The Republican “American Health Care Act(AKA AHCA), (AKA tax cut for billionaires) also known as Trumpcare or Ryancare, and The Affordable Care Act (ACA), also known as Obamacare, clearly represent two vastly different ideologies. The first is representative of the ideology of the solitary hunter, like a leopard, who wins by dominating the others. In this system, there are phenomenal winners – but very few of them. And a lot of losers, who are left out and left behind. The second is representative of the ideology of the herd or the pack. We take care of each other, and measure our success by how many people we help, not by how many people we exploit. This is known as the social contract, the unspoken principles by which we are associated. We are our brother’s keeper. Understand, this is our choice, each of us.
The AHCA delivers most of its benefits in the form of tax breaks, which mostly benefit people in high tax brackets. Those people in high tax brackets object to the ACA, because they feel it is a wealth transfer scheme. They never seem to realize that their high income, and indeed, the whole economy, is a wealth transfer scheme, from the poor person’s labor to the rich person’s bank account. The ACA delivers its benefits in the form of support for those who are struggling economically. The AHCA touts its claim to offer equal access to all Americans, which it does. A $14,000 per year policy is equally accessible to a person earning $300,000 per year and a person earning $26,000 per year. Not surprisingly, this seems fair to the person earning $300,000, and not to the one earning $26,000. The first person would be required to devote about 4.7% of their gross income to healthcare. The second would need to devote more than 50%. In the second scenario, equality is considered equality of opportunity and outcome, rather than a strict rationing of dollars. The Better Care Reconciliation Act (Senate version) includes most of the same concepts as the AHCA, but includes draconian cuts to Medicaid.
Some would argue that the $300,00 per year American deserves a better policy, because (s)he has worked harder for it. But that’s not true. There are plenty of $26,000 a year workers who work very hard, and there are plenty of $300,000 citizens who don’t work very hard at all. It’s a sad fact that there are some lazy cheaters in the world, but they’re not characterized by poverty. The malaise cuts across class lines. And all those who pick up a free ride make the rest of us pull all the harder to move the wagon forward. Sad but true. There might be a way to change that, but it won’t be by disenfranchising poor people. Paul Ryan would do well to get a little sensitivity training in class consciousness. He is the poster boy for the “takers.”
Whenever a strong argument is made by the proponents of Trumpcare, anecdotal evidence is offered. They will cite someone who had to pay more on Obamacare, or someone who would be better off on Trumpcare. The trouble with anecdotal evidence is that one can always refer to some rare event that supports any position one wants to take. But social policy is not to be formulated on anecdotal stories or rare events, but rather on how it will affect the broad swath of the American people. How a policy affects one person here and another there is not the litmus test, although those cases need to be addressed. But policy has to be determined by its overall effect on most people.
And if we follow the argument of Paul Ryan and the republicans who, amazingly, actually think he’s smart, that we just can’t afford it, that there’s not enough money to insure everybody’s healthcare, just think about a few pennies every hour, extracted from every American who works in a factory, store, lab, office, whatever, every person who works for someone else, all those pennies magically showing up in the bank accounts of the billionaire oligarchs, eventually finding their way to Swiss bank accounts or the Cayman Islands, never to be seen or accounted for again. That’s where all the wealth is that could fund healthcare for all of us. And that’s wealth that’s been produced by all of us. Hey. That makes us the makers.