Health Care in the Hands of Fascists:
“If They Can’t Afford It, They Shouldn’t Have It.”

May 22, 2017 | Revolution Newspaper |


At the beginning of May, the U.S. House of Representatives, with a strong push by Trump, passed the American Health Care Act (AHCA)—their replacement for Obama’s Affordable Care Act (ACA), which went into effect in 2010. The replacement of the wordAffordablewith the wordAmericanis entirely appropriate. If the AHCA bill becomes law, it will cut $880 billion from Medicaid over the next 10 years—a quarter of the Medicaid budget. Estimates are that 14 million people will lose their health care by 2026.

The Senate is now taking up its version of the health bill, where significant changes will likely be made before there is a final law. But the basic framework is in place with the House bill, so let’s call it what it is. What these ghouls are doing, in the most chilling and grotesque way, is deciding who will live and who will die. Deciding who will have their medical care taken away, and delivering death sentences to unknown numbers of people no longer able to afford health coverage. This is going to disproportionately impact Black, Latino, Native American and other oppressed people, and it is also going to threaten the lives of much broader sections of the poor of all nationalities; those sick with pre-existing conditions, women, and the growing population of older adults.

Disastrous for Women

This bill is disastrous for women. It denies the use of any federal funds at all to go to any services provided by Planned Parenthood (half of their 2.5 million patients rely on Medicaid), doing the greatest harm to Black and Latina women. And in 105 counties, especially rural counties, Planned Parenthood is the only clinic that offers a full range of reproductive health services. That means denying women basic health services like life-saving cervical and breast cancer screenings and access to birth control. This bill could allow insurance companies to define things like treatment for sexual assault, domestic violence, postpartum depression, pregnancy, and Caesarean sections as pre-existing conditions—making women who have these “pre-existing conditions” face higher premiums. And it endangers all abortion coverage—by barring federal subsidies to any insurance plans that offer abortion.

“If They Can’t Afford It, They Shouldn’t Have It.”

One liberal congressman recently told the story of a constituent who, when told that “Obamacare” would provide medical coverage to some people who couldn’t afford it, said that was not a good thing. And that constituent went on: “If they can’t afford it, they shouldn’t have it.” What better way to capture the ugly, reactionary logic at the core of capitalism—that something so basic to humanity as health care is a commodity, which those who can afford it “deserve” to have and those who can’t, don’t. What kind of system and what kind of society breeds this kind of mentality!

And who are the “they” that this asshole and others like him are saying “shouldn’t have it”? Clearly, they’re talking about immigrants, Black and Latino people, Native Americans, and other oppressed nationalities in this country. The reality is that there are all kinds of government subsidies that disproportionately go to white people—and the higher up the economic scale, the better the employer-paid health insurance and the greater the government benefits from things like tax breaks, with the most generous benefits going to those who least need them. (See “Unspeakable Realities Block Universal Health Coverage In America,” Chris Ladd, Forbes, March 13, 2017.)

“Make America Great Again” Health Care

The logic and direction of the new American Health Care Act that the House has passed and Trump has welcomed is completely in line with what the Trump/Pence regime means when they say “Make America Great Again.” A cornerstone of the ideology of these fascists, and the program rapidly being put in place, is the contention that a major cause of America’s “decline” is that—in response to the uprisings of the 1960s, especially the revolutionary movements of Black and other oppressed people—the government has increasingly interfered with the “natural” workings of the cutthroat “survival of the fittest” capitalist-imperialist system by creating and enforcing a “welfare state.” For them, it’s the imagined “government handouts” going to those darker-complexioned “freeloaders” that is to blame for the deteriorating conditions confronting large sections of lower middle class and poor whites. In fact, it is the workings of the capitalist-imperialist system, and the consequences of its global scramble for profits, that is the cause. This is a country that has racist white supremacy and anti-immigrant xenophobia deeply woven into its history and present-day reality.

To fully recognize the magnitude of the crime of turning the Trump/Republican health care bill into law, look at the savage inequalities that already exist today in the access to desperately needed medical treatment of the people at the bottom of this society. (See “Inequality and the health-care system in the USA,” Samuel L. Himmelstein, MD, The Lancet, April 8, 2017.) For the 27 million uninsured, this means no routine medical visits, tests, treatments, and medications because of cost; neglecting chronic conditions; and waiting till it’s an emergency before going for help. It means people with serious psychiatric disorders unable to get care. And on top of that, for Black people and other oppressed people, all of this is magnified through the lens of all-encompassing racism within the medical field. Together with the lack of a healthy diet and the stresses that come from everyday survival in the inner cities, this becomes genocidal in its implications for the oppressed.

Today in this country, the life expectancy of the wealthiest Americans is 10-15 years greater than for the poorest. At the time the ACA was being debated, there were 45,000 needless deaths each year in the U.S. because people did not have adequate health care. The Trump/Pence regime and its fascist cohorts in Congress are fully aware that their “Make America Great Again” hell-care law will mean death for many—with the poor and oppressed targeted at the top of their list. We cannot allow this to happen!





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