Tuesday, November 11, 2014

Republicans and Healthcare.

Democrats and healthcare are easy to explain.  Democrats want everyone in the US to have access to health insurance.  The easiest way to achieve that is by the federal government.  Every other industrial country has managed to have its national government guarantee all citizens access to health insurance, so why not the US?

But what about Republicans and healthcare?   Why does Obamacare drive them to such hysteria that they are willing to see people in their states suffer rather than the plan succeed?  Some people would say it is pure partisan spite.  I imagine there is an element of that, but it didn’t start with Obama, after all.  Universal healthcare has been a Democratic goal since the days of Truman, and Republicans have thwarted it every time.   They did make an exception in the case of Medicare-D under GWB, but it took a lot of arm-twisting to get it passed, and Republicans have generally repented of Medicare-D as a failing they have vowed never to repeat (although not, of course, to repeal).  What is the big deal here?

When I feel nasty, I want to say that Republicans value a high rate of uninsured as a positive good.  But that is (probably) unfair.  More accurately, the libertarian wing of the Republican Party considers it deeply immoral for government at any level (with the possible exception of county indigent funds) to spend taxpayer money making healthcare available to anyone.  The “constitutionalist” wing has no objection to state or local governments doing so, but considers it unconstitutional for the federal government to spend taxpayer money on healthcare.  And Jonathan Haidt would assure us that the Tea Party sees any government guarantee of health insurance as violating the laws of karma, since anyone who is uninsured must have done something to deserve it.

Regardless of which view one takes, this is an awkward position to be in, since the federal government has, in fact, been spending taxpayer money quite regularly on healthcare since 1965.  And, worse yet, the American people seem to like it and would get terribly upset if the government actually stopped.  So what do you do?  Well, stop the rot where it is now, and hope that maybe some day in the distant future you can reverse it.  This means an almost hysterical overreaction to any attempt to expand government coverage of health insurance at least partly as an act of displaced aggression against the illegitimate abominations like Medicare and Medicaid that already exist.

It is really like the intensity of a lot of conservative churches in their opposition to same sex marriage.  They denounce same sex marriage as an existential threat to traditional marriage of a man and a woman.  There is just one little problem here.  The traditional Christian view of marriage was not just one man, one woman, but also a lifelong indissoluble bond.  Easy divorce is a greater threat to traditional Christian marriage than same sex marriage ever could be.  But conservative churches failed to hold the line against divorce, and now it is too late.  So the fight against same sex marriage is at least partly a displaced aggression against all the other changes that have happened to marriage, a matter of stopping the rot now in hopes of reversing it some time later.

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