One of the most ludicrous frauds in American politics is Paul Ryan’s ability to convert exactly one note — a Cliff’s Notes version of John Galt’s courtroom speech, with Special Guest Appearances at soup kitchens to make his rapacious support for upward wealth distribution to look like concern for the poor people whose lives his political career is devoted to making worse — into a reputation is a serious policy wonk. But his attempt to defend his we’ll-have-a-plan-soon to strip health care from millions of people is making him look especially ridiculous:
Having the freedom to “buy what you want” sounds good! Only in the context of health care, it’s a disaster for the non-affluent. Many people cannot afford basic health care services, and the vast majority of people cannot afford care for an unexpected major illness. Giving rich and poor people alike the “freedom” to purchase as much health care as they think they need is a cruel joke, not a serious health care policy. And it’s worse than that; people cannot, in fact, reliably predict how much health care they might “need” in the future, which is why insurance is necessary for practical access to health care in the first place.
Ryan is also attacking the regulations that require insurance—both employer-provided and purchased on exchanges—to meet minimum coverage requirements. But this is not “freedom” of any value. Regulations that protect customers from junk insurance reduce their “freedom” in the sense that FDA regulations take away people’s “freedom” to buy beef laced with strychnine. It’s true that under the ACA young and healthy people pay more for insurance than they would under a “free market” in health care, but this is how insurance works: You pay more now so you can afford insurance later. Objecting to the ACA because the young and healthy pay more than they otherwise would is like saying its unjust to pay taxes to support the fire department when your house hasn’t burned down.
While it would be very wrong to be complacent, at least it’s looking more and more likely that Ryan won’t be able to pull ACA repeal off. That members of Congress who actually believe this abject nonsense about the value of the freedom to be bankrupted by and perhaps to be killed by preventable illnesses might be responsible for saving the ACA would be like a black fly in your Chardonnay, but we also have to credit the many members of the public who have stood up to Ryan’s war on access to health care.