The Republican Health Care Plan In Three Words

Monday night’s Republican debate on CNN featured another one of those moments—last week it was the audience cheering the execution of 234 people in Texas—that tends to surprise people who haven’t been paying attention to the devolution of the Republican Party. 

Wolf Blitzer asked Ron Paul about the welfare of a guy who gets sick, goes into a coma, but lacks health insurance: “Are you saying society should just let him die?” Blitzer asked.

Paul’s answer, which essentially was that such an unfortunate fellow should rely on volunteers and churches for his care, was drowned out by shouts of “Let him die!” from the Republican debate-watching crowd.

Let—Him—Die.

I’m reminded of former congressman Alan Grayson’s presentation on the House floor in 2009:

If you get sick in America, the Republican health care plan is this: Die quickly.

Here’s a short discussion between Republican Joe Scarborough and Pulitzer-winning columnist and Democrat-leaning Eugene Washington from Morning Joe this morning:

JOE SCARBOROUGH: …the crowd last night at one point cheering the possibility of the death of a young man in a coma—I guess in 2008 we had “drill, baby, drill”; last night it seemed to be “die, baby, die.”

I think CNN may have magnified a political segment of this society beyond the representation of the general population.

EUGENE WASHINGTON:  That’s probably true.  There was an air of unreality to the debate last night. It was as if we were in some sort of parallel universe…

The truth is that what was on display last night at that Republican debate reflects the reality of Republican politics these days.  Those shouts of “Let him die!” were not made by some extremists who snuck into the debate against the wishes of the candidates or the planners or CNN.  Those folks are mainstream Republicans these days.  And their disturbing shouts—which no candidate on the platform bothered to contradict—represent how far right the GOP has moved philosophically, and they came as no shock to those of us who have been following that movement.

Whether it is shouting out heartless things about uninsured, comatose people, cheering executions, raucously applauding the labeling of Ben Bernanke as treasonous, loudly supporting Michelle Bachmann for her stand against raising the debt ceiling—all things that have happened in just the last two GOP presidential primary debates—we cannot take any comfort from pretending that the people who did these things are somehow on the fringe of the Republican Party.

They are, sadly and regrettably, its heart and soul.

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28 Comments

  1. Seriously, that was the most disturbing part of last night’s debate.

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    • Agreed. Even though there were other disturbing parts, that was by far the most disturbing, particularly because none of the candidates rebuked the notion expressed by the shouters.

      Duane

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  2. ansonburlingame

     /  September 13, 2011

    Duane,

    Some Republicans would disgree with the response from the crowd but how many, who knows.

    But ask the same question in a Democratic forum and the cry would be “Keep him alive no matter what it costs”.

    I only know how I feel personally about the issue. I don’t like EITHER response. If I get sick in my older age and “extraordinary means” are required to sustain life, I have a will saying “don’t do that”. Hopefully my wife and two sons will respect that wish on my part. Just keep me pain free and “pull the plug”.

    The man with no insurance made his own choices along the way,whether he has a will or not.

    So the question really becomes one of how far must government go to support that single man or the millions just like him. When is “enough enough” in such circumstances?

    The real debate is between the two extremes in my view. And there comes a point where enought MUST BE enough from government. We can all argue over where exactly that point is, depending upon what is, is!! But leave government out of the argument and we all have our very own views on such matters, for sure, personally.

    And in having such different ideas, we all can work to achieve our own personal goals, can we not?

    Anson

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    • Anson,

      Of course, some of us have our own personal wishes about how we want to die, given certain circumstances. But I’m guessing that when you were younger, if you made a bad decision, you wouldn’t have wanted to pay for it with your life, especially if the decision could be rectified.

      The issue Wolf Blitzer raised had nothing to do with the scenario you outlined. You misunderstood the point of the question. It had nothing to do with costly, heroic efforts to keep someone alive per se. It had to do with the foolishness of youth and whether folks who are young and myopic should suffer the deathly consequences of short-term thinking. You seem to think it might be okay to let him die, or at least you didn’t express any disgust with that notion. “The man with no insurance made his own choices along the way,” you say.

      So, the real debate is not, as you would have it, between the two extremes you present: spend unlimited amounts of money on him or let him die. That totally misses the point. The larger question raised by Blitzer’s question is whether we, as a society, will have the will to force the 30-somethings in the scenario to purchase health insurance as part of a duty to themselves and the society that will eventually take care of them if they don’t.

      That’s what you missed, Anson. The debate about whether to take care of the person in Blitzer’s scenario is over, my friend. We will take care of him. The question is whether we will require him to join us in the effort, even when he thinks he doesn’t need to.

      Here is the transcript of the portion we are discussing, so others can understand the context:

      BLITZER: Thank you, Governor. Before I get to Michele Bachmann, I want to just — you’re a physician, Ron Paul, so you’re a doctor. You know something about this subject. Let me ask you this hypothetical question.

      A healthy 30-year-old young man has a good job, makes a good living, but decides, you know what? I’m not going to spend $200 or $300 a month for health insurance because I’m healthy, I don’t need it. But something terrible happens, all of a sudden he needs it.

      Who’s going to pay if he goes into a coma, for example? Who pays for that?

      PAUL: Well, in a society that you accept welfarism and socialism, he expects the government to take care of him.

      BLITZER: Well, what do you want?

      PAUL: But what he should do is whatever he wants to do, and assume responsibility for himself. My advice to him would have a major medical policy, but not be forced —

      BLITZER: But he doesn’t have that. He doesn’t have it, and he needs intensive care for six months. Who pays?

      PAUL: That’s what freedom is all about, taking your own risks. This whole idea that you have to prepare and take care of everybody —

      (APPLAUSE)

      BLITZER: But Congressman, are you saying that society should just let him die?

      PAUL: No. I practiced medicine before we had Medicaid, in the early 1960s, when I got out of medical school. I practiced at Santa Rosa Hospital in San Antonio, and the churches took care of them. We never turned anybody away from the hospitals.

      (APPLAUSE)

      PAUL: And we’ve given up on this whole concept that we might take care of ourselves and assume responsibility for ourselves. Our neighbors, our friends, our churches would do it. This whole idea, that’s the reason the cost is so high.

      The cost is so high because they dump it on the government, it becomes a bureaucracy. It becomes special interests. It kowtows to the insurance companies and the drug companies, and then on top of that, you have the inflation. The inflation devalues the dollar, we have lack of competition.

      There’s no competition in medicine. Everybody is protected by licensing. And we should actually legalize alternative health care, allow people to practice what they want.

      (APPLAUSE)

      Duane

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    • Anson: “The man with no insurance made his own choices along the way,whether he has a will or not.”

      I know people that work very hard and make good choices, yet, born into poverty, they stay impoverished. And….without healthcare, not through bad choices. Through luck of the draw and belonging to the only modern industrialized nation that does not have a plan to cover all (legal) citizens.

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  3. I don’t really want to be one of those “Let him die” guys but I consider it a problem when hospitals are expected to hand out care for free to some bum that anyone else would be expected to pay for. I guess the only fair and humane solution is free health care for all.

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    • Single-payer. And it’s not free. Taxes pay for it.

      Everyone is required to carry liability insurance, why not use the same line of reasoning to do the right thing, use tax money for health care instead of stupid, wrong-headed wars and prohibitions?

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    • You know, to some extent there is a disconnect between our policy of mandatory treatment of emergencies (for those hospitals that accept federal money) and the current policy of allowing people to either elect to go without insurance or tolerating a situation in which they can’t afford to purchase it. One solution was the insurance mandate in the ACA. That hasn’t gone over too well with much of the country. Another solution is repealing EMTALA, which likely wouldn’t go over too well with much of the country. Another solution is Medicare for all, with the taxes to support that system coming from premiums currently paid for private insurance and co-pays and deductibles that go with that insurance. That’s the humane solution, as far as I’m concerned.

      Duane

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  4. Pat McQueen

     /  September 13, 2011

    This is to Anson. “The man with no insurance made his own choices along the way,whether he has a will or not.” Some people do not make their own choices, circumstances and society and insurance companies make those choices for them. Until “Obamny Care”… I had a neice and a nephew who could not get insurance because of pre-existing conditions from their birth, so I guess you could say God made that choice. Even though both children from different parents were working tax paying individuals and the children were in college and contributing, because of their pre-existing conditions they were uninsurable.

    Not everyone can make their own choices….

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  5. Here’s an example of what can happen when a person reaches a point of no return. This case exemplified the misuse of political power and the courts. The president of the United States at the time, George Bush, even became involved. A young woman by the name of Terry Shiavo suffered irreversible brain damage that resulted from oxygen deprivation. She remained in a persistent vegetative state until her husband decided that it was time to remove her feeding tube and let her die since assisted suicide even for a brain-dead person is illegal in Florida.

    Terry’s parents couldn’t bear to see their daughter die even though by legally definition she was already dead. A court battle ensued between the husband and parents. Each time the case was resolved in favor of the husbands Terry’s parents appealed with increasing support from Christian conservatives. It eventually went to the Supreme Court of Florida and then from there onto the Supreme Court of the United Sates. Even President Bush got involved and this, all over a woman who had been wasting away in a vegetative state for almost 15 years.

    It seems that Republicans are willing to choose who can live and die when it suits them regardless of the costs. It seems to me that their efforts would be better spent trying to support those who are aware that they’re alive and desire to live. Terry Shiavo’s condition had progressed beyond all medical hope. She was in effect with help of medical science, a living and breathing corpse. There’s a time to fight for life and a time to accept when it passes, and that decision should be left to those qualified to make it, Doctors and the patient.

    http://en.wikipedia.org/wiki/Terri_Schiavo_case

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    • HLG,

      I wrote about Terry Schiavo more than a year ago in the context of my former congressman Roy Blunt’s campaign for Senate. Blunt played a role in that horrible episode in American political history, but that and other things that Roy Blunt did mattered not at all to frustrated Tea Party-drunk voters here in Missouri. (And the turnout in Democratic strongholds was around 37 percent.)

      Duane

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      • That was an embarrassing and shameful episode. Since the politicians had no shame or embarrassment, I have it for them.
        IF my father deteriorates to that point, I hope the hell the conservatives mind their own business if mother and I must let him go.
        We don’t need “Life-panels’ either!

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  6. This whole surreal series of “debates” and especially the things the crowd cheers for, remind me so much of 17th century England and public hangings in front of the drunken crowds.

    “Hang the buggers….chicken thieves, all of them!”

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    • Tracy,

      When you put it that way, I suppose nothing much has changed, has it? Your comment reminds me of the lynchings that took place here in America not that long ago, in front of crowds, including families. Most of the victims were black folks, but here is a couple of men who were lynched in my home town, Fort Scott, Kansas in 1900:

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      • I never forget what happened to the Osage here in SEK either. After the full-bloods were removed to the reservation, many half-breeds still legally owned land here. They were, for the most part, murdered, farms burned and ran out of the state. The MKT and other RR’s were the real powers then and the law looked the other way.
        Another off topic ramble. Oh well.

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  7. So interesting to note from Ron Paul to the commentors here people say this 30 year old made a bad decision. He didn’t buy healthcare insurance! I live in south Mississippi where many 30 year olds are earning 7 to 12 dollars an hour. They graduated from a very poor school system and grew up poor. They work hard everyday and support a family, with their wife’s help. They don’t get section 8 housing or food stamps and they have never been on a vacation or had anything of any substance ever given to them. Everyday they show up and roof houses or build seawalls or make plastic counter tops. No Insurance and 38 hours a week to make sure they don’t qualify for it. Let me guess, the upper middle class and the richer folks say let him die. He isn’t a valuable commodity anyway. E.R.s dont turn these sick away. They give them very modest treatment and discharge them asap. Shame!

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    • Lynda,

      Here’s the way Wolf Blitzer set up his question:

      A healthy 30-year-old young man has a good job, makes a good living, but decides, you know what? I’m not going to spend $200 or $300 a month for health insurance because I’m healthy, I don’t need it. But something terrible happens, all of a sudden he needs it.

      So, that’s a little different from your scenario. But I couldn’t agree with your point more. The plight of the poor in this very rich country is depressing, especially the increasing difficulty in getting out of poverty.

      The problem is that these poor folks don’t vote in large enough numbers. If they did, things would change. Unfortunately, Republicans around the country are doing everything they can to make it harder, not easier, for people in the trap you so earnestly describe to vote.

      Duane

      Like

  8. ansonburlingame

     /  September 14, 2011

    To all,

    And once again we are back to basics related to health care.

    Duane said, “…question is whether we, as a society, will have the will to force the 30-somethings in the scenario to purchase health insurance as part of a duty to themselves and the society that will eventually take care of them if they don’t.”

    I believe “forcing people to purchase HC insurance” is a great idea, a wondderful idea. Someone “up above” suggested the healthy 30 yr old that CHOSE not to pay “$200 or $300 per month” for HC and then wound up in trouble, right. And the implication was that WE had to take care of him. Now tell me that is not a lousy choice on his part yet WE still must paid the price of that bad choice.

    And on top of all that discussion, liberals remain adamant that government itself must do something about that situation. Well government has now tried and some believe they were unconstitutional in exerting such force on all Americans. We await that outcome.

    Might I suggest that we USED to have a perfectly good mechanism in place. If you had no insurance you SUFFERED for that lousy choice. OK, in this case the man dies. Hell, we won’t even allow someone to “suffer” much less die today. At what cost, i inhumanely ask.

    And I AM NOT TALKING ABOUT the CANNOTs in this instance. I am talking about the WILL NOTs, the man above as later described being a classic example of someone that refused to purchase insurance when it was there for his purchase and a job to pay for it.

    Liberals in large part campaign hard to create a “pain free” society, physical, financial and emotional freedom from “pain” for everyone. And we are going broke in such an attempt.

    Life is in large part some “pain and suffering” on all counts and for sure we all die at some point. So we argue over limiting pain or suffering and prolong life for some to the point of becoming ridiculous. The Shriva case being a great example.

    So I disagree Duane. We are arguing about how far we must go in society under the control of government to limit pain and suffering of all sorts. It is not right to argue either extreme. But somewhere in the “middle” is where we should be, not “tending toward” either extreme. And the bank accounts of government MUST play a role in such arguments.

    So sure, Sekan, go with single pay HC but pay for it as well. No one has shown me yet a way to do so. HLG quotes a lot of European statistics for sure but he has not come close yet, to convince me of the payment argument. Morally it sure sounds good, but…….?

    Anson

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    • Voted for Obama because he originally championed single payer.
      Seems the corporations and other big money interests put a stop to that with all their scare tactics through the PAC’s.

      We can ALL AGREE that the rate that care costs have rocketed is completely out of line with the rest of the world, especially since the actual care doesn’t warrant increases in the thousands of percents.
      The “system”, like the tax code, is a mess.
      The lobbies seem to like it that way, as the payer keeps getting screwed.
      While we’re mentioning it, why is it unreasonable to require people to have health insurance? We force them to have other insurance. It’s forcing them to take responsibility. Isn’t that what conservatives want?, but at the same time they cry about a nanny state and too many laws/regulations! Makes about as much sense as some of Perry’s remarks.
      Some candidates start to make sense, until they get “booed” for not being conservative enough.

      Anson, I started out answering about single payer, the rest of this is just a ramble and certainly not aimed at you….you do make sense, and I also know irresponsible people “WILL NOTS”.
      Single payer addresses the can nots and the will nots. Too bad our citizens “WILL NOTS” refuse to listen/hear how much sense single payer does make!

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      • Tracy,

        I am not familiar with Obama ever advocating or championing single-payer, although I know he has said that would be his preferred system if he were starting over. I could be wrong, but at least as long as I remember following his campaign, I don’t recall his actual adoption of a single-payer concept. Seems to me that he sort of always had the Romneycare idea in his head, although originally he was against the mandate and Hillary was in favor of it.

        And I agree that the “will nots” are frustrating folks. As you suggest, the best way to fix that problem is to move to Medicare for all.

        Duane

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        • I know at one point, not exactly when.
          I admit my memory is not as good as it should be. Guess I need those “memory pills” that Pat Roberts pulled out on Face the Nation (or one of those shows….memory you know.)

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    • Imagine this, Anson, under your scenario:

      HOSPITAL: Sir, do you have insurance?
      SICK MAN: No.
      HOSPITAL: Well, okay, then. Now, I have to ask you, Why don’t you have insurance?
      SICK MAN: Uh, well, I didn’t think I would need it?
      HOSPITAL: So, you could afford it, but you didn’t want to buy it because you thought you might get lucky?
      SICK MAN: I guess so.
      HOSPITAL: I must ask you and your sick ass to get out of the hospital, sir. Have a nice day, though.

      Now, is that practical? Nope. Of course not. So, we treat folks without insurance for whatever reason they are without it and we should force folks to purchase insurance if they can afford it.

      Better yet, we should simply put everyone under Medicare and be done with it. The money to pay for it would come from premiums (which are paid now by both employers and employees in most cases) and from co-pays and deductibles and so on. It’s really not that hard and it would be better than what we have now. Everyone is insured and everyone gets treatment and every hospital and doctor gets paid for their services.

      Sure, people would balk at what would amount to a “tax,” but whether one is paying premiums, along with one’s employer, and whether one is paying deductibles and co-pays, what does it matter? Except that such a system would be much better than the one we have now, with nearly 50 million folks without insurance.

      Duane

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  9. Duane/Sekan

    Obama has spoken many times voicing support for a single payer system, but his legislative goal was inline of a two tier system. For example Canada has a two tier healthcare system. The difference between that and single payer is rather small. In in a two tier system everyone is covered under a universal single payer plan while leaving the door open to those who can afford it to purchase private insurance. Health insurers however became concerned that in time everyone would opt for first tier coverage, which would leave on a few opting second tier coverage.

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  10. The Tea Party and many Republicans appear to me to have moved toward if not into the Libertarian philosophy. In the context of this post I would like to share what I just wrote (in a different post) to ImaLibertarian (one of the commenters here):

    A couple of years ago I found myself getting interested in the Libertarian point of view, just as you are, but I have come to change my mind. You know, it is appealing from the viewpoint of someone who has already found some measure of security in the existing structure of life, and that appears to include you because you say you don’t really need Medicare and Social Security. But, there’s a different perspective I wish you would consider.

    Human beings, as we all know, come in a full spectrum of qualities, smart to dumb, attractive to ugly, strong to weak, altruistic to selfish, honest to crooked. But at the end of the day, as we age and as we succumb to the vagaries of fate, we eventually find ourselves in the care of others. We are social creatures through evolution and we need other people.

    So isn’t it not only arrogant, but actually impractical to declare one’s-self independent of others, even excluding one’s family? Nobody knows what really awaits us as we trudge through life, whether disease (like cancer, stroke or heart attack), natural disaster (like tornados, hurricanes or lightning), or accident (like automobile crashes or falling off a ladder), or loneliness when our loved ones die (my personal greatest fear). And when something does happen, we depend not just on other individuals but the systemic structure of society such as hospitals, hospice, churches, social services. Hell, even seeing the postman once a day can be a big plus. Is is not in your own best interest to see that the quality of that social structure for everybody is as good as it can be?

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