Right now there seems to be a certain complacency that eventually the Republican governors who are refusing to expand Medicaid even though the Federal government will be picking up the tab and their states will get more than their fair share of the money because their programs are so crappy now will eventually see the light. Never mind the free money - never mind that the hospitals are screaming for help, never mind that making poor people go to emergency rooms costs more from everyone already than just giving them insurance, never mind that getting people on Medicaid lets them be healthier and avoid financial disaster.... Never mind that it's just human decency to run society so that becoming poor for any reason shouldn't be a death sentence. Digby has several posts (here and here) why that's just not going to work with the heartless bastards of the GOP.
Let's use the tools they've unwittingly handed us. Let's hang them with their own words and slogans. Let's call them what they are:
(But let's be smart about it. More below the Orange Omnilepticon.)
Who Needs Medicaid When You Have Word Salad?
If you've been paying attention to the Republican framing about Medicaid expansion, it's all about fear that the Feds will someday cut back leaving the states holding the bag, that the administrative costs are a deal breaker, that there are more effective market based solutions*, that the states should be left to their own solutions, etc. etc. Digby links to Douglas Holtz-Eakin with some word salad summing it up:
... A superior option would be the flexibility to address the needs of the sub-poverty populations on a state-by-state basis in ways consistent with each state’s norms.Digby translates:
Right. And if a state's "norms" is to let people die it would be wrong to interfere. People are different! We shouldn't inflict our values on them. Letting some Americans languish in poverty and illness and die early preventable deaths while others are allowed to have health care and security -- all on the basis of some arbitrary lines drawn up long ago --- is a perfectly respectable moral position. No biggie.* like unicorns - often talked about, but never seen.
YOYO Worldview - You're On Your Own.
The conservative world view is very simple: you're on your own. Your problem is just that - your problem. Expect to neither give nor receive help in this world - it's morally wrong and weak to look for help from others, from society, from government - it just creates dependency. You have what you can take and hold; screw everyone else. This goes hand in hand with an authoritarianism centered on private power rather than civil authority. What you've gotten by any means, fair or foul, is yours - you owe nothing to anyone.
From a factual viewpoint, expanding Medicaid to cover poor people makes objective sense in several ways. It's far more effective to give people preventative care (cost-wise and outcome-based) instead of forcing them to resort to the emergency room when they have no other choice. It's better for everyone when you don't have a whole bunch of people chronically ill, unable to work, going bankrupt from medical bills. At the most basic level, it's a lot nicer than having to step over dead bodies on the sidewalks while ignoring diseased beggars. Fewer plagues, too.
The real problem conservatives have with Medicaid expansion is the same problem they have with Medicare or Social Security: seeing people getting stuff without fighting and clawing for it offends them on a deeply spiritual level. It just doesn't make sense to them; they have a fundamentally different view of the world that colors their reactions to almost everything. They see it as rewarding failure, a sin in their world view.
UPDATE: David Atkins weighs in with more on this over at Digby's.
For GOP governors and their base, there are two kinds of people: those who deserve to prosper and be happy and those who don't. For them, the greatest injustice in the world is the taking of their tax dollars to assist the undeserving, and the removal of their private authority to abuse and exploit the undeserving.Going There: Hitting Them With Their Own Words
Sometimes the definition of "undeserving" is based on race. Sometimes on gender. Sometimes on sexual orientation. Sometimes simply based on how much money one has, which in circular fashion is itself proof of one's worth. Sometimes it's all of the above. But for modern Republicans, it's about much more than just the money. It's about ideology.
So, how do we respond to people who've built an elaborate series of rationalizations to justify letting people suffer and die when it's not necessary? One way is to use their own belief system against them to A) make them question their own beliefs - or at least struggle over them, B) change the framing away from the one they're using to kill Medicaid, and C) use it as a wedge to open up space for different world views. And to be effective, we have to reach them on an emotional level - because that's where they live.
If there is one issue the Republicans have used to rally their troops and demonize their opponents, it's the right-to-life versus freedom-of-choice culture war. They've made the rights of the unborn paramount. They've elevated the rights of 'fetus Americans' to restrict the rights of women over when, where, how they do or do not choose to have children, essentially turning them into slaves of their wombs. They use it to pursue their agenda even when it makes no rational sense.
So.... when Republicans start going on about Federal tyranny and the trap of free money, the loss of freedom at the state level to solve problems their own way, and all the other diversions from the issue of people sick and dying because they lack health care, ask them this: What about the unborn?
What about children who have no choice about being born in the 'wrong' womb suffering because their parents don't have health insurance, not because they're lazy or made bad choices, but because of bad luck, or other reasons? How many will miscarry because of lack of care? How many will not survive birth, or will die too soon? Why should these innocent children suffer because their parents might have lost their jobs? (How does a single mother pay for health care if she can't work because she's pregnant?) And how do you justify letting this go on for one more day in hopes that somebody, somewhere will come up with an answer that might be better - just not today? How can you turn it down when the money is already there, when that will save those precious lives while you try to find a better way?
The vaginal probe crowd has enough speech on record about the sanctity of unborn life that this should really be a hard argument for them to answer without sounding like hypocrites. It should not be hard to use their own sound bites against them. The actual hypocrites will try to change the subject or counter attack. The sincere ones may shut up or at least start to think about what they're saying. The ones who've been going along with the flow may start paying a little more attention and start thinking for themselves.
And maybe, it won't just be about the unborn if we can use this to open up the conversation.
When do you dump kids on their own? When do they become freeloaders on the government health care tit? What about people who have had bad things happen to them - natural disasters, plant closings, etc. Do they deserve to be punished with death and disease for being in the wrong place at the wrong time? How do the Bishops defend their patriarchal cult of the embryo over the woman, while trying to block health care for those unborn and the families around them? Why is the only choice live free or die, when it too often comes down to live free AND die in real life?
Odds are die-hard conservatives will not be persuaded or convinced. But... that may not be the case for their followers. If we want them to accept this, demand it even, we have to do it in a way that reaches them emotionally, in a way they can understand. We don't have to be screaming and abusive about it - just insistent that they justify their own values. We might even be able to make some of them ashamed if we're deft enough. And we can do so in a way that makes life hell for their sociopathic leaders.
What's not to like?
Wed Jul 04, 2012 at 5:56 AM PT: UPDATE: Before this diary slips out of sight, let me see if I can sum this up. The right bases much of its legitimacy on self-proclaimed moral superiority. They oppose Medicaid expansion because, as Atkinson notes, "the greatest injustice in the world is the taking of their tax dollars to assist the undeserving, and the removal of their private authority to abuse and exploit the undeserving." At the same time, they use the unborn as an excuse to restrict the rights of women (and to enshrine the power of that private authority) on moral grounds - the defense of truly innocent lives. Well, they can't have one without comprising their stand on the other. Maybe it's not enough to collapse this fortress of 'morality' they've built - but it's enough to open chinks in that armor and discredit them in the eyes of the rest of the world. What's more important to them - the lives of the innocent, or their tax dollars? That's a question for which they have no good answer.
Of course, none of their answers for anything are really that good judging by the track record where they've been put into practice.