This week, the GOP-controlled House of Representatives voted for the 33rd time in 18 months to repeal the Affordable Care Act. But even if that act of political theater is over for now, Republicans will keep repeating their favorite parts of the right-wing script well past Election Day in November. That their tried and untrue lines about "the largest tax increase in history," Obamacare "adding to the debt," a "government takeover of health care" (Politifact's 2010 Lie of the Year) and, of course, "death panels" (Politifact's 2009 Lie of the Year) have been thoroughly debunked won't prevent conservatives from continuing to mouth them.
And that debate-distorting performance is literally sickening. Because while some of the GOP's best and brightest darkly warn that the Affordable Act may kill you, other Republicans insist the lives of some Americans aren't worth saving. Meanwhile, without the ACA fully in place, study after study after study show the status quo has a real body count, with up to 45,000 of the uninsured dying unnecessarily each year. Nevertheless, the party of Romney, Ryan, Boehner and McConnell would prevent 30 million people from gaining the health insurance they need and millions more the basic patient protections they deserve.
Senate Minority Leader Mitch McConnell gave the game away two weeks ago on Fox News when said of those 30 million uninsured, "That's not the issue." But a more telling episode came during the September 2011 tea party/GOP presidential debate. As ABC reported, the tea partiers who protested Democratic health care reform in 2009 by holding a "die-in" at Senate offices cheered Ron Paul on when he said churches, not government, should address the U.S. health care crisis:
CNN moderator Wolf Blitzer's hypothetical question about whether an uninsured 30-year-old working man in coma should be treated prompted one of the most boisterous moments of audience participation in the CNN/Tea Party Express.Somewhere, California Congressman David Dreier (R-CA) was probably cheering. As he explained this week in calling for the repeal of the ACA and its prohibition on insurance companies banning patients with pre-existing conditions:
"What he should do is whatever he wants to do and assume responsibility for himself," Paul responded, adding, "That's what freedom is all about, taking your own risk. This whole idea that you have to compare and take care of everybody..."
The audience erupted into cheers, cutting off the Congressman's sentence.
After a pause, Blitzer followed up by asking "Congressman, are you saying that society should just let him die?" to which a small number of audience members shouted "Yeah!"
"I don't that think someone who is diagnosed with a massive tumor should the next day be able to have millions and millions and millions of dollars in health care provided, I do believe that there can be a structure to deal with the issue of pre-existing conditions."Just not if Mitt Romney becomes president of the United States. As he put it in March, "We can't play the game like that."
Of course, since 2009 Republicans have been playing games with the truth when it comes to Americans' health care. On no point has this been more true than when early versions of the Democratic health care overhaul contained a provision requiring Medicare to cover end-of-life counseling for the elderly. In the hands of Betsy McCaughey, the woman whose mythology helped torpedo the Clinton health care initiative in 1994, that statute which could have helped millions of Americans instead became "death panels." Sarah Palin, who later claimed she was speaking metaphorically, famously framed the GOP slander this way:
The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama's "death panel" so his bureaucrats can decide, based on a subjective judgment of their "level of productivity in society," whether they are worthy of health care. Such a system is downright evil.That would be evil, if it was true. But Palin's fraud didn't stop some of the GOP's more senior, and theoretically, more sentient leaders from regurgitating the bogus death panel sound bite.
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Take, for example, Iowa Republican Sen. Chuck Grassley. In 1993, Grassley joined GOP Sen. Orrin Hatch (R-UT) and 19 other Republican senators in proposing their own bill that "would have required everyone to buy coverage, capped awards for medical malpractice lawsuits, established minimum benefit packages and invested in comparative effectiveness research." (Sixteen years later, both would be among those who would call the ACA's individual mandate unconstitutional.) But as the debate over health care grew overheated in August 2009, Grassley's rhetoric turned incendiary:
"There is some fear because in the House bill, there is counseling for end-of-life. And from that standpoint, you have every right to fear. You shouldn't have counseling at the end of life. You ought to have counseling 20 years before you're going to die. You ought to plan these things out. And I don't have any problem with things like living wills. But they ought to be done within the family. We should not have a government program that determines if you're going to pull the plug on grandma."Grassley wasn't done. After claiming that under the Democratic plan "someone is going to decide grandma's lived too long," Sen. Grassley suggested that among the mythical death panel's victims would be one of Orrin Hatch's "closest friends in the world," Ted Kennedy:
"In countries that have government-run health care, just to give you an example, I've been told that the brain tumor that Sen. Kennedy has -- because he's 77 years old -- would not be treated the way it's treated in the United States. In other words, he would not get the care he gets here because of his age."Grassley, of course, had plenty of company on the Republican side of the aisle and its right-wing media echo chamber. As Rep. Virginia Foxx (R-NC) famously put it three years ago, Democratic health care reform will "put seniors in a position of being put to death by their government."
But the nonexistent death panels weren't the only mechanism by which Republicans charged Democrats would slaughter the American people. In October 2009, Mitch McConnell (R-KY) charged that the so-called "public option" for health insurance (which sadly did not survive in the final bill) could literally kill you:
"It may cost you your life. I mean, we don't want to go down that path."But a path McConnell was more than willing to follow was the one blazed by President George W. Bush and disgraced House Majority Leader Tom Delay. President Bush, as you'll recall, declared in 2007 that "people have access to health care in America. After all, you just go to an emergency room." In July 2009, McConnell doubled-down on Delay's proclamation that "there are 47 million people who don't have health insurance, but no American is denied health care in America."
DAVID GREGORY: Do you think it's a moral issue that 47 million Americans go without health insurance?In a further attempt to demagogue what become the Affordable Care Act, McConnell in the summer of 2009 invented a straw man to protest how covering the uninsured must not be done. "Once government health care is the only option," he warned on June 3 that year, "Bureaucratic hassles, endless hours stuck on hold waiting for a government service rep, restrictions on care, and rationing are sure to follow." Or as he would go on to state repeatedly:
MITCH McCONNELL: Well, they don't go without health care. It's not the most efficient way to provide it. As we know, the doctors in the hospitals are sworn to provide health care. We all agree it is not the most efficient way to provide health care to find somebody only in the emergency room and then pass those costs on to those who are paying for insurance. So it is important, I think, to reduce the number of uninsured. The question is, what is the best way to do that?
"All of us want reform, but not reform that denies, delays, or rations health care."Which is more than a little ironic. Because rationing care is exactly what the 2010 Paul Ryan budget, a blueprint which secured the votes of 235 House Republicans and 40 GOP senators, would inevitably do.
The Ryan plan doesn't merely call for the repeal of the Affordable Care Act and gutting Medicaid spending, steps which by themselves are forecast to result in 48 million Americans losing health insurance. In his 2010 proposal, Ryan called for replacing the Medicare system serving 46 million seniors with an under-funded voucher scheme that the nonpartisan CBO predicted would massively shift costs onto the elderly. As Ezra Klein summed it up two years ago:
It's hard, given the constraints of our current debate, to call something "rationing" without being accused of slurring it. But this is rationing, and that's not a slur. This is the government capping its payments and moderating their growth in such a way that many seniors will not get the care they need.(Ryan's 2011 revised plan, introduced with Oregon Democrat Ron Wyden, preserves the traditional "public option" as one of the insurance choices seniors can purchase with their future Medicare premium support. But, as discussed here, the threat of draconian cost-shifting and de facto rationing remains.)
In a rare moment of candor, or perhaps, half candor, Paul Ryan (R-WI) acknowledged Klein's truth, even if he would not regarding the ACA's Independent Payment Advisory Board (IPAB) for Medicare:
"Rationing happens today! The question is who will do it? The government? Or you, your doctor and your family?"Of course, Ryan left out the real culprit—the private insurance market. But with 50 million uninsured, another 25 million underinsured, one in five American postponing needed care and medical costs driving over 60 percent of personal bankruptcies, Congressman Ryan is surely right that "rationing happens today."
But that's not all that happens today. As the Urban Institute, Harvard Medical School and Families USA concluded in their respective studies, lack of health insurance results in between 22,000 and 45,000 preventable deaths in the United States each year.
If Mitt Romney and his right-wing allies get their way in Washington, D.C. and in the states, today's horrifying health care statistics will only grow worse in the GOP's future nightmare for America. That's just the sad truth.
And not another Republican killer lie.