him to push for single-payer from the very beginning. The optimist in me hopes that after the provisions of the law take effect, they work well enough that they bolster support for expanding the reform into single-payer.

  • Ima Pseudonym

     No. 

    At best, we’re a source of labor to be utilized and revenue to be harvested at need.  Nothing more. 

    At worst, we’re more like stray dogs that hang around outside because one of their lesser children made the mistake once upon a time of giving us a snack or a pat, for which said child was subsequently punished.  We’re occasionally vaguely useful in a limited capacity, such as guarding the house against people they want to stay away.  Mostly we just slink around and take up space, and they ignore us unless we call attention to ourselves, in which we get a good kick in the ribs to drive us back under the porch.  And if we’re especially mangy and sick, then they call out the animal control officers…or that particularly ugly batch of cousins who enjoy light target practice with high-powered rifles.  They go out for dinner and a movie, and when they come home a few hours later, only a few bloody spots remain, which Daddy then sprays away with a hose before the wife and kids can see.     

  • Michael Cule

    The conservative American position on being ‘pro-Life’ is neatly summed up in the cynical old couplet:

    “Thou shalt not kill: but needst not strive
    Officiously to keep alive.”

  • http://www.facebook.com/chrisalgoo Chris Algoo

    It’s the Batman Begins school of ethics.

  • christopher_young

     the cynical old couplet

    The Latest Decalogue; one of my favourite poems. Clough speaks directly to these people from the first half of the nineteenth century.

  • Mira

    I can understand reasonable disagreement about the question of how best to pay for universal access to non-emergency health care, given that a) the employer system is clearly not working, particularly for the unemployed and state and local governments, b) the pre-existing conditions issue, c) the fact that single payer would, indeed, be a major financial feat, d) a lot of people don’t trust the government to run things, and e) the private insurance industry currently exists. “How we do this” is, honestly, a hard question to figure out in concrete details – I mean, see the ACA for a weird Frankenstein type attempt.

    But questioning the very idea that we should do whatever is in our power to ensure that people can access to treatment, even if they are poor or unemployed, or even middle-class with a mind-bogglingly expensive condition? That doesn’t seem like reasonable disagreement. 

    At this point I have no idea how to talk to someone who disagrees on this. Fortunately I’ve ensconced myself in a liberal bubble most of the time, but geez. 

  • http://twitter.com/FearlessSon FearlessSon

    I can understand reasonable disagreement about the question of how best to pay for universal access to non-emergency health care, given that a) the employer system is clearly not working, particularly for the unemployed and state and local governments, b) the pre-existing conditions issue, c) the fact that single payer would, indeed, be a major financial feat, d) a lot of people don’t trust the government to run things, and e) the private insurance industry currently exists. 

    Do not forget transitory employees, like contractors and migrant workers.  Even if our agencies and places of employment provide insurances, they only do so when we are on contract, and every new contract represents applying to a new policy.  What happens if we get a chronic condition at one point, then the insurance company refuses a new contract on that basis?  

  • Parisienne

    Once again I am deeply grateful to live in a real Socialist country with an actual Socialist President (you can also vote for a genuine bona fide Communist party if you want but that’s probably another subject).

    Our pinko-Commie healthcare system is not paid directly by the State as such. All medical professionals/hospitals etc are self-employed or private businesses. (The State sets standard fees for them but they are free to charge more if they want. If they do, the only people who go there are the ones with very good/expensive insurance. The rest of us all use the ones charging standard fees.) You pay upfront and then get the money refunded. If you are *really* broke, the State refunds all of it, for everyone else, the State refunds about 70% and you take out (pretty affordable) insurance for the rest.

    Technically a hospital could refuse to treat you if you turned up with no means to pay their bill. However, in France there is an important safety net – there is also a law on the French statute book for a criminal offence called “non-assistance of a person in danger of death”. It basically makes you criminally liable if you were in a position to help a person in serious medical danger and you didn’t do it (it could also be invoked for something like leaving the scene of an accident without calling the emergency services). A hospital that turned someone away would run a major risk of getting prosecuted for this and consequently none of them would every risk it. They will probably come after you for the money later, but if they can’t get it, too bad for them.

    My main point is that French hospitals can end up providing treatment to people with no means to pay for it but (a) it stops people dying and (b) the system hasn’t gone bankrupt.

  • http://loveiswhatyoudo.wordpress.com/ J.R. Goudeau

    As someone who spends a great deal of time with the working poor, the health care debate makes me NUTS. I challenge anyone to work in a minimum wage job and take their kids to the doctor, as well as pay rent, bills, etc. for a family. If you make a decent salary, you don’t qualify for medicare or medicaid, but you can’t afford any health care at all. It’s an impossible system. So while the rich have health care (and I’m one of those people), the poor will keep going to the emergency room, where they are guaranteed treatment whether they can afford it or not, and the rest of us will keep footing the bill. It needs to be fixed. Praying for today’s decision.

  • http://twitter.com/shay_guy Shay Guy

    What do you think the public would make of a proposal to extend Medicare to minors?

  • Jenny Islander

    Some states already offer free or very cheap health care to minors; in Alaska, this is called Denali KidCare.  However, I think this should go farther.  At the very least, we should go back to the days when the Powers That Were first drew a line between the “deserving” and the “undeserving” poor.  Basically, if you wanted to work but couldn’t, you were “deserving,” and if you could work but chose not to, you were “undeserving.”  That’s more or less where we are now, although the goalposts have been moved.  People who do not rack up lots of income units are being punished, with the excuse that they should have known that their field was going to stagnate or their employer was going to move their job site to another country, or they should be able to attend a job interview in another town on four hours’ notice with a wheezing car, or “unemployed need not apply,” or that new con where you have to work 30 hours of “training” for no pay before they’ll tell you whether you’re hired or not.  Basically people are being punished for not having rich parents or for not having precognitive psychic powers.
    However, there was a third category: the very old, the very young, and the severely disabled (“cripples,” etc.), who were not expected to work at all.  These days, they get punished too.  Think of the rhetoric so-called pro-lifers use when women are faced with unplanned pregnancy.  How often is it heavily implied that the child should be born and raised in poverty in order to punish the mother?  This has to stop.  I say we open Medicare to all senior citizens and all minor children.  We also have to make it easier for disabled people to get benefits and quit punishing them for needing help by making them struggle along for years before they see any money.  Will an easier system lead to more fraud?  Yes, probably.  But I will pay my tax money to 5 fraudulent disabled peoople if that means that 95 other people who really did hurt their backs get to keep their homes, means of transportation, and savings and see a doctor whenever they choose.  What does it profit me if they are desperately poor on top of being disabled?

  • Ika Musume

    They have Medicaid already, if their parents are lazy and low income earners.

  • Ika Musume

    People that earn minimum wage get Medicaid for their children, so sure they are going to take them to the hospital since we are paying for their treatment of a running nose and other minor things. I have to pay monthly to a hospital because we can’t afford health insurance for our children, if one of them gets sick. I have health insurance, but the donut hole kills me once it becomes visible. The poor have a better life then most people and it’s about time to stop this free-give-away.

  • EllieMurasaki

    To clarify: There are people who have to work low-wage jobs and refuse raises and promotions because if they were to earn any more than they did, they and their severely ill kid would be booted off Medicare, and this story predates Obamacare so there wasn’t a health insurer in the country who’d take the kid on.

  • http://apocalypsereview.wordpress.com/ Invisible Neutrino

    Disqus seems to not like some HTML tags such as img. Chop it all out and paste it as a raw URL instead. Also, your HTML will bugger up easily if you accidentally change a > to a < and don't notice it.

    http://24.media.tumblr.com/tumblr_mbekrpZ3Tt1rpqpg5o1_250.png

    EllieMurasaki's picture.

  • EllieMurasaki

    Thanks!

  • friendly reader

    You know, I can’t count the number of times I’ve tried to explain to people in Japan about how I was denied health insurance because of a pre-existing condition (I lie about what the condition was, but that’s another story), and I’ve yet to have anyone understand it. And not because of the language barrier, just because they genuinely do not understand why you would intentionally not give health insurance to people who actually need it.

    Now, don’t get me wrong: the National Health Insurance only covers 70% of your medical costs, and while private insurance plans can be purchased that cover the rest, if you’re gravely sick it can still suck up a lot of money. But everyone gets basic medical coverage, regardless of employment or health status. And as a result, life expectancy is 80 here in spite of how everyone smokes like chimneys.

  • http://mordicai.livejournal.com Mordicai

     It turns out the Republicans are angry about “death panels” not because they are OPPOSED to “death panels” but because it seems like a Big Government bureaucracy getting in the way of the “free market” deciding who lives & dies.

  • Don Gisselbeck

    If Mitt Romney works as hard as a Florida tomato picker, he should make as much.

  • Lori

    We need to accept the principle that sometimes poor people will die just
    because they are poor. Some of you don’t like the sound of that, but we
    already let the wealthy enjoy all sorts of other goods — most
    importantly status — which lengthen their lives and which the poor enjoy
    to a much lesser degree.  

    Holy crap what an asshole.

  • Tonio

    No, calling Cowen an asshole is an insult to the anus.

  • Tricksterson

    After all assholes perform an important function.  If it wasn’t for them we’d explode.  or leak crap through our pores.  Either way it would be unpleasant and messy.

  • Ika Musume

    Rich people die too, but most of the time it’s because thy don’t want to have themselves check. Poor people seldom die because they take advantage of the free screenings paid for by the tax payers for them.

  • Eamon Knight

    Re Bryan Fischer’s comment:  Putting sentiments like that in near proximity to the title “Family” should, by rights, cause mutual annihilation in a massive explosion, like matter and anti-matter. But we’ve known for a long time that “Family” is code for “We hate gays and women” and has nothing to do with what’s good for actual parents and children.

  • christopher_young

    Muted congratulations on the ruling.

  • Lori

     

    Muted congratulations on the ruling.

    It’s going to take a while for folks to read the whole (very long) thing and put out the Cliff’s Notes version, but looks like it’s better than I had dared to hope for.  The mandate was (very logically) upheld as a tax, and early word is that most of the other provisions were also upheld. The Medicare provision has apparently be “limited”, which could turn out to be a bad thing. We’ll see.

  • http://apocalypsereview.wordpress.com/ Invisible Neutrino

    The Medicaid provision:

    The financial pressure which the federal government puts on the
    states in the expansion of Medicaid “is a gun to the head,” Roberts
    wrote.
    “A State that opts out of the Affordable Care Act’s
    expansion in health care coverage thus stands to lose not merely ‘a
    relatively small percentage’ of its existing Medicaid funding, but all
    of it,” Roberts said,
    Congress cannot “penalize States that choose
    not to participate in that new program by taking away their existing
    Medicaid funding,” Roberts said.

    The Medicaid provision is projected to add nearly 30 million more
    people to the insurance program for low-income Americans — but the
    court’s decision left states free to opt out of the expansion if they
    choose.

    http://nbcpolitics.msnbc.msn.com/_news/2012/06/28/12457822-supreme-court-upholds-health-care-law?lite

    Five bucks says the first state to back out of this will be run by a Republican governor with a Republican-majority state legislature, just because they want to be assholes who dress up their rhetoric in the flag and apple pie.

  • Nirrti

     So it’s the good ole’ fashioned “Let the States Decide” cop-out? And I’m pretty sure how my very red, Southern state will decide regarding this.

  • Lori

     

      So it’s the good ole’ fashioned “Let the States Decide” cop-out? And
    I’m pretty sure how my very red, Southern state will decide regarding
    this. 

    The states can decide about one aspect of the ACA, expanding Medicare, without losing all their Medicare funding if they don’t chose to do so.  Other provisions of the ACA aren’t within state control.

    Also, AFAICT SCOTUS only said that the feds can’t punish states for refusing to expand Medicare by pulling all Medicare funding. Strictly speaking there may be some other way for the feds to punish asshat red states who do their asshat red state thing.

  • http://twitter.com/FearlessSon FearlessSon

    So it’s the good ole’ fashioned “Let the States Decide” cop-out? And I’m pretty sure how my very red, Southern state will decide regarding this.

    Actually, to an extent, individual states can opt out, but only if they can provide another plan that meets or exceeds the benefits provided by the national plan.  The national plan is not the be-all, end-all, it just ensures a strong minimum national standard.  As I understand it, Vermont is considering taking advantage of this provision to go to a state-wide single-payer system.  

    That provision is set to take effect in 2017, five years after giving the national a shot.  

  • http://twitter.com/mcclure111 mcc

    As explained on the previous page (though this probably wasn’t obvious, it’s hard to tell in this system sometimes what’s responding to what) the comment you’re responding to is talking specifically about a new opt-out Judge Roberts just wrote into the bill, where states can opt out of a requirement they increase their medicaid coverage. 
    As I understand this effectively means shifting costs to the federal government because someone not receiving medicaid will probably wind up getting their insurance through the new ACA subsidies, so Roberts basically just decided he was gonna increase the federal deficit with the stoke of a pen because apparently the time-honored practice of withholding federal funds unless a state does XYZ (like Ronald Reagan did to raise the drinking age nationally) should not be allowed for Democrats or whatever.

  • Nirrti

    How the hell can these politicians sleep at night knowing that people are dying due to their refusal to see healthcare as a right? They must really really hate the poor with a passion. That just takes a certain kind of sociopath-like thinking to be so cold toward your own constituents. Now I can kind of get not having empathy for a bunch of brown folks in Iraq, but to willingly do that to your own people???

    And their constituents are so beat down from years of being abused by corporations and these politicians that they’ve developed Stockholm Syndrome as a result, siding with their abusers rather than demanding they stop killing them. And make no mistake, these people are killing them just as someone taking a Glock to someone’s head.

  • Lori

     

    They must really really hate the poor with a passion. 

    They don’t hate the poor so much as they really love money and power, which they can get and keep by treating the poor like crap.

  • Jeff Weskamp

    From this day forward, I am going to refer to the Republican Party as the “Sociopathic Party.”  For a long time they have declared through their actions, and more recently through their words, that they are utterly, totally lacking in empathy for their fellow human beings.

    I’ve said this before, but it bears repeating: The Democratic Party’s slogan should be, “Vote for us!  We’re not perfect, but at least we’re not sociopaths!”

  • Nobody

     From this day forward, I am going to refer to the Republican Party as the “Sociopathic Party.

    me t00

  • Lori

    The Cliff’s Notes, via SCOUTUSblog:

    In Plain English: The Affordable Care Act, including its individual
    mandate that virtually all Americans buy health insurance, is
    constitutional. There were not five votes to uphold it on the ground
    that Congress could use its power to regulate commerce between the
    states to require everyone to buy health insurance. However, five
    Justices agreed that the penalty that someone must pay if he refuses to
    buy insurance is a kind of tax that Congress can impose using its taxing
    power. That is all that matters. Because the mandate survives, the
    Court did not need to decide what other parts of the statute were
    constitutional, except for a provision that required states to comply
    with new eligibility requirements for Medicaid or risk losing their
    funding. On that question, the Court held that the provision is
    constitutional as long as states would only lose new funds if they
    didn’t comply with the new requirements, rather than all of their
    funding. 

     

  • http://apocalypsereview.wordpress.com/ Invisible Neutrino

    I have never been so glad to be a Canadian until this moment. Politicians here trying to openly trash our health insurance system as “welfare for the poor” would rightly be excoriated and probably blizzarded with letters, petitions, demonstrations, and where possible, recall initiatives.

    Why do some American politicians and members of the commentariat seem so determined to race backwards in history rather than forwards?

  • Tonio

     

    Why do some American politicians and members of the commentariat seem
    so determined to race backwards in history rather than forwards?

    They’re engaging in demagoguery, playing to a segment of the electorate that, in short, romanticizes the Happy Days and Mad Men eras. A few years ago, I was in line at the post office and I heard someone else ranting to a friend for several minutes. I would have loved to record the whole thing, because it was like a drinking game for almost every fatheaded attitude of our era.

  • SkyknightXi

    Basically, they see themselves in an embattled state–they think the lower class are Out to Get Them. Somehow, they’ve come to the conclusion that their conveniences exist more because of, than in spite of, their impelled austerities. Therefore, those who cannot take the austerities gladly, even for the alleged delayed payoff, MUST be defective, and from that, inherently the enemy.

  • JonathanPelikan

    It says something very negative about myself that I expected an aunursa-like figure, perhaps the man himself, to come riding into one of these threads with some poll statistics that clearly show 51.4 percent of people (margin of error +- 14 points) support skullfucking the poor to death to save on healthcare and welfare expenses.

    I’ll take every victory wherever I can find them, though. I expected the SCOTUS to go a lot worse than they did, for sure.

  • Tonio

    You too on both counts, huh?

    My answer is even if 80 percent of voters said that people without insurance should be left to die, it would still be wrong.

  • Lori

     

    It says something very negative about myself that I expected an
    aunursa-like figure, perhaps the man himself, to come riding into one of
    these threads with some poll statistics that clearly show 51.4 percent
    of people (margin of error +- 14 points) support skullfucking the poor
    to death to save on healthcare and welfare expenses.  

    Don’t give up yes, it’s still early.

  • aunursa

    Gosh, I wouldn’t want to disappoint Lori ^^ and you.

    The only poll that matters today is the one in which 56% of the justices upheld the law.

  • VMink

    I’m actually surprised the mandate survived the Roberts court.  After Citizen’s United, I expected it to be a 5-4 split against it.

    I’m torn about the mandate.  I wanted single-payer from the start, or at least a public option.  And I’m not happy at all with feeding more people to the murderous health insurance companies* that helped get us into the state healthcare is in this country.  And I know that there’s a lot of violently unhappy people who have wet nightmares about this sort of thing and are already considering the prices of ammunition and fertilizer.  And I know for others this was just further diminishing of the legitimacy of a partisan — or any — Supreme Court (and some of them disliked Citizens United, too.)  So I can sympathize with the irritation with the mandate.  But at the same time… I see why it’s needed.  I see why it’s required, why it has to be the way it was set up.

    It doesn’t affect me much.  I have a job and health insurance.  I don’t have a conscientious objection to healthcare**, or to making healthcare coverage available for more people.  I don’t have an objection to paying the penalty myself if I felt the need to go without health insurance, since that ‘penalty’ goes to help others who don’t have coverage at all.  I get that not everyone feels the same way I do.

    A part of me had hoped that the mandate would have gotten shot down, so we could push for Medicare for all or single-payer… but after the past couple of years, I doubt that’d be even a possibility anyway.  IN the long run, it’s better this way, so long as we’re continuing to work towards universal healthcare.

    * – And, really, I don’t want to hear anyone chiming in that they tots hate the mandate, too, we’re more alike than you know! unless they also agree that health insurance is the only industry in the world that makes a profit by denying services, and should be treated as such.
    ** – I do know someone who is morally opposed to hospitals and formalized health care for herself.  She has no intention of getting health insurance.  Thus she feels that the ACA is bullying her and unjust.  And yes, she has problems with her tax dollars going to wars and torture and etc. etc. etc.  I guess it’s just easier to be able to look at the mandate’s penalty and see it as being forced to buy into something she has no intention of ever making use of.  And I can get that position, too.

  • Tonio

     

    unless they also agree that health insurance is the only industry in
    the world that makes a profit by denying services, and should be treated
    as such.

    I’ve been saying from the beginning that insurance shouldn’t be about making a profit at all. My alternative to single-payer would be low-interest government loans to start non-profit membership corporations as insurers. Dumb question – if we had Medicare for All, what would happen to the for-profit insurers? Did nations like France have insurers before moving to national health care?

  • Becky

     

    Dumb question – if we had Medicare for All, what would happen to the
    for-profit insurers? Did nations like France have insurers before moving
    to national health care?

    Here in Canada we have for-profit health insurance companies that provide things our universal health care system doesn’t cover.  The three biggest being prescription drugs, dental care and vision care.

  • Tonio

     The prescription drug part is confusing, because I had read that under Canada’s system, the government negotiates the prices with the drug companies.

  • http://apocalypsereview.wordpress.com/ Invisible Neutrino

    It’s a confusing patchwork quilt. Some prescription drugs, but not all, have their prices regulated under the agreements, and trying to figure out the rhyme or reason seems to be like navigating shifting sands in the ocean.

    Eg. One time I needed a medication. It was free. A year later I needed said medication again. Price? $10.

    IDEFGI.

    A person I know has had to argue with the Ministry of Health to get a certain drug paid for under provincial Medicare since it’s been deemed necessary by their medical practitioner for quality of life. Since it’s so new, the health authorities haven’t set the fee for it yet, so the price would normally be mucho $$$.

    Finally the government agreed to cough up, so now it’s free to my friend.

  • Kubricks_Rube

    “I’m actually surprised the mandate survived the Roberts court.”

    With hindsight it makes sense. Roberts always sides with business, and the mandate (especially if the rest of the bill would have stood without it) is good for business.

  • Tricksterson

    Wait, it was Roberts who voted with the liberal wing?  That does surprise me.

  • Tricksterson

    I wasn’t surprised because I didn’t have any expectations.  it was a given that Scalia, Thomas and Alito would vote against it and a high probability that Roberts would but Kennedy is very tough to predict.

  • HCSR

    Here is the same argument posted by the Rt. Hon. MP for the Conservatives Alan B’Stard (while stoned)

    http://www.youtube.com/watch?v=LVltOSC0JMQ&feature=related

  • http://twitter.com/FearlessSon FearlessSon

    Sometimes, I wonder if we, as a culture, have passed the “Poe Event Horizon” beyond which parody and seriousness become indistinguishable.  This clipping from The Onion in 2007 would suggest so.  

  • http://tiferet.dreamwidth.org Tiferet

    Ethics, compassion and religious belief aside, these people don’t seem to understand that one of the things that creates epidemics and superbugs is a large population of poor people with terrible health care or nonexistent access to health care who don’t take all their antibiotics (they might need some later and not be able to get them), don’t get their immunisations, go to work sick because they’ll get fired if they don’t, send their kids off to family members or schools or churches to be cared for when sick because they’ll get fired if they stay home to take care of them, and don’t go to doctors until the symptoms are so awful they need the ER and by this time have already infected everyone they know.

    These people seem to not understand that you cannot isolate yourself from things like that with money.  Once the virus or drug-resistant bacterium has evolved in the general population, it is out in the wild and it doesn’t care how much money you have, and all the money in the world can’t help you if you have to depend on a luxury healthcare system that isn’t dependent on research and tax dollars and universities which is not adequately staffed nor prepared to deal with new bugs and hasn’t got the drugs to deal with the new improved versions of the old ones.

    It’s like they want Mira Grant’s Kellis-Amberlee virus to be a thing.

  • Michael Pullmann

    Gee, and I thought this brain defect that requires me to either take expensive medication or go crazy was genetic. Turns out I haven’t been living the right lifestyle. Same thing with the defective valve in my mom’s heart.

  • Michael Pullmann

    Almost forgot Grandma’s Alzheimer’s. We’re so irresponsible, we Pullmanns.

  • Tonio

    I don’t know whether to laugh or cry…

    http://www.washingtonpost.com/blogs/compost/post/obamacare-fears-the-reaper/2012/06/28/gJQAkeJP9V_blog.html

    “Progressivism is in both parties,” she said. “It’s a cancer.” I wanted
    to ask whether this counted as a preexisting condition, but she
    continued: “It’s like the family member of an alcoholic. They’re
    supporting — they’re exploiting human weakness . . . even as they
    destroy our nation”…

    “We are going to be the ones that rebuild our country, who recreate out
    of the ashes the real rule of law where natural consequences happen.” It
    will, she added, be a “spiritual challenge, living in a tyrannical
    government . . . it sounds like government has no limits. But, again, I
    haven’t read the decision
    .”

  • Lori

     

    “We are going to be the ones that rebuild our country, who recreate out of the ashes the real rule of law where natural consequences happen.”  

    The fact that she clearly thinks that she will never be on the bad end of “natural consequence” or that if she is she won’t mind is sort of mind-boggling.

    I’ve said it before and I’ll say it again—the world would be a better place if a lot of wingnuts would just LARP and leave the rest of us out of their fantasies.

  • PJ Evans

     Lori,m I thought they were LARPing, because they seem to think the rest of us are non-playing characters that they can ignore or do whatever they want to.

  • Tonio

    I had the same thought, because the Just World Fallacy treats all of life as LARPing.

  • http://blog.trenchcoatsoft.com Ross

    First, eliminate the federal requirement that hospitals have to treat any patient who shows up. That’s the place to begin. Get government out of telling hospitals who they have to do business with. There is simply no way to control the cost of health care if hospitals are obligated to provide healthcare to all regardless of their ability to pay.

    If I saw this out of context, I ‘d assume it was a Swift-style satire.

  • Justin.Boston

    In general the poor already do get access to medical care through state run programs.. its the people just above poverty who are working hard that benefit most from this I feel because they do not qualify for government issued insurance.  Why anyone would be against expanding coverage to all makes no sense to me.  I would rather just see taxes go up and Medicare be expanded to all.  Problem solved.  Figure out the details of streamlining care later.  

  • Justin.Boston

    Just to add:  I work MORE than full time, earn a decent salary, but my health insurance is lousy.  The monthly cost between myself and my employer is over $500 yet I also have a $1000 yearly deductible, all tests I pay for out of pocket.. its a terrible plan but its all my small non profit can afford.  

  • Ciaphas

    The spiteful attitude towards the poor reminds me of something I read which I am now going to paraphrase badly.

    Q:  Why do the poor  resent the rich?
    A: Because the rich have done terrible things to the poor.

    Q: Why do the rich resent the poor?
    A: For exactly the same reason.

    I suspect that people are so quick to demonize those they oppress because then they aren’t bad people for being oppressors.

  • Erista

    You know, I used to wonder why Republicans went on and on about imaginary death panels.

    Now I know that it’s because Republicans want to institute death panels, but death panels that they and their loved ones are immune from. As long as it’s Other people who are subjected to death panels, Republicans are fine with it; it’s when that they themselves might not be able to escape their own policies that they get nervous.

  • Tonio

    Ever see a child jealous because a sibling has been invited to a party? That’s the underlying mentality at work. They conceive of governments and laws as being like parents, and object to what they perceive as parental favoritism (“No fair!”) only when they don’t benefit from it. At its most basic, a single-payer system would be everyone putting money into a pot where anyone who needs some can use it. But this mentality seems unable to interpret this as anything but a net loss, as if the parent is taking the child’s toy and simply giving it to a sibling. There’s some fear of the Other at work, but much of this is simply sibling jealousy.

  • Ika Musume

    Vote No to Obama and the sales tax increase for ( Pre-K ) in San Antonio that will benefit only children of the poor, and children of the illegals in our city. Those that work and earn a good income your children won’t qualify, so why vote for something that won’t benefit your children.

  • http://apocalypsereview.wordpress.com/ Invisible Neutrino

CLOSE | X

HIDE | X