Revelations from the ridiculous

Or how in America no one dies from having no access to healthcare.

Protesters rally during U.S. House voting on the American Health Care Act, which repeals major parts of the 2000 Affordable Care Act know as Obamacare on Capitol Hill in Washington
Protesters rally during US House voting on the American Health Care Act, which repeals major parts of the 2000 Affordable Care Act known as Obamacare on May 4 in Washington DC [Reuters/Yuri Gripas]

So long as Republicans stick to their talking points and carefully selected allocutions, there’s enough double talk, flimflam, and amphibology that a listener might think there’s sense there. Or at least that the speakers think so. But then there are the unfiltered utterances. It is from these that real revelations come.  

Republican congressman Raul R Labrador, for example, declared: “Nobody dies because they don’t have healthcare.”

Of course not. And no one gets cold because they don’t have a coat, and cars don’t crash when their brakes don’t work.

He later tried to walk his talk back toward reason-world. “I was trying to explain that all hospitals are required by law to treat patients to emergency care regardless of their ability to pay.” Which was very important because the Republican plan that he voted for “does not change that”.

That sounds better, but it’s actually worse.

The original statement is self-evidently idiotic. But the explanation contains grains of semi-truth, so it’s misleading and it requires research to realise how fatuous and dangerous it is. An accurate statement would be that most, not all, hospitals are required to treat patients, but only if their condition qualifies as an emergency. And only to the point where they are stabilised.

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Waiting until they’re at the precipice and releasing them as soon as you’ve hauled them back from the edge is not a prescription for creating optimum health.

But does it make the original assertion – that no one dies from lack of healthcare – true? Or near to the truth?

No. In 2009, the American Journal of Public Health published a study that concluded that “nearly 45,000 annual deaths are associated with lack of health insurance …” and that “uninsured, working-age Americans have a 40 percent higher risk of death than their privately insured counterparts.”

On a per capita basis, Americans spend 50 percent more on healthcare than the Swiss and Norwegians, double what the Swedes and French spend, and two and a half times what they spend in Japan and New Zealand.  

For all that money, Americans get less. Except for drugs. They get way more of them than anyone else. But they have fewer doctors. They’re down at number 31 in life expectancy. Infant mortality is almost twice as high as the average of OECD countries. They are the most obese.

The use of emergency rooms for what should be doctors’ office visits is one of the reasons for such high costs and poor results. That’s why Labrador’s explanation is worse than his original statement. It sounds like it has some sanity in it, but it’s an endorsement and an embrace of the most expensive and less effective way to provide medical care.

One commonality of all the places that pay less to get better results is that they have universal healthcare. So why do Americans resist it with the ferocity of an animal in a trap gnawing off its own leg?

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Congressman Mo Brooks of Alabama explains that the people without “pre-existing conditions” are “those people who lead good lives. They’re healthy. They’ve done the things that keep their bodies healthy.” People who have pre-existing conditions, in the mind of Mo Brooks, must be people who’ve lead bad lives and deserve to be ill. Putting them both in the same insurance system is what is causing the dreadful result for the people “who have done things the right way that are seeing their costs skyrocketing.”

Mo might suggest raising taxes on processed foods, sweetened drinks, tobacco, and alcohol to discourage them and to pay for the damage they cause. Or cutting premiums for people who demonstrate healthy choices. He could fight for access to healthy food, building more parks and playgrounds, and spending more on physical education in schools. But Mo doesn’t go there.

Is Mo a lone loon, or is this really representative of the Republican vision?

Here’s Republican Congressman Roger Marshall. “Just like Jesus said, ‘The poor will always be with us.’ There’s a group of people that just don’t want healthcare and aren’t going to take care of themselves … morally, spiritually, socially … just don’t want healthcare.” Keep in mind that Marshall is a doctor.  

Provided that you’re greedy, with a strong sense of what’s mine is mine and I deserve it, and you’re willing to let people die in the streets because you understand that costs of caring for the indigent in emergency rooms is simply shifted over to the insurance system, refusing to provide medical care for the less well-to-do has a certain logic to it.

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But Republicans don’t stop there. They’ve come out against motherhood! Really. They have. Expressing how appalled they are at rules that would require maternity care to be included in health insurance.

The always sententious Charles Krauthammer wrote: “Best to mandate nothing. Let the customer decide. A 60-year-old couple doesn’t need maternity coverage. Why should they be forced to pay for it? And I don’t know about you, but I don’t need lactation services.” This business of paying for births really sticks in the male Republican craw. Representative Scott Perry of Pennsylvania said: “I have two children; we’re not having any more, I don’t want to pay for maternity care … Some people don’t want to own a Cadillac, but should we want to make everybody pay for a Cadillac?” As it happens, Perry’s children are both girls. They may, someday, become pregnant. Is Perry missing some fundamental concept of how life functions?

Republican Congressman John Shimkus thinks men shouldn’t have to buy insurance that includes pre-natal care. He’s virulently against abortion. In sum, the life of the unborn is sacred, but the health of the unborn is somebody else’s business. Certainly not their father’s or grandfather’s. Even less, that of the community.  

And always there are the claims that the free market will do it better. While the United States has never had a truly “free market” in healthcare, its systems lean much further in that direction than any place else. That’s produced the worst results. Even worse before Obamacare. Consumers should be free to choose, to comparison shop, and pick the healthcare that suits them best. Imagine, if you will, being rushed to the hospital during a heart attack. As the surgeon and his team prepare to cut you open for the by-pass that will save your life, you say, “Wait! Can I have a list of your charges. And I’d like to compare them to at least three other providers. Make sure that you include all the options. I hate it when I get to an airline and have to pay extra for carry-on bags.”

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Presumably there are real solutions to America’s healthcare woes. Other nations have succeeded. It would be nice to report that the kinds of nonsense quoted above are just debating tricks to create confusion and obfuscation in defence of various kinds of profiteering. But, sadly, they seem sincere. 

Larry Beinhart is a novelist, best known for Wag the Dog. He’s also been a journalist, political consultant, a commercial producer and director.

The views expressed in this article are the author’s own and do not necessarily reflect Al Jazeera’s editorial policy.


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