Republican policy makers see “repeal-and-replace” of the affordable care act as a fundamental test of governance. It has nothing to do with health-care policy, or the rights of participants in a free-market economy.
If it did, they would be forced to recognize that the sick should have the right to change insurers when denied treatment. This is possible only if pre-existing conditions are disallowed as an exclusion for coverage – which means that everybody must have coverage, because otherwise the greedy would wait until they got sick to get insurance.
Against this reality, the Republicans raise the fantasy of “entitlement programs.” This was the specter raised by Salma Hayek in the early 1900’s: democratic governments would face popular pressure to allocate resources from the wealthy to the poor. When such programs were established, it would be impossible to get rid of them, because beneficiaries would only elect those that safe-guarded the program.
But let’s get real about this: the wealthy are beneficiaries of the original entitlement known as private property. This is a fiction established by legal writ and armed might that allows greedy people to allocate to themselves what was once held by the people. The oppressive machinery of the private property state was what destroyed native cultures during the colonial era.
To Republicans, would you surrender that protection? Is it fair that contract law allows insurers to bury exemptions from coverage in impenetrable legal and medical terminology? Is it fair that employers should enrich themselves while their workers surrender health to physical, mental and emotional stress? That is what the entitlement of private property allows: the transfer – without recourse – of energy and wealth to the greedy through a slow grinding down of people who are simply trying to take care of those they love.
Argue the merits of health-care policy. The moral purpose of an economy isn’t to make your donors rich. It’s to provide for the well-being of the people.
And put Hayek away. If you’re going to dismantle state programs, on principle you’ll have to accept that inevitably the peasants will march on your estates with torches and pitchforks, and the proper response of “government” will be to sell the popcorn.