Do poor people deserve to die?

On hating Obamacare and scaling the “societal ascent graveyard.”

I’ve been trying to understand what makes people oppose life-saving ACA subsidies.

You probably know ACA stands for Affordable Care Act, a.k.a, “Obamacare.” Passed in 2010, it’s intended to guarantee affordable access to basic health care for all Americans who don’t qualify for Medicare or Medicaid.

Conservatives call the ACA a disaster. Admittedly, it’s flawed, partly because GOP pushback is so unrelenting, it’s hard to implement a health care strategy that isn’t riddled with imperfections and causes new problems.

Meanwhile, the ACA averted the unthinkable, preventing medical bankruptcy for over 500,000 people per year. Since 2014 it’s saved 6 million citizens from the unlucky nightmare of having to shoulder life-changing health and financial problems at the same time.

But we’re just getting started.

ACA gave 20 million more Americans access to life-changing treatment.

As a result, funeral parlors sold on average TWENTY-FIVE THOUSAND fewer coffins per year. Okay, maybe not literally, but the data shows 25,000 Americans per year would have died if not for the ACA.

If each of those deaths were a coffin, the stack would be 7 miles high. Higher than Mount Everest.

(“Societal Ascent Graveyard” By Stella Stillwell)

12 of these towers, one for each year since the ACA was passed, would represent a “societal ascent graveyard,” a vertical cemetery containing the casualties of austerity, and tax cuts for the rich. Ostensibly in the name of freedom, innovation, and the lifting of all boats, minus the 400 thousand boats previously belonging to residents of casket city.

And I wonder: Who’d be inside these imaginary towers if we didn’t have the ACA?

Definitely the elderly. But also thousands of children, and people of every age. Mostly decent people who like dogs, because that describes most people, in my experience. 🐶🐕🦮🐕‍🦺🐩🌭

Not criminals. Just regular American citizens who couldn’t afford life saving care. 250,000 of them.

If that many people stood shoulder to shoulder they’d make a line roughly 118 miles long, about the distance from New York City to Philadelphia.

Every last one of them would be deserving of a hug. I mean, just imagine: dying unnecessarily from something totally treatable, in the wealthiest country in the world. What a slap in the face.

Meanwhile, thanks to Obamacare sparing their lives, they still walk among us. Working and middle-class doers, front line laborers, struggling artists, loving grandparents.

That hug they deserve? It’s still on the table. Remember that next time you see them. And while you’re at it, look them in the eye and explain to them why the conservative half of the richest country in the world wanted them dead in exchange for extra tax breaks.

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FACT: Almost all modern Western democracies have guaranteed health care. But for some reason the U.S., the wealthiest nation in the world, isn’t one of them. Why?

“Because if you give away free stuff” the conservatives warn, “people won’t work as hard.”

But the data shows the opposite: healthy people work harder, live longer, and produce more. Universal health care boosts GDP and quality of life scores in every country that guarantees medical treatment.

Nonetheless, conservatives seem to feel it’s still not worth it.

To me, there’s something urgently euphoric (and maybe tenaciously American?) about peeling the onion to see why half the country is okay with hundreds of thousands of innocent Americans needlessly dying every year.

This week, during the shutdown, I simply had to find out WHY there’s so much hate around this ACA thing.

I reached out to conservative friends and family. I asked calmly. Didn’t judge. Just wanted to know their true feelings.

What I uncovered is nothing new but I’ll report it to you anyway because it bears repeating. If the following doesn’t merit our sustained and concentrated attention I can’t imagine what else would.

So, here it is:

They think people generally get what they deserve.

They think that if you’re doing okay and can afford health care, you’re probably morally better.

They think that if people suffer or even die, they only did it to themselves.

They ask, with restrained annoyance: why should I be forced to pay someone else’s doctor bills?

They also ask this: Why should poor people get medical treatment they didn’t earn?

They say: People who stick up for the poor in this context are indulgent fools who want to see themselves as virtuous. And that the result of this self-righteous, performative hubris, is that they’re hurting the exact people they’re pretending to want to help.

They claim that anyone who is pro-Obamacare is simply wrong and doesn’t know the facts.

They assert that liberals, if not motivated by self-righteous posturing, are motivated by sloth, envy, and lack of faith.

Conservatives insist that this explains why liberals want to tear down the successful people who actually contribute to the world.

I could go on, but let’s stop there. That’s enough torture for one article. Take a deep breath; I’ll wait.

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Okay. So, in short, they want evolution to cull the weak. They firmly believe cutting ACA subsidies will help do that, with a side benefit of forcing lazy people to work harder and solve their own damn problems for once.

After all, “By the sweat of your brow you will eat your food until you return to the ground…” Genesis 3:19

I’m not saying there are no lazy people. But nothing in my life has ever even slightly indicated that people want to be dependent on handouts. Dependency is cloistering, humiliating and destabilizing.

Sometimes things just don’t work out. Often, people start from behind. Plus, the lower you sink, the harder it is to claw your way back up.

And if you study basic economics, you know that carrying a small but steady margin of unemployment is a feature, not a bug, ensuring a reliable pool of affordable labor. Without an unemployment rate by design, businesses couldn’t function or maintain profitability.

Plus, we’re not all endowed with the same lucky gifts. There’s always going to be a bottom half, bottom 20%, 10%, 2%, in skill, talent, connections, charisma, and just plain luck.

Nobody asked to be born, nobody chooses who their parents are, nobody has any say in the external factors that determine what happens to any of us.

So what do we do with all this?

Well, we can keep calling the health care debate a simple, honest disagreement about budgets and economics.

But isn’t it really more about how we decide what matters? After all, no economic or market rule can tell us what to care about in our hearts.

And as we discussed, almost every other successful democracy in the world now has universal healthcare, in ways that boost quality of life and economic activity, without exception.

Chances are it’s NOT a facts and logic debate, as much as conservatives want to pretend it is in polite company.

It’s more primal. Heart-to-heart conversations reveal what they really believe: that a sick, poor person who gets help they didn’t EARN is a stain on the world.

An even bigger stain than a seven-mile-high coffin tower every year, filled with people who are just like you and me in all those little non-fiscal ways that make us lovable.

There’s an old lady in one of those hypothetical coffins who really just wanted to bake cookies for you. 🍪

But ACA opponents are happy letting her die because it’s nature, and it’s not their problem.

Instead of funding the ACA, they want tax cuts on the rich, for no other reason than it’s their money and they earned it.

As a side note, they claim that the money trickles down into new jobs. But the data shows that’s not always the case. And even when it is, it’s largely the kind of activity created downstream of private capital seeking the highest yield.

The argument is that wealth frees up lending. But it’s not the kind of lending that serves humanity’s best interests.

It rarely creates jobs that lead to a cleaner, fairer, kinder planet. And while there’s massive demand for those things, it’s not the kind of demand that’s easily monetized. (So much for supply and demand.)

Tax cuts for the wealthy (who currently already pay historically low marginal tax rates) worsens the already out-of-control wealth inequality, and reroutes life-saving capital into the rent-seeking, private-equity-based aspects of our economy. Plus, many billions of dollars wind up in offshore accounts and investments.

All of that is instead of saving lives, boosting quality of life scores, and growing our overall economy in ways that preserve democracy, just like most other reasonable countries. Germany, France, the UK, Canada, Australia, Sweden, Israel and so forth.

So please don’t be fooled. This is NOT a disagreement about facts, but about what America is for, and about WHAT A HUMAN BEING IS FOR.

And given how conservatives see the world, we’re not debating anymore. We’re just pretending to because the truth is too awkward, too damning.

Call their hatred for affordable health care what it is: a theology of cruelty, and a cult of greed.

If some of your loved-ones are religious people, you know full well that you can’t debate theology with logic.

The conversation ends the same way: with the subject changed, the zone flooded, the positions distorted. You’re trying to reason with a worldview that thinks helping someone who’s down is encouraging laziness or perpetuating weakness.

There’s no shared premise in that.

Just a brick wall.

Behind that wall is the belief that the preventable death of innocent American citizens is the price of freedom.

Pick a side.

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