First, congratulations! Seriously. If you were one of the thousands who did magical work, wrote letters and emails, called, showed up at town halls, demonstrated, blogged, tweeted, and/or talked to your family and friends, this nation owes you a debt of thanks. As a breast cancer survivor who spent many an anxious night worried about the return of the dreaded “pre-existing condition” exclusion that condemned women like me (for whom a re-occurrence is always just one little lump, felt in the shower, away) to bankruptcy and death, I owe you a debt of thanks. Unbelievably, and against all odds, we did it. On election night, when I saw that the Republicans, who have spent almost a decade focused on repealing the Affordable Care Act, had captured the White House, the Senate, and the Congress, I firmly believed that we’d soon see the end of affordable health care for the vast majority of Americans. The fact that, even though they were in complete control, the Republicans weren’t able to strip health care from most of us is simply — honestly — amazing. You did that. Democracy did that. Never doubt what a powerful magic worker you are, what a committed citizen you are, what, as Margaret Meade said, a small group of thoughtful, committed citizens can do to change the world.
Second, zombies. You know how zombies are. You think that you’ve finally dispatched them, and then, bam, there there are again, still staggering towards you and still chanting, “Braaaains!” Here’s one of the big differences between the Democrats and the Republicans: When we Democrats win something — school desegregation, the right to use birth control, public education, labor laws, civil rights for African Americans, same-sex marriage, environmental protections, etc. — we tend to dust off our hands, think we’re good to go, and look to the next campaign.
But Republicans never think like that. They are always staggering towards us, chasing “Braaaaaains!” Social security may have been around for 80+ years, but they’re still trying to undo it, although they use words such as “privatize,” or “save,” or “modernize.” Thomas Jefferson himself may have advocated for public education and millions of our immigrant grandparents may have seen their descendants live better lives because of it, but, at this very minute, millionaire Betsy DeVos is scheming to destroy it, utterly. Women may have won the right to abortions in doctors’ offices, instead of back alleys, almost half a century ago, but Republicans have been trying for just as long not only to outlaw safe abortions, outright, but also to chip away at that safety through vaginal ultrasounds, partner consent laws, personhood laws, waiting periods, etc. And we’re now seeing the same, largely successful, tactics applied to same-sex marriage. OK, you may have a constitutional right to marry, but not to have it performed by a government official in your county, but not to rent a hall for your wedding, but not to have a wedding cake, but not . . . .
All of which is relevant to the current health care battle because, although we may have won this round, that doesn’t mean that we’ve really killed the zombies. They’ll be back, arms extended, chanting “Braaaains,” and trying to chip away at health care even if they haven’t yet been successful at sending old women like me off on ice floes (besides, global climate change threw a wrench in those plans).
So do not become complacent. Don’t stop calling your Senators. Be vigilant for their next attempt to, likely buried in some boring appropriations bill, take away our health care.
Third, why ARE Republicans so determined to take away affordable health care from all but the most wealthy? Right now, there are two main reasons.
First, as Bill Kristol explained, when urging Republicans to defeat then-first-lady Hillary Clinton’s health care plan, “The long-term political effects of a successful… health care bill will be even worse—much worse…. It will revive the reputation of… Democrats as the generous protector of middle-class interests. And it will at the same time strike a punishing blow against Republican claims to defend the middle class by restraining government.” Mr. Kristol also understood that, like Social Security (TVA electricity, Medicare, interstate highways, AMTRAK, reliable weather reports, protections against adulterated food and medicine, clean water), once middle class Americans obtained a government benefit, they would be reluctant to lose it. We ARE Americans. We work for our benefits. Why SHOULD we not get them????
Second, Republicans are determined to repeal the Affordable Care Act (which Republicans, in what may turn out to be their one most egregious branding mistake, labeled “Obamacare”) because it was proposed by a black man. It’s been clear for decades that America, like most of the developed world, needed to figure out some way to provide health care to its citizens. In 1974, Republican Richard Nixon proposed a comprehensive health insurance care plan — called CHIP — to Congress. The individual mandate, the basis of the plan that President Obama proposed, was originally a conservative idea. “It was first proposed by the Heritage Foundation in 1989. And scores of Republicans—not just Mitt Romney—backed the idea in the past couple of decades.” President Obama, bless his heart, assumed that if he proposed the Republican plan, Republicans would accept it.
He didn’t understand just how much Republicans hated black people. He may have proposed their own plan to them, but Republicans were busy meeting the VERY NIGHT of his Inauguration and planning to take him down. And calling his health care plan “Obamacare,” (aka The Ni***r’s Heath Care Plan) was never anything more than a way for Republicans to get a lot of poor white people to vote Republican. As President Johnson said, “”If you can convince the lowest white man he’s better than the best colored man, he won’t notice you’re picking his pocket. Hell, give him somebody to look down on, and he’ll empty his pockets for you.”
So, for almost a decade, the Republicans ran on repealing “Obamacare.” They didn’t really have an alternative proposal because President Obama had given them their own proposal. But for a long, long time Republicans ran on getting rid of that black man’s plan just to spite the black man. But then, with Trump’s electoral college win, they were forced to put up or shut up and, in the end, they mostly had to shut up.
And, as Jonathan Chait explains, Trumpcare failed mostly because the Republican Party cannot govern.
One might dismiss this kind of rhetoric as a typical Trumpian boast. But the candidate was merely translating into the vernacular the somewhat more carefully hedged promises his party had made for years into terms in which they were meant to be understood. Paul Ryan’s “A Better Way” road map offered what it called “a step-by-step plan to give every American access to quality, affordable health care. … more choices and lower costs.” And why wouldn’t Republicans believe this? After all, Obamacare was, supposedly, a train wreck, a complete failure of design. It therefore followed that they could easily replace it without significant harm to anybody.
In truth, it was never possible to reconcile public standards for a humane health-care system with conservative ideology. In a pure market system, access to medical care will be unaffordable for a huge share of the public. Giving them access to quality care means mobilizing government power to redistribute resources, either through direct tax and transfers or through regulations that raise costs for the healthy and lower them for the sick. Obamacare uses both methods, and both are utterly repugnant and unacceptable to movement conservatives. That commitment to abstract anti-government dogma, without any concern for the practical impact, is the quality that makes the Republican Party unlike right-of-center governing parties in any other democracy. In no other country would a conservative party develop a plan for health care that every major industry stakeholder calls completely unworkable.
Health care. We all need it.