The recent health-care debate reminded most Americans, if any reminder were really necessary, of what they don’t like about modern Republicanism: Republicans, as a group, just don’t care about their less fortunate fellow citizens.
As the insurance plan the GOP Congress, with the full support of its president, trotted out to replace the Affordable Care Act (ACA) demonstrated, it’s all about money; those who have it are blessed, those who don’t are of no consequence or concern. The fundamental Republican position, as expressed in House Speaker Paul Ryan’s late, unlamented American Health Care Act, is that whoever can’t afford free-market health care doesn’t deserve health care of any kind. The nonpartisan Congressional Budget Office (CBO) estimate of 14 million fewer people with medical coverage next year under the GOP plan (and 24 million by 2026) didn’t cost conservative lawmakers any sleep, except insofar as it could have threatened their reelections.
The health plan endorsed by President Trump and the Republican congressional leadership was an accurate reflection of their basic world view, which arises from a negative estimate of human nature. In brief, the “haves” deserve what they get because of their moral superiority; they’re the makers (so anointed by 2012 GOP presidential nominee Mitt Romney), whose material good fortune derives not from luck or birth, but from virtue, talent, and hard work. The “have nots” are morally suspect, having never “met a payroll” (the ultimate conservative putdown); they deserve little because they’re society’s takers, freeloaders whose relative impoverishment is an accurate reflection of their lack of purpose and ambition.
Given this perspective, why would God-fearing Republicans want to indulge human weakness by providing “free” health care to the poor, the aged infirm, or the unemployed through Medicaid? Instead, benefits should be punitively cut, as their withdrawn plan did, and operated as a tight-fisted form of public charity, not entitlement. Tough love, disseminated sparingly and reluctantly, was the GOP answer for those they deemed ne’er-do-wells. For the under-65 able-bodied with slightly more resources, Republicans offered the opportunity to strive for one’s health coverage — it’s not a right, after all — by giving up luxuries (and maybe some necessities) in exchange for scrimping and saving. They would have thrown in some flat tax credits to offset premiums, but allowed premiums to rise with age, permitting oldsters, who use too much medical care anyway, to be legally charged up to five times more than the young and healthy by private insurers.
The prevailing attitude of Republicans was expressed succinctly by one of their number, Utah Congressman Jason Chaffetz, who urged Americans to stop complaining, buy fewer consumer products, and start saving whatever spare cash they had for the health-care market — a bit like ancient cave dwellers gathering roots and berries to survive the long winter.
Along the way, Republicans planned to make getting and keeping health insurance as hard as possible for the average person. ACA exchange enrollees who let their coverage lapse for a short period would have been charged 30% more in premiums to re-up and have faced additional late-enrollment penalties if they had preconditions. And starting in 2020, Medicaid recipients who left the program and returned (because of, say, losing a job) would have found their coverage reduced and capped; those who enrolled under Medicaid expansion and left wouldn’t have been allowed to return at all.
Two groups, however, stood to laugh all the way to the bank: Taxes on large businesses and individuals with annual incomes exceeding $200,000, imposed to help pay for the ACA’s subsidies, were slated for repeal; these humanitarian reductions were expected (according to the Joint Congressional Committee on Taxation) to deliver $600 billion in desperately needed tax relief over the next decade to America’s richest corporations and families, including $145 billion for health insurers, $25 billion for drug companies, $20 billion for medical-device manufacturers, and $158 billion for wealthy investors. Oh, so good, as Donald Trump might say.
A lot of this class-based behavior was curiously intertwined with “freedom,” an important word in the Republican lexicon. Freedom is defined by conservatives as the right of the economically privileged to do as they please in acquiring their riches, with no regulatory limitations, and to keep every bit of what they stockpile without being compelled to contribute to the maintenance of society broadly or the nation in particular. The British refer to this attitude as “I’m all right, Jack;” the uncharitable might call it old-fashioned selfishness. But to the conservative Republican mind, there’s no connection between freedom and social responsibility.
Case in point: the administration’s proposed federal budget for fiscal 2017-18, which slashes everything in sight except for the military-related departments of Defense (+$522 billion), Homeland Security (+$42 billion), and Veterans Affairs (+$75 billion); Defense alone gets a 10% increase. The cuts, conversely, focus like a laser on domestically oriented departments critical to ordinary people, including, ironically enough, many of Donald Trump’s hapless working-class supporters, suddenly (now that the election is over) as dispensable as the agencies and programs serving them.
High on the GOP’s departmental hit list are the following: Health and Human Services (-16%), Labor (-21%), Housing and Urban Development (-12%), Education (-14%), and Transportation (-13%). Meanwhile, the State Department (-29%) is given what can only be described as an institutional death sentence, as is the Environmental Protection Agency (-31%). Evidently, we need neither a foreign policy nor a livable environment.
The mad hatter behind these draconian reductions is one Mick Mulvaney, Trump’s appointed budget director, a reactionary former Republican congressman from South Carolina who once said, “We have to end Medicare as we know it.” He hasn’t gotten around to that yet, but he has slated for total elimination the Meals on Wheels program, the Corporation for Public Broadcasting, the National Endowments for the Arts and Humanities, the Legal Services Corporation, the Low Income Energy Assistance Program, and the Interagency Council on Homelessness — to name just a few.
This budget is not a political program; it’s an exercise in vindictiveness. It’s also not an aberration, but a representative statement of values Republicans have long held, but were reluctant to express openly. Now, they have a reinforcing echo chamber in Fox News and a president who’s “normalized” political mean-spiritedness. What was always there has risen to the surface.
Wayne O’Leary is a writer in Orono, Maine, specializing in political economy. He holds a doctorate in American history and is the author of two prizewinning books.
From The Progressive Populist, May 1, 2017
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