Charlottesville, Health Reform and the GOP

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45’s public statements regarding Charlottesville are shocking, inexcusable, unforgivable, and members of the Republican establishment, inside and beyond the Beltway, have responded appropriately.

I applaud them for their responses in this instance, but I condemn them for going along to get along up until now.

Misogyny and sexism, class warfare and climate change denial weren’t enough, despite the real harm caused by Agent Orange and those in his thrall. Nazism was the red line. Of course, Nazism is reprehensible, but 45 has crossed many red lines before he got to this one, and where was the outrage?

The immediate, widespread, vehement response to the last of this parade of horrible actions and statements seems to prove some twisted corollary of Godwin’s Law.

What does this mean for those who were previously either GOP apologists for el jefe or those just holding their noses while trying to extract some benefit from the fact that their party holds both houses of Congress and the White House?

To me, it bespeaks a colossal abandonment of the public trust.

Exhibit A: Health care.

Health reform — repeal of Obamacare — as conceived by this barbaric Congress, supported by most of the folks now wagging their fingers at el presidente, would have caused more death and other grievous harm to more people, disproportionately people of color, by ripping a trillion dollars out of the Medicaid budget just for starters — than the whiny alt-right has thus far or is likely capable of killing and harming, even with the continued support of the goofball-in-chief.

The harm — including excess morbidity and mortality across the board, but likely concentrated in many of the populations targeted more explicitly by the alt-right — that would have been caused by ACA repeal is inarguable. (For starters, see these examples of the effects on Medicaid beneficiaries generally, lower income women, lower income elders, some of the CBO estimates and more on the effects of repeal from the Health Affairs blog and the Journal of Health Politics, Policy and Law.)

This leads me to conclude that the Republican leadership in Congress and elsewhere supported the ACA repeal efforts for one of two reasons: (1) They never believed the legislation would be enacted, and they were simply grandstanding for their “base,” who are apparently too confused to realize that repeal of Obamacare will harm most of them; or (2) They espouse the same policies of economic and racial elitism as 45 because it benefits them and theirs, and to hell with everyone else.

If their support is due to the first option above, then the ineluctable conclusion is that these elected officials are interested only in keeping themselves in office in order to enjoy the trappings of power and influence while in office, and to increase the payouts that come while in office and thereafter from their wealthy supporters who also benefit from appearing to pandering to the “base,” while in fact simply acting to line their own pockets to the detriment of the “base.”

If it’s the second option that is driving these behaviors, then the Republican legislators are acting no less shamefully; they are simply being more honest with themselves. They’re just acting in (not-so-enlightened) self-interest, or at least in the interest of their paymasters, the Koch brothers et al. 

We could run through this analysis for every issue in every sector: stewardship of federal lands, environmental policy, etc., etc. It is difficult to tease out where the GOP pols are grandstanding to appease the base, and where they are truly supportive of the incoherent and arbitrary justifications for the many harmful proposed and already-implemented changes in policy.

The expressions of outrage from GOP leadership following 45’s Charlottesville statements ring hollow to me. They are no better than the “thoughts and prayers” statements often made by legislators after the latest mass shooting — even though they consistently manage to not pass meaningful gun reform.

Part of the reluctance to take action seems to be due to the fact that folks who have been on the outs in DC are now very much on the inside, and it must hurt to put the brakes on that ride.

But let’s be blunt: The cost is too high. These folks took an oath to defend the Constitution. Every day they continue to do nothing they are violating that oath. If they are really outraged, then they need to take a look in the mirror and decide: Am I going to work to remove 45 from office or am I part of the problem?

David Harlow

The Harlow Group LLC

Health Care Law and Consulting

Image credit: Oregon State UniversitySolar eclipse, CC BY-SA 2.0, Link

You should follow me on Twitter: @healthblawg

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