‘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.

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