Over at TNR, Jonathan Bernstein is having a terrible time figuring out why Republicans have such incredible hatred for the Affordable Care Act. Is it wonky worries about Medicare costs? No — if that were the care, they would embrace the ACA’s attempts to hold down those costs. Is it fears for private insurers? No — private insurers are not only protected by the ACA, but given literally millions of new customers. Then what is it?
It’s really quite simple, although you can spin it two ways. They are outraged that the government is helping working people who cannot afford health insurance purchase it. The more charitable spin concerns how Republicans (and conservatives generally) think about health insurance. For them, it’s a commodity. If you can afford a widget, you buy a widget; if you don’t, you don’t. If you can afford a car, you buy one. If you don’t, you don’t. If you can afford health insurance, you buy it; if you don’t, you don’t. That’s the way the market works.
Democrats and progressives disagree, although we don’t have a good way of talking about it. Some have used the language of “rights,” as in a “right to health care.” But as with all positive rights, this obscures the issue: many states have the “right to education,” but that doesn’t mean that everyone gets the education they want. They get something minimal, and have a claim on the public fisc to get it, although as states all over the country are showing, that claim is quite tenuous during a recession and when Congress seems devoted to avoiding its responsibilities to assist the states. But whatever health care is, it’s not a commodity.
The less charitable spin — which (as I’m sure will come as a shock to all) is what I agree with — comes from Bernstein’s TNR colleague Jonathan Chait. The core of Republican belief, he explains, is that
all success is earned success. They do not believe that luck or life circumstance play an important part in economic success. They believe that wealth and poverty are essentially moral categories, interchangeable with “hard work” and “sloth.” They decry government, but they don’t really oppose government per se. They oppose those government functions that transfer resources from the rich to the non-rich.
What Chait could have said but didn’t is that this is essentially Social Darwinism 101, or Scrooge, or Rand. Ironically enough, this is the only Darwinism in which Republicans believe. So instead of the man himself, I would suggest replacing the elephant as the GOP’s symbol with William Graham Sumner, the late 19th social Darwinist. Although Sumner’s academic bona fides would no doubt offend most in the party, his insistence on the futility and downright immorality of doing anything to assist workers and the poor would be quite congenial.