A Death Row
The grim, inescapable realities of healthcare policy under the Republican regime
There’s an old Latin phrase that used to honor the naming of new Popes: sic transit gloria mundi, “thus passes the glory of the world.” It was a small reminder of worldly temporality amid the comical pomp and flowery regalia of Church processions. Even some of the wealthiest, most privileged theocrats kept themselves at least nominally aware of their — and ostensibly others’ — undeniable mortality.
Fast forward some centuries later and America’s neo-theocracy, the Republican trifecta of Congress, the Presidency, and the Supreme Court, seems intent on ripping apart the last vestiges of the American welfare state. The ACA will be first to go, along with the provisions that until now kept American healthcare from descending into Randian apocalypse. To add insult to injury, federal funds to Planned Parenthood will also be axed. Medicare will be financially burdened by the ACA’s repeal and the block-granting of Medicaid fantasized by House Speaker Paul Ryan will significantly limit health services to our society’s poor, not to mention slash much-needed funding for mental health and addiction treatment. Many of these cuts will disproportionately benefit the wealthy. In other words, this world’s passing will soon be glorious only to rich men.
The callousness of these moves is shocking to anyone attempting to wrap their minds around the country’s already byzantine health system but is sadly par for the course in US politics. Science doesn’t matter in the face of party politics. The success of other nations’ healthcare systems and the persistent failures of our own don’t matter in the face of the free market. Conservative ideology, a harbinger of economic slumps time and again, is guiding our shortened attention spans by the nose, through the dark.
The immediate effect of the Republican extravaganza of healthcare de-legislation will be that healthcare is more difficult to acquire and afford, despite what GOP lawmakers may say. If the ACA is done away with entirely and the single market scrapped, health insurance will revert to the terrible state it was in in 2008: a budget-busting, preexisting-condition-avoiding, purposefully confounding luxury good subject to nonstop price climbs as insurers probe how far they can gouge American budgets for access to care. The centralized state and federal exchanges, the logistical convenience of which was overlooked in the press in lieu of the sites’ buggy rollouts, would disappear and be replaced with a plurality of online and in-person insurance outfits competing and, as incentivized by competitive capitalism, contradicting one another to better entice and entrap the potential insured. Pharmacological companies, already allowed to price-hike as they see fit, would have even less reason to care about customers as insurance prices climb. American healthcare would become, in practice, a kleptocracy.
As dozens of economists have noted, healthcare is unlike any other market product since not being able to afford it is more than mere inconvenience but an existential concern — as in, you won’t exist without buying it. The Randian delusions of the current Republican game plan (which, despite sloganeering, appears to be Repeal and Not Replace) ignore this inconvenient truth. Members of Congress are wealthy, after all, and have their taxpayer-backed flexible spending accounts to fall back on. They don’t have any skin in the game.
Beneath the fine print and wonkish details of what’s to come for American healthcare, past the anxiety-inducing headlines that keep revenue flowing to anxiety-mongering media conglomerates, there is a simple truth: the Republicans now in control of our federal government have a deep-seated contempt for healthcare legislation. They’ve spent the last six years demanding that the ACA be repealed without any evidence of a replacement plan beyond “let the states deal with it,” suggesting their plan on the national level is a return to the pre-ACA nightmare years of the individual insurance market.
And, lest you think social media awareness-raising is a form of effective activism, let me remind you that these people are in power. No amount of cry-it-from-the-mountains journalism, dogged Twitter attacks, or smarmy Youtube testimonials can change the fact that, for at least the next two years — and probably well beyond that if Democrats don’t start winning — there is nothing stopping Republicans from disemboweling social services to the thunderous applause of insurance providers, pharmacological companies, and the rows of middlemen attendant to each. On top of this, if Trump gets his way on congressional term limits, the individual Republican politicians won’t be in power long enough to suffer (read: care about) the long-term political consequences of their policies.
That is the score, plain and simple. People will die because of it.
During a Reddit AMA, physician and health policy expert Dr. Zeke Emanuel was asked by one commenter to give them some hope for the future of American healthcare. His response was, “Escaping to Mars on Apollo 64.” Thus passes the glory.
Nicholas Morley attended Brown University and is completing a premedical postbac at the University of Vermont. He’s based in Burlington, Vermont.
