Frank's Musings

How do you explain the remark quoted by Eyal Press in his article, “Deadly Principle,” in the April 6, 2020, New Yorker--“Ain’t no way I would ever support Obamacare, or sign up for it.  I would rather die.”?  That sentiment expressed by an Alabama resident shows why it and twenty-four other states have opted out of the expanded version of Medicaid permitted under the Affordable Care Act.  Consequently, low-income residents of those states are unable to pay for some of the essential medical services they mortally need, like early diagnosis and treatment of cervical cancer.  

There are surely a number of medical conditions that will not reach a life-threatening stage if detected early.  Once they have reached a terminal state, standard Medicaid apparently already pays for their treatment.  However, by that time it is usually too late to save a patient’s life.  Many state governments have decided that the expense of minimizing residents’ death is not worth it because they fear that low-taxpaying residents, particularly undocumented immigrants and, tacitly, low income non-white residents, will take advantage of the program to obtain the same preventive health care services that the wealthier strata of the population normally can. 

There is, of course, a source of the resistance to more widespread application of ACA provisions that is separate from the public expense of them.  The current Republican Party has made a deal with the devil by aligning with Donald Trump.   It has attached its prospects for continued political strength to Trump’s appeal to the xenophobia and racism of a resentful segment of the public.  Although he may not share their biases, Mr. Trump has found it necessary to rely on that segment’s support for election victory, as have the Republican state and national politicians.  The latter group of politicians is most interested in expanding their careers.  Mr. Trump, on the other hand, is solely interested in satisfying his ego.

Choosing what our society should pay for on behalf of all of us is a complex challenge.  We have sacrificed trillions of dollars and tens of thousands of lives in fighting off an attack on our common health by an inanimate virus.  But when another frequent and non-willful cause of illness can be associated with alien people, it is often considered unnecessary to alleviate it for everyone.  The deadly principle of politics is that it’s appropriate to take advantage of unseemly prejudice when it serves a politician’s interest.