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Imagine that the Centers for Disease Control (CDC) warned that America was about to be hit by a preventable epidemic of a deadly, though curable, virus. In response, the federal government budgeted funds for each of the 50 states to purchase antidotes to save the afflicted and vaccines to immunize residents against future outbreaks. Recognizing the gravity of the situation, the White House raised the revenue to completely cover the costs of the emergency program for three years and promised to pay 90 percent of the bill after that. Even having to pick up 10 percent of the tab, most states would come out ahead by virtue of not having to pay for the care of the sick and the dying. All the 50 governors and state legislatures had to do to save thousands of their residents from needless deaths was to say one word to free money from Uncle Sam: Yes.

Now, imagine that 24 states simply said no, for no other reason than their leaders' dislike of the president and his political party.

If that sounds inconceivable, it shouldn't. It's actually happening right now. By rejecting the Affordable Care Act's expansion of Medicaid, Republicans are making the unconscionable routine by guaranteeing that thousands of their own constituents will die every year.  Die, that is, from the GOPer virus.

That's not hyperbole, but a grim reality. Due to what might be the greatest act of political spite in modern American history, Republicans will needlessly leave millions of people uninsured, many hospitals on the edge of financial ruin and thousands of Americans dead, mostly in the states the GOP itself controls.

Continue reading to see how the Republicans' killer math works.

Prior to the full implementation of the Affordable Care Act, studies from the Urban Institute, Families USA and Harvard Medical School estimated the numbers of preventable deaths among America's 50 million uninsured at between 22,000 and 45,000 a year. But as 25 plus million Americans gain coverage over the next decade (according to the nonpartisan CBO), that unnecessary death toll would drop dramatically. Just not, it turns out, in the GOP-dominated states that refused to accept the Affordable Care Act's expansion of Medicaid to millions of their currently uninsured constituents.

That's the conclusion a team of researchers from Harvard Medical School recently published in Health Affairs. The authors of "Opting Out Of Medicaid Expansion: The Health And Financial Impacts" tallied up the coming body count in the Republican states that rejected the ACA's extension of Medicaid to millions of their residents:

Nationwide, 47,950,687 people were uninsured in 2012; the number of uninsured is expected to decrease by about 16 million after implementation of the ACA, leaving 32,202,633 uninsured. Nearly 8 million of these remaining uninsured would have gotten coverage had their state opted in. States opting in to Medicaid expansion will experience a decrease of 48.9 percent in their uninsured population versus an 18.1 percent decrease in opt-out states...

We estimate the number of deaths attributable to the lack of Medicaid expansion in opt-out states at between 7,115 and 17,104. Medicaid expansion in opt-out states would have resulted in 712,037 fewer persons screening positive for depression and 240,700 fewer individuals suffering catastrophic medical expenditures. Medicaid expansion in these states would have resulted in 422,553 more diabetics receiving medication for their illness, 195,492 more mammograms among women age 50-64 years and 443,677 more pap smears among women age 21-64. Expansion would have resulted in an additional 658,888 women in need of mammograms gaining insurance, as well as 3.1 million women who should receive regular pap smears.

To put those findings in terms Republicans can understand, up to 3,000 of Rick Perry's Texans will needlessly die each year. Those dead will joined by up to 671 from Scott Walker's Wisconsin, 1,176 in Nathan Deal's Georgia, 2,221 in Rick Scott's Florida and 1,145 in Pat McGrory's North Carolina. It's no wonder Ohio GOP Gov. John Kasich got biblical on Buckeye State Republicans to extend Medicaid coverage to 300,000 of their state's residents:
"When you die and get to the meeting with St. Peter, he's probably not going to ask you much about what you did about keeping government small, but he's going to ask you what you did for the poor. You'd better have a good answer."
Mercifully, it's not too late for Americans to immunize themselves. When they go to the polls in November, they can vote Democratic and kill the GOPer virus dead in its tracks.

For more background, see "GOP's Obamacare spite means death toll for red states."

Originally posted to Jon Perr on Fri Apr 18, 2014 at 10:32 AM PDT.

Also republished by Obamacare Saves Lives, South Dakota Kos, and Daily Kos.

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Comment Preferences

  •  G.O.P. = "G.O.deathPanel" /nt (4+ / 0-)

    Warning - some snark may be above‽ (-9.50; -7.03)‽ eState4Column5©2013 "I’m not the strapping young Muslim socialist that I used to be" - Barack Obama 04/27/2013 (@eState4Column5).

    by annieli on Fri Apr 18, 2014 at 10:33:30 AM PDT

  •  These people understand only scarcity. (1+ / 0-)
    Recommended by:

    It's their whole paradigm for making sense of life. It's why they vote Republican. They're like the child in the dysfunctional alcoholic family, all proud of his "self-sufficiency" and contemptuous of others who actually show needs.

    It's here they got the range/ and the machinery for change/ and it's here they got the spiritual thirst. --Leonard Cohen

    by karmsy on Fri Apr 18, 2014 at 10:40:42 AM PDT

  •  If the GOP is the virus, the Supreme Court is the (4+ / 0-)

    route of infection.

    Conservatives seem to believe that the rich will work harder if we give them more, and the poor will work harder if we give them less. E.J. Dionne

    by blueyescryinintherain on Fri Apr 18, 2014 at 10:46:16 AM PDT

  •  The Civil War - (1+ / 0-)
    Recommended by:

    by Ken Burns et al.  Watching that series again recently helped me understand the RW nutjob POV.  This "oppression  that must be fought" feeling and hatred of "the other" will never die.  And since hate-entertainment-news has been feeding it for the last 25 years, the sickness has grown and is killing us now.  

    •  From what I can tell... (0+ / 0-)

      most Republicans come from the dysfunctional/addictive side of things.  The two hallmarks of dysfunctional or addictive behaviors are denial and blame.

      First they deny there is a problem.  If they have to admit to there being a problem, they look for someone else to blame the problem on.  That way they can avoid having to take any responsibility for any thing negative that happens.

      This is the true "victim" mentality.  When they see themselves as victims, their world gets divided into two different groups - the "rescuers" and the "persecuters."  That makes everything black and white.  The "rescuers" are always there to agree with them, and tell them how great they are, and the "persecuters," do just the opposite.

      As George W. Bush said "Yer either fur us or agin us."  And that's how they view the world.  That makes everything very simple for them.  

      Also, many of the religious fundamentalist come from this same point of view.  One trait they all have in common is their inability to admit to the possibility that they might be wrong about anything.  Being wrong doesn't fit in their black-and-white world.

  •  Red State electorates taught Empathy is Socialism (0+ / 0-)

    "If Wall Street paid a tax on every “game” they run, we would get enough revenue to run the government on." ~ Will Rogers

    by Lefty Coaster on Fri Apr 18, 2014 at 11:00:26 AM PDT

  •  There Will Be Many Hospitals And Clinics (2+ / 0-)
    Recommended by:
    wilderness voice, Gooserock

    that will go out of business.  Many will be in poor areas.  

    "Don't Let Them Catch You With Your Eyes Closed"

    by rssrai on Fri Apr 18, 2014 at 11:04:15 AM PDT

    •  Problem Solved. No Indigent Patients Sucking (0+ / 0-)

      other peoples' tax or insurance dollars for treatment.

      We are called to speak for the weak, for the voiceless, for victims of our nation and for those it calls enemy.... --ML King "Beyond Vietnam"

      by Gooserock on Fri Apr 18, 2014 at 12:19:39 PM PDT

      [ Parent ]

  •  I Presume Those Are Annual Deaths nt (1+ / 0-)
    Recommended by:

    We are called to speak for the weak, for the voiceless, for victims of our nation and for those it calls enemy.... --ML King "Beyond Vietnam"

    by Gooserock on Fri Apr 18, 2014 at 12:20:37 PM PDT

  •  It is an excellent metaphor that needs to be used (0+ / 0-)


    I distrust those people who know so well what God wants them to do, because I notice it always coincides with their own desires. - Susan B. Anthony

    by pajoly on Fri Apr 18, 2014 at 12:35:52 PM PDT

  •  By this logic.... (1+ / 0-)
    Recommended by:

    President Obama is responsible for every uninsured death since he didn't enact a universal system.

  •  Movement Conservatism (7+ / 0-)

    is a national security threat to the United States.

    Movement Conservative policy and political practices will kill more Americans, and will keep killing innocent Americans, than Osama Bin Ladin or Tim McVie could ever dream of killing for their malignant causes.

    If a foreign country was doing to America what Movement Conservative policy, via the Republican Party, is doing, Senator John McCain would be calling for air strikes and no-fly zones to be an immediate priority. Current Senator Lindsey Graham and former Senator Joe Lieberman would be standing behind him and nodding fiercely in agreement.

    It's only hyperbolic to say it if you put keeping Cokie Roberts and Ron Fournier off of the fainting couch ahead of the (rising, mounting) body count.

    “Once is happenstance. Twice is coincidence. Three times is enemy action.” — Auric Goldfinger

    by LeftHandedMan on Sat Apr 19, 2014 at 08:08:27 PM PDT

  •  Some of these states shouldn't be on the list (10+ / 0-)

    If only people had gotten out to vote in 2010:


    In Virginia the government may shut down over this July 1st because the crazies control the very gerrymandered House of Delegates.

    "Corporations exist not for themselves, but for the people." Ida Tarbell 1908.

    by Navy Vet Terp on Sat Apr 19, 2014 at 08:11:44 PM PDT

    •  The policies enacted in these swing states since (10+ / 0-)

      The 2010 election should wipe away completely any notion that "there is no difference between the two parties."  The GOP majorities in these states are sadistic, wholly owned subsidiaries of ALEC and the Koch brothers (and their ilk) and determined to ram through every cruel, extreme law they can before the pendulum swings back.

      "It ain't right, Atticus," said Jem. "No, son, it ain't right." --Harper Lee, To Kill a Mockingbird

      by SottoVoce on Sat Apr 19, 2014 at 08:16:42 PM PDT

      [ Parent ]

    •  Exactly as Maine is a reliable blue state for (5+ / 0-)

      Presidential elections and I would say considerably more liberal overall than some of the states on the list. And PA has not voted Republican for President since 88.  

      These states are blue enough to have Democratic Governors and hopefully a few of them will after November...we need to double down on GOTV efforts for these Governor races as well as Senate and House races.

      I know my first priority for GOTV in my state of PA is for governor.  We need to get this crackpot wingnut Corbett out of office.

      Keystone Liberals on Twitter @ KeystoneLibs , Join PA Liberals at

      by wishingwell on Sat Apr 19, 2014 at 08:33:35 PM PDT

      [ Parent ]

      •  Does Corbett want to expand it? (1+ / 0-)
        Recommended by:

        He said he wants to, but only if work requirements are added. He is looking for a way out like the other GOP governors.

        •  We are betting if he gets a second term, he will (1+ / 0-)
          Recommended by:

          be worse, He will refuse to expand and sink even deeper into teabauchery. We think he will spend his second term doing more damage, cutting more from education, and he seeks to privatize most anything he can. If he could, he would sell the state capitol to the highest bidder. He is disgusting.

          I would take Tom Ridge back in a flash or Thornburg if it was between one of them and Corbett. He is that bad.

          Keystone Liberals on Twitter @ KeystoneLibs , Join PA Liberals at

          by wishingwell on Sun Apr 20, 2014 at 12:07:46 PM PDT

          [ Parent ]

  •  Thanks. (0+ / 0-)

    They really don't care.

    "Mr. President, I'm not saying we wouldn't get our hair mussed. But I do say no more than ten to twenty million killed, tops." General Buck Turgidson

    by muledriver on Sat Apr 19, 2014 at 08:14:19 PM PDT

  •  Not to mention abortions (10+ / 0-)

    As a person who believes both reproductive education and comprehensive health care are the remedies, I constantly confront my "fundamentalist" friends about abortion.

    Canada has 1/7 the abortions of the US because they have universal health care.

    An American waitress in Florida (because Skelator has rejected health care) who makes ~12000 A YEAR AND find she is pregnant has the choice of paying a year's salary to birth a baby or ~300 to Planne Parenthood. If you really believed that women were moral and smart, you'd expand Medicaid.

    Will candidates really tell the truth? In a recent special election in Florida, Alex Sink just pussifutted around the real issues and lost.

    •  Abortion is fearful to some people because (0+ / 0-)

      it makes them think "I could have been an abortion" and that's scary as all get out.
      How could someone think that? Well if one exists in an ineffable present where there is no past and no future, because time as a linear process is not perceived, then even what did not happen is a constant threat.
      Reality does not intrude into the mind of the idealist.

      by hannah on Sun Apr 20, 2014 at 03:50:51 AM PDT

      [ Parent ]

      •  I don't think that's it (4+ / 0-)

        In some cases, people simply want to punish women who have sex. Having the baby is a punishment. In other cases, they have just fixated on "the greatest sin" in a sort of dominionist system--easy to understand, one voting issue. (The gun folks are of the same mindset.)

        It makes voting easy. It also helps you identify those who agree with you, with those bumper stickers and license plates. These folks, above all, want to believe that everyone else agrees with them. Just look at the video of Rove's face when he was told Obama won the second time.

  •  Mass Murderers! (5+ / 0-)

    Call these Republican governors what they are,
    mass murderers.

    P.S. Everybody should recall that the given figures are deaths per year, each and every year.

  •  Fox News Statistic (1+ / 0-)
    Recommended by:

    I must state one again the reporting sloppy statistic such as this really brings down the credibility of the site.  Fox News has to misrepresent data because the 'facts' it want to promote are not supported by evidence of any kind.  We don't have to resort to such chicanery because the results are broadly supported by data. However, by presenting data in a misleading manner, certain specifics are presented as truths without being supported by data, which tends to undermine the facts that are supported.

    The first sloppiness is representing the numbers such as '38'.  Does the precision of the data really warrant such a number, or is this just representative of sloppy analysis.

    Secondly is reporting numbers instead of percents, especially as the populations of the states so broad.  For instance Texas and Wisconsin are both killing off 0.01% of the population. Other states like Idaho and New Hampshire are killing, on a percentage basis, a miniscule number of people. In Idaho increased traffic safety may save more people than the lack of the ACA kills.

    Which does not negate the fact that the ACA is probably going to save a bunch of lives.  But is every red state going to result in statistically significant deaths?  No.  And don't say that statistical significant is heartless. It is the way statistics work.

    •  Perhaps This Statistic Will Be More Helpful (4+ / 0-)
      Recommended by:
      Creosote, KenBee, FindingMyVoice, Piren

      The rejection of Medicaid expansion by Republican-led states nationwide will kill between 145% and 355% of the total number of Americans killed in the Iraq War. The figure is between 233% and 567% the number slaughtered on September 11, 2001.

      And that will happen every year.

      •  exactly (0+ / 0-)

        The number of homicides in Chicago over the time period of the Iraw war are 121% of US combat deaths during that war.  We might say that Chicago is more dangerous than being a soldier in Iraq, but that ignores the fact that, in general, there were more people living in Chicago than US soldiers deployed in Iraq.

        Which is the point. Fox News can only create semi-valid  statistics to 'prove' things that will scare it viewers into buying the products advertised.  We don't need to fabricate statistics. We see everyday the people with health insurance have the opportunity to lead better lives.  It is not necessarily about death, it is about the everyday pain and suffering.

    •  Well, it's not data. It's a projection, (1+ / 0-)
      Recommended by:

      a prediction, a prognostication. There is no truth in what hasn't happened -- a point that should probably made more often about our lazy media, who all prefer to write and talk about the unknowable and unknown so they can't be right or wrong.

      by hannah on Sun Apr 20, 2014 at 03:54:52 AM PDT

      [ Parent ]

  •  Needless deaths=crashing 25-30 fully loaded 747's (2+ / 0-)
    Recommended by:
    chloris creator, Piren

    Splitting the difference, 12,000 deaths would equal 25 to 30 fully loaded 747's...

  •  How's that death panel working for ya, Sarah? (3+ / 0-)
  •  what is not included is (7+ / 0-)

    the number of people who are able to get treatment in emergency rooms but are then saddled with an untenable economic burden, driven to bankruptcy or simply have the charge written off and their credit destroyed.

    These long-term economic impacts drive up the cost of health care for everyone in the state but also adversely effect future economic opportunities for the family and their ability to care for their children.

    This is a compounding effect that is arguably even more destructive than the simply "lives lost" metric.

    Be the change that you want to see in the world

    by New Minas on Sat Apr 19, 2014 at 09:28:30 PM PDT

  •  The sad/tragic/maddening thing is (0+ / 0-)

    Many of the the people in these states who could have been helped will blame the wrong people for their plight.

    (I say that as a Hoosier who's been Penced off.)

  •  JEL (Just Eliminate Lies) (0+ / 0-)

    Couldn't it be possible to make JEL-style ads with crosses representing those that needlessly died due to GOP inaction?  I seem to remember those being effective in cutting down smoking and they did get a lot of publicity.

    Faith Manages. -- J.M. Straczynski

    by Master Alchemi on Sat Apr 19, 2014 at 09:40:22 PM PDT

  •  Each uncovered person can infect more people (4+ / 0-)
    Recommended by:
    KenBee, hamjudo, FindingMyVoice, Piren


    •    naturally occurring flu, including the next deadly mutation, and

    •    intentionally engineered and released biological weapons,

    ...both of which which every expert says will arrive sooner or later.

    Republicans' and swing voters' failure to connect the dots between healthcare and "National Security"™, especially the transmission role of food-handling workers without sufficient medical checks or sick leave, is a particularly bizarre example of mental compartmentalization.

  •  Or we could be mad (1+ / 0-)
    Recommended by:

    at the Democratic Party for squandering a Supermajority and going with the insurance company bailout ACA instead of the healthcare program that the rest of the world has.  Single-payer.

    But yes, let's be mad at the GOP because Republicans.  Go Team Blue!  Rah Rah Rah!

    U G L Y, they ain't got no alibi, they ugly!

    Go TEAM!

    Bowers v. DeVito "...there is no constitutional right to be protected by the state against being murdered."
    Director of Merchandising - the Liberal Gun Club
    Owner, Olsen Training Group

    by ErikO on Sat Apr 19, 2014 at 11:07:01 PM PDT

    •  Because we live in a federal system in which (0+ / 0-)

      regulating insurance, as well as the certification of professionals like doctors and nurses and lawyers is relegated to the several states, as is the authorization and registration of subordinate corporations (counties, cities, towns, commercial and industrial), it wasn't possible to set up a national purchasing cooperative at one fell swoop. The states wouldn't have it. Indeed, 26 refused to participate and rejected the proferred pre-payment bribe.

      The fiction that taxes, rather than Congress, are the source of dollars is promulgated for many reasons. But the main one is that both Congress and the several states have as much reason to dissemble where dollars come from as parents have in promoting the myth of the storch. The don't want to be responsible for the results and they want to push on-going mistakes and/or deprivations off on someone else.
      Congress has spent decades privatizing its functions and shedding obligations and, inadvertently, relinquishing the power of the purse. The ACA confronted them with the realization that any control over a $2.5 trillion dollar industry was about to escape. I suspect that they were privatizing themselves right out of influence didn't register until it was too late. Now all they can hope for is to deep six the whole program, as they've also been threatening with Social Security and Medicare.
      When programs become automatic and are run according to objective criteria, then Congress' ability to distributed bennies to privileged groups (hospitals, research institutes, universities, non-governmentals) shrinks and, without those goodies to distribute, there's nothing left but military contracts with which to "earn" votes.

      by hannah on Sun Apr 20, 2014 at 04:15:35 AM PDT

      [ Parent ]

  •  They're not needless. (1+ / 0-)
    Recommended by:

    Undertakers need them to swell their bottom line.
    The GOP need them to prove they don't make idle threats.
    Even Democrats need them to prove the GOP are bad.

    That said, I don't think "needless" is a good word to begin with.  "premature" would definitely be better. Premature deaths would go nicely with the premature live births the GOP also favors.

    by hannah on Sun Apr 20, 2014 at 03:38:34 AM PDT

  •  Devastating argument (0+ / 0-)

    Democrats would be wise to immediately adopt this argument against GOP indifference toward mainstream American society, and hammer Republicans with it daily, from now until November.

  •  It is not just deaths, it is health (2+ / 0-)
    Recommended by:
    FindingMyVoice, Piren

    Deaths are easier to quantify, but poor health is another drag on the system, reducing productivity

    by chloris creator on Sun Apr 20, 2014 at 05:45:35 AM PDT

  •  This is by design (2+ / 0-)
    Recommended by:
    dagnome, Piren

    It is a core feature of their drive to thin the commoner herd.

    Absolutely irrefutably nothing less.

    Thanks for noticing.

    And providing me some more fine stats.

    Legal means "good".
    [41984 | Feb 4, 2005]

    by xxdr zombiexx on Sun Apr 20, 2014 at 05:50:07 AM PDT

  •  Wisconsin (0+ / 0-)

    It should be pointed out that here in Wisconsin (to my knowledge) there is no Medicaid gap. By this I mean there is no one who is too poor for subsidized exchange coverage but too "wealthy" for Medicaid. Medicaid (BadgerCare) eligibility was very high in WI, due to a waiver, and many blue-collar families were covered. Walker lowered this to 100% of FPL and subsidized Exchange coverage kicks in at 100% of FPL.

    I'm not a supporter of Walker and I'd prefer single payer but I keep seeing that thousands will die in Wisconsin in the Medicaid gap but it simply isn't true. Please stop. Focus on states like Texas or Georgia where it is actually the case.

    That, or show me how I'm wrong.

  •  Far More Millions Will Needlessly Suffer (3+ / 0-)
    Recommended by:
    FindingMyVoice, dagnome, Piren

    Beyond the deaths to be caused by non-expansion of medicaid, far more will live lives of pain and suffering.  They will not be able to afford the drugs and treatments they need to live normal (or at least near normal) lives.  Instead they will have to suffer through life with chronic diseases which if they had affordable access to health could be cured or made tolerable.

    We shouldn't forget these people and the suffering they are going through because of Republican politics.

    "Some men see things as they are and ask, 'Why?' I dream of things that never were and ask, 'Why not?"

    by Doctor Who on Sun Apr 20, 2014 at 07:30:16 AM PDT

  •  Soon Those Constituents Will Come Knocking.... (0+ / 0-)

    at their door.  They could have been insured too if the Republican legislatures & Governors they voted for had expanded Medicaid.

    But no.....

  •  Sickness or savior? (0+ / 0-)

    If there was a virus that selectively wiped out the right wing would it be a disease or a gift from God?

  •  It is at your great personal peril, Dear Repubs/ (0+ / 0-)

    Baggers, that you continue to deny health care coverage for your constituents who so desperately need and deserve it! Among the obvious fallout is an extreme loss of votes for you, which is also richly deserved. But over time, when you finally conclude that the ACA is here to stay - yes, it is not going away - and you begin to realize how badly you sabotaged millions of innocents through your petty small-mindedness, because the thing you despise more than anything else is seeing our current president achieve success at anything. And we all know that you detest him so much because of the color of his skin. Great way that you all have of taking the moral high road. Wish I could be like you! Thanks so much for your assistance and support.

  •  It is only a matter of time before the voters (0+ / 0-)

    themselves who live in these states whose governors and legislators have chosen to refuse Medicaid expansion, thereby denying health care to their neediest citizens, will experience a long overdue awakening and let the dirt bags know how they feel when they go to the polls. Guess the most we can do now is make sure there are plenty of porta-potties stationed at the voting venues.  

  •  Death panels (0+ / 0-)

    Who would have thought back when the Republicans were warning everyone about death panels that would prevent Grandma from getting care or allow Sarah Palin's little son to die, that these panels would really come into existence; they are otherwise known as Republican legislators and governors who refuse to apply for Medicaid assistance on principle.  That actions are responsible for additional preventable death, if the people had only received care.  To misquote Pogo- The GOP has seen the enemy and it is them.

  •  Sarah Palin was right (0+ / 0-)

    Obamacare did initiate death panels.  She was just wrong about who they would be. The Death Panel is the Republican Governors' Council.

  •  Should the govenors (0+ / 0-)

    and the legislatures who refused to expand Medicaid be charged with man slaughter?

  •  A staggering figure.... (0+ / 0-)

    Had an illness in 2011 that put me in a county hospital for 7 nights and 6 days.  The bill without all the tests was $27,500.  I am sure that same stay in 2014 is well over $30,000.   We all have stories to tell.  Healthcare is the single most bankrupting thing that can happen to anyone struggling.

  •  Health Care Is A Privilege (0+ / 0-)

    for those who can afford it. Everyone else will simply have to suffer debilitating illnesses or die. We don't care.

    Conservative Haters and Bigots of America

  •  Federal government should do Medicaid single- (0+ / 0-)

    handed in states that reject it.

  •  Looks like the GOP has the dreaded "death panels." (0+ / 0-)

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