Paul Ryan is Trying to Kill Me

I’m not generally one for hysterics, but as we approach a new administration, I find it more than a little worrisome that the Speaker of the House is so dead set on repealing the Affordable Care Act before coming up with any replacement. At the present moment I am in between jobs (as the euphemism for unemployed goes), on a COBRA health plan, and still dealing with a chronic disease. Crohn’s disease is most certainly what would qualify as a pre-existing condition; one that has sent me to the hospital more times than I would care to remember. And the President-Elect’s newfound approval of certain ACA measures to bar insurers from denying coverage based on such pre-existing conditions notwithstanding, I am faced with the prospect of seeing those protections go up in smoke.

The GOP has still yet to clarify what their actual replacement to the ACA would be, and if there will actually be sufficient protections for people like me. All of which means that sometime after January 20th, 2017 I might not just lose insurance, but I might very well become uninsurable. And just to be blunt about why this is so viscerally important to me, my health insurance is what pays for the fairly expensive healthcare coverage that keeps me from endlessly vomiting and/or shitting blood. So I am left with the unmistakable reality that, no matter his intentions, the policies Speaker Paul Ryan wants to enact would very likely be the death of me.

Why does the current Speaker hate people like me so much? Is it because we are undeserving of the costs associated with medical attention? Is it because he watched A Christmas Carol one too many times and decided that Tiny Tim really was a leach on the generous Mr Scrooge after all? Well, if I were a betting man, I would have to guess that Mr Ryan is in love with ideology more than he is with governance. His ideology clearly tells him that government is incapable of doing anything good, and that the private market is always the answer. Incidentally, he is able to hear his ideology tell him this because the United States’ government has adequately funded a military to make sure the din of warfare is kept far from his ears. His ideology has so convinced him that government must be opposed that he has risen to one of the highest levels of the government to ensure that government never does any good for the people it was designed to protect.

It is astonishing to me that Mr Ryan is one of the highest ranking Republicans, because the first Republican President, Abraham Lincoln, described the proper function of government as doing “for the people what needs to be done, but which they can not, by individual effort, do at all, or do so well, for themselves.” This seems like recognition that government is not simply a necessary evil, but rather a necessary good for those people who find themselves born, through no fault of their own, into a world that does not guarantee equal opportunities. A necessary good to unite the common efforts of citizens toward greater goals than mere subsistence. A necessary good to continue the efforts laid out in our founding documents and defend what were described as the unalienable rights of all people, e.g. life, liberty, and the pursuit of happiness. It is astonishing to me that the group of people who claim the mantle of the party of Lincoln are capable of so coldly writing off the needs of their fellow citizens, the citizens they are bound to represent, for the sake something which must seem worthwhile to them but which I am clearly incapable of comprehending.

I do my best to understand viewpoints different from my own. I try to understand the people who say they value free markets above all else, and therefore shun any unnecessary governmental function. I just find myself at a loss how anyone can argue that protecting the sick from the worst incentives that do arise from the private healthcare system is anything other than a necessary governmental function. I find myself at a loss how people can think it is sound governance to defend a healthcare system that is almost designed to ensure that Americans spend as much money as possible for results that are just not terribly impressive. Particularly when we see a wide range of national healthcare systems that deliver better quality and length of life for a fraction of the cost. I find myself at a loss how Mr Ryan is capable of so distancing himself from the true human cost his policies will inflict on this nation. But then I am biased, because after all I will almost certainly be one of those human costs.

The Affordable Care Act is not perfect. Hell, the ACA isn’t even a left wing piece of legislation. We are talking about policies that were first proposed by Nixon and his colleagues, supported by the conservative Heritage Foundation, and first put in practice by Mitt Romney. All of that notwithstanding, we are talking about a piece of legislation that does more good than it does ill. The ACA is just about the best that can be done with the existing framework of private healthcare. Any further improvements to cut costs, increase accessibility, and produce greater outcomes would require the government to create a public option, as is done with the more progressive French healthcare system; or at least force the government to take a much more active role in dictating to healthcare providers and pharmaceutical companies what kinds of prices they can charge, as is done with the more conservative Singaporean healthcare system.

I mentioned earlier on that I am now on a COBRA plan. Such plans have their origins in the Reagan administration, back at a time when the Republican party still had the capacity to care for some of the sick and dying Americans they are charged to represent. Granted, that same administration was more than willing to watch as members of the LGBT community were sick and dying of AIDS, but let’s give some credit where it’s due. Yes, even President Reagan was capable of recognizing that as much as he might like parts of Ayn Rand’s ideology, she was wrong when it came to defining what are necessary governmental functions. He agreed that the government should require hospitals to admit patients in emergency situations, irrespective of their ability to pay for it. I would argue, given the reality that ER care is the most expensive, it is more expedient to cover preventative medicine too, but I’m not some bleary eyed optimist who thinks the Paul Ryan is ready to do anything proactive to protect American lives.

So the party of Lincoln and Reagan becomes the party of Trump and Ryan; God have mercy on us all. What does that mean for you? Well, if you commit to never getting sick, and if you commit to never finding out that you have a pre-existing condition, then you might be able to live long enough to enjoy a good, old fashioned tax cut. Nice. Now, that is of course barring the possibility that the new administration sets off a nuclear arms race that accidentally turns hot when the new president goes off on a 3AM tweet binge and gives everyone some more pressing concerns, such as immolation. And you’ll need that sweet, sweet tax cut when Social Security and Medicare get cut. But I’m sure that you’ll be just fine. Me on the other hand, the future is less bright than a thermonuclear blast for me. See, I know that I have a pre-existing condition. I know what happens to my insurance once the ACA protections go away. I know that the Remicade that keeps me healthy costs up to $10,000 each infusion, an infusion I need every 8 weeks. I know what happens to me when my insurance goes away, and it ain’t pretty… unless you think all toilet bowls would look better with a candy-apple red coating.

So Mr Speaker, I’m begging you, don’t repeal the ACA. At the very least, come up with and pass a plan that will protect people with pre-existing conditions before you do repeal it. To do anything less is an admission that you are not the party of Lincoln or Reagan and you certainly don’t give a damn about my right to life. I wake up every morning hoping to find out that the election was a great big joke, and that we can all laugh about the big hoax that was pulled. Unfortunately, you and I wake up in the reality we actually inhabit. So sadly, it’s not because I’m laughing too hard that I have to say to the Speaker, “Stop it, you’re killing me.”
Happy Holidays!