The debate over Trumpcare has exposed Republican attitudes toward the people they represent more than any debate in recent memory. We've always known that they value some lives more than others, but they don't say it out loud very often—instead, it's dog-whistled most of the time. Now, though, when we're talking actual life and death for millions of people, they're unleashed.
First it was Rep. Mo Brooks of Alabama with his comparison of "those people who lead good lives, they're healthy" and have pre-existing health conditions "through no fault of their own," versus the people who brought it on themselves and therefore don't deserve affordable insurance. Now it's popular vote loser Donald Trump's budget director, Mick Mulvaney, who is doling out health care on the basis of virtue.
A top Trump administration official defended the American Health Care Act, the GOP bill to repeal the Affordable Care Act, by arguing Thursday that it would take care of people who have pre-existing conditions without asking healthy people to pay for those who made poor choices. […]
"We have plenty of money to deal with that. We have plenty of money to provide that safety net so that if you get cancer you don't end up broke," Mulvaney said at the Leaders in Global Healthcare and Technology forum.
But then he drew a distinction between people like [Jimmy] Kimmel's son, born with a congenital heart disease, and people who end up with conditions like diabetes. "That doesn't mean we should take care of the person who sits at home, eats poorly and gets diabetes," Mulvaney said, according to a Washington Examiner account consistent with real-time social media reports. "Is that the same thing as Jimmy Kimmel's kid? I don't think that it is."
The American Diabetes Association would like Mulvaney to understand that life—and diabetes—don't work that way.
"All of the scientific evidence," they say, "indicates that diabetes develops from a diverse set of risk factors, genetics being a primary cause." But asking a Republican to understand, much less accept, scientific evidence is an exercise in futility.
Also impossible is getting them to accept how insurance functions: everybody pays in to cover everybody else, and that's just how it works. They don't want their money going to cover people they believe are undeserving, like women, the poor—anybody who isn't them, basically. They don't think that’s how insurance should work, so they're going to try to make sure it doesn't work that way anymore.