Have the Republicans finally boxed themselves into a corner on healthcare? As President Obama pointed out in his press conference on Friday, it seems that the one unifying principle of the Republican Party these days is making sure that people don’t have health care. It used to be that pretty much everyone thought that being without insurance was a bad thing. Not only does the lack of insurance expose families to bankruptcy in the event of a catastrophic accident or illness, but hospitals also charge people without insurance much higher rates, and the lack of insurance also makes people less likely to seek medical attention when they need it. And apart from the sympathy that even Republicans feel for the uninsured, there is the free rider problem. Because a lot of healthy people choose to take the chance of going without insurance, that increases the cost of premiums for the rest of us. When some of these uninsured get sick and have to resort to emergency rooms and charity hospitals, the rest of us end up paying for that also.
It used to be that pretty much everyone, Democrats and Republicans, thought these problems deserved a serious solution. Republicans’ unrelenting opposition to the Obama administration’s efforts to fix the problem, however, has led them to actively embrace employers who do not want to provide their employees with health insurance (thus foisting the cost of their care on the rest of us), to campaign to urge young people to go without insurance (putting them at risk, and again imposing the cost of their care on the rest of use), and in many states controlled by Republican legislatures, unconscionably to turn down billions of dollars in expanded Medicaid coverage, which will leave many low income citizens without coverage, and force hospitals to provide care without any expectation of reimbursement. So-called conservatives who claim to favor fiscal responsibility and individual self-reliance now find themselves, for political purposes, advocating policies that will make it harder to balance state budgets, and that encourage the uninsured to act irresponsibly.
As a political strategy, this seems short-sighted. The politics of resentment rarely obtains a majority. As public policy, however, you just have to shake your head and wonder. When the political logic of Republican opposition takes the party to the extreme of actively trying to keep people from being able to obtain affordable health insurance coverage, that goes way beyond an “every man for himself” ideology. We’re now in the realm of pure spitefulness. That kind of sabotage not only hurts people who are being encouraged to do without insurance, but also increases costs for all the rest of us. That kind of opposition is just designed to make the system collapse, instead of trying to make it work, for the sole purpose of trying to blame the people who tried to make the system work, for the system’s collapse. This opposition will fail, however, because enough people are trying to make the system better that the saboteurs’ efforts will be seen for what they are.