THE BOSTICK REPORT-Why did the Republicans fight so hard against the Affordable Care Act? I’m not a party ideologue who thinks black and white, good and evil, Democrats are smart and Republicans are stupid.
I approach this question respectfully because this year cost the Republicans a lot. It was the root of the debt ceiling debacle, our government shutdown, and a stagnant congress.
I don’t think Republicans are stupid. They achieved something to get to where they are and every person in an elected position as powerful as the House of Representatives was savvy enough to negotiate the complexities of party politics to rise up within the system, or they were successful within some private industry and leveraged that influence into a political career, or they exhibited superior organizing skills within their community to rise up from the grass roots level and upend conventional powers. In other words, they aren’t stupid.
So, why did seemingly intelligent people cash in all of their credibility, power, and influence for a year of foot dragging and obstructionism?
There’s no sense to it. There’s no tactical advantage in trading any progress we could have made in 2013 to fight a law that had been passed in 2010. You don’t even achieve party unity with a quixotic battle against a law that was judged as constitutional by a conservative Supreme Court.
Republicans weren’t building towards anything in their hate affair with Obamacare. They were digging in and when you dig in, you’re fighting with your heart – not your head. So, what is at the heart of this fight?
I can only explain it as a fundamental difference in philosophy and I’ve come up with two versions. One deals with the question of whether healthcare is a natural right and the other centers on the mythos of personal responsibility.
On natural rights, we’re talking about Thomas Jefferson – life, liberty, and the pursuit of happiness. Democrats believe that basic access to healthcare is a natural right, particularly in a country as advanced as the United States. But, the GOP believes that healthcare should be a profit-based enterprise. There it is in a nutshell.
To Republicans, patients are customers, not people, and those patients are as useful as they are capable of profiting the healthcare provider. The “great” thing about this is that if a patient runs out of money or dies, then another one will come along because the reality of this version of a "free market" is that healthcare isn't optional. In essence, you have a trapped customer base.
There’s an interesting irony in this. Here’s a party that dedicates ungodly efforts to subject us all to its own social morality, yet they place no moral boundaries on profiting in the free market off customers who have no power to walk away from a “deal”.
Republicans do push for universal access to catastrophic insurance because it benefits the profit margin. By denying people prevention-based, wellness healthcare, you let the patient’s wounds fester so that the damage is larger and the costs to that customer are higher. Catastrophic coverage gets the customer into the store and the fallout is out of pocket.
As a business model, this requires less effort on the part of the corporation and it’s exerted over a shorter period of time. From a free market perspective, that’s a pro-business approach quite appealing to the core fundamentals of the Republican Party. But again, that’s as long as you remove any semblance of morality from the healthcare market.
Because the perverse reality is that permitting healthcare to act in the traditional sense of a free market fails to accommodate for the lack of customer choice, a critical counterweight to corporate power in the free market. Free choice doesn't exist in healthcare because we can't walk away from pneumonia or a broken arm or a heart murmur in our baby.
You can walk away from the Ford dealership if you don’t like their product. Your ability to compare prices and accommodate for the deficiencies of one car is much greater than your ability, in the moments of a heart attack, to figure out a better option once you get to the hospital.
Now, maybe I’m wrong. Maybe the GOP fight against Obamacare isn’t their full-on embrace of capitalism over people. Maybe the Republicans haven’t dehumanized the idea of a patient.
The only other explanation I can think of is that this fight is an extension of the GOP belief in personal responsibility – that people should be held accountable for poor lifestyle choices, that people should know that they have to save money for that rainy day of sickness or disaster, and that if people don’t plan to take personal responsibility for themselves, then they should suffer the consequences. Setting aside the fact that that is distinctly un-Christian in this case, I would have to say that it would only work if people lived and died in a bubble. But, we don’t.
I don’t think either reason is a good one. This fight has consumed years of progress and Republican efforts to stymie its implementation have harmed our recovery from the Great Recession. I support the ACA and would like to see it morph into single-payer universal healthcare.
That said, let me end this with a proposition. If you can explain the reasoning behind the GOP hate affair with Obamacare in a way that makes sense, let me know.
(Odysseus Bostick is a Los Angeles teacher and former candidate for the Los Angeles City Council. He writes The Bostick Report for CityWatch.)
-cw
CityWatch
Vol 11 Issue 105
Pub: Dec 31, 2013
