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Mitch McConnell and Paul Ryan Are Trying to Kill People For a Tax Cut

[ 94 ] June 28, 2017 |

TrumpCare is a plan to inflict preventable death, suffering, and/or financial ruin on large numbers of people to pay for a massive upper-class tax cut:

The Congressional Budget Office projects that if the Senate Republicans’ health care bill becomes law, 14 million Americans will lose their health insurance in 2018, and, by 2026, 22 million would lose coverage.

Drawing on that work, we estimate that if the Senate bill becomes law, 22,900 excess deaths will occur in 2020 — and the figure will grow over time. 26,500 extra deaths will take place in 2026. Over the next decade, we estimate that a total of 208,500 unnecessary deaths will occur if the law is passed (see Table 1).

We also calculate anticipated additional deaths, state by state, using state-level coverage losses for the year 2026 (see Table 2). The predicted excess deaths by state range from 30 in North Dakota to 2,992 in California in 2026 alone.

Some commentators have argued that it’s inappropriate — beyond the pale — to suggest that people will die as a result of this legislation. To the contrary, we contend that no debate over a health care policy can ignore evidence that it could have negative effects on health and mortality.

In making these calculations, we draw on the scientific literature demonstrating that expanding health insurance reduces deaths. We specifically apply the results of a particularly robust study of the effects of health care reform in Massachusetts on mortality. Massachusetts’ health care reform — which expanded Medicaid, offered subsidized private insurance, and included an individual mandate — famously served as a model for the ACA. The Massachusetts study looked at county-level mortality data in 2001 to 2005 (pre-reform) and 2007 to 2010 (post-reform), and compared the changes to carefully selected control groups in other states that had not enacted health reform.

For every 830 individuals insured, the authors found, one life was saved. In medical terms, 830 in this context is the “number needed to treat.” To put this into perspective, the colonoscopy number needed to treat is 1250; you need to conduct 1250 colonoscopy screenings to prevent one colorectal cancer death.

Overall, in Massachusetts, insurance coverage expansion was associated with a 3 percent decline in mortality from all causes, and a 4.5 percent decrease in deaths from causes that are especially amenable to being prevented by health care — including heart disease, infection, diabetes, and cancer.

That’s it. That’s all it is. Tell as many people as you can.

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  • MikeEss

    …when Grover Norquist says he wants to “shrink [government] down to the size where we can drown it in the bathtub” this is what it looks like. Government is conceptual and virtual…you can’t actually drown it. But you can quite easily kill people who depend on government. And if you have no moral code or conscience it’s easy to convince yourself that “you can’t make an omelet without breaking a few eggs”, and shrinking government is always a good thing…as long as you’re not the one dying from lack of proper access to healthcare/food/shelter/etc…

    • But you can quite easily kill people who depend on government. And if
      you have no moral code or conscience it’s easy to convince yourself
      that “you can’t make an omelet without breaking a few eggs”, and
      shrinking government is always a good thing…as long as you’re not the
      one dying from lack of proper access to healthcare/food/shelter/etc…

      The true triumph of Moloch is that his Grand Old Party seems to have actually convinced its own loyal voters that shrinking government is always a good thing even when they’re the ones dying from lack of proper access to healthcare/food/shelter/etc.

      • D. C. Sessions

        You really have to admire their ability to do that, don’t you?

        • ArchTeryx

          Tribalism is one of the most powerful drugs there is, and fanaticism knows no bounds. Suicide bombers in one country, people offering themselves and their *families* up as human sacrifices to their tribe in this one.

          • Mona Williams

            One poor man said he had to suffer so his grandchildren wouldn’t have to suffer from the terrible debt. The way we are suffering from our grandparents’ debt?

        • In the way you admire the skill of a man like Yertle McTurtle for making up principles from whole cloth and getting the media to cover them seriously, perhaps. I realise this is probably sarcasm though. (People need to use the sarcasm font more!)

      • DrDick

        And his supporters will be among the hardest hit by this.

        • twbb

          Honestly I think a fair number of them realize it but just don’t care. They figure they’re heading for an early, pain-filled death, might as well take down other people with them.

          • tsam100

            No, they think that once they get a tax cut from their 40K salaries, they’ll be able to buy health insurance. They honestly think that the taxes they pay are the obstacle to fabulous wealth. It’s the immigrants and all the free shit they get, the lazy blacks and their food stamps, salaries that congress members get, unions….

      • xq

        The bill has only 17% support. This isn’t really a case of Republican voters accepting anything due to tribalism.

        • Rob in CT

          Well, on the one hand that’s a low support number. On the other, the question really is how many of the GOP-voting people who disapprove would break from the GOP over passage of the bill?

          There is a difference between “I like this!” and “this kind of sucks but I’ll suck it up because the other side is worse,” but the difference is small (the second reaction is better because maybe some of those people stay home on election day. Maybe.).

    • D. C. Sessions

      if you have no moral code or conscience it’s easy to convince yourself
      that “you can’t make an omelet without breaking a few eggs”, and
      shrinking government is always a good thing

      You’re doing Norquist a disservice. He plainly does have a moral code, as you acknowledge in the bolded text.

      • DrDick

        I think that is properly an “immoral code”. He, like all conservatives, is a selfish sociopath who cares nothing for anyone else.

        • twbb

          Meh, at least it’s an ethos.

  • Denverite

    Come on Scott, you know that we can’t know whether it’s 150,000 extra deaths or 200,000 extra deaths or 250,000 extra deaths, so we have to just disregard that eventuality and above all not talk about it.

    /Dilan

    • sanjait

      Uncivil!

    • Scott Lemieux

      Sorry, I can't pay attention to your comments until you establish your credentials as a medical scholar.

    • Hogan

      Takes me back to the debate about the Lancet study on excess mortality after the Iraq invasion. Apparently if you (don’t) understand confidence intervals, it was possible that the invasion brought people back from the dead.

      American exceptionalism–is there nothing it can’t do?

    • JMP

      Now now, let’s not bicker and argue about who killed who, this is supposed to be a happy occasion!

    • ArchTeryx

      And people called me uncivil for comparing this monstrous bill to Nazi death camps. (Though I’ve actually talked with folks that say it’s closer to an Aktion T4 prelude – something which makes it no less monstrous).

      • JR in WV

        I agree that it is despicable and immoral, they actually appear to plan a genocide of people not willing to vote for them, statistically. Much like the research they did when passing voter-id requirements in most states, poring over census records in order to craft laws excluding racial minorities and the lower paid poorer members of their society (using the word loosely) to select out people more likely to vote for Democratic candidates, and kill them.

        What else would you call that, in some third world country like Africa?

        Extracting people more likely to be opponents and selectively encouraging them to die quickly. Genocide by any definition of the word. Unfortunately, they will discover that when you begin allowing (requiring?) people to die quickly, some will have time to take violent political reaction to the plan, as we are awash in weapons. No one need resort to machetes or knives in this country!

  • El Tigre Sabroso

    I take back all that grumbling I did about my former wife spending $36K on a Harvard MPH. That is some great work.

  • Denverite

    Also, keep in mind that the expected deaths number DOESN’T include deaths to people still on Medicaid resulting from the inevitable Medicaid services cuts that will accompany the loss in funding. When a state Medicaid agency kills off a home health care program causing recipients to be institutionalized, that’s going to lead to some additional deaths, even if Medicaid is paying for the institutional care. Ditto when they restrict access to screening services (colon, breast, etc.). Ditto when Medicaid recipients can’t get appointments with specialists because those specialist no longer see Medicaid patients due to the cut reimbursement rates.

    • aab84

      Also, it’s not like death is the only relevant metric here. Inability to afford a doctor early enough can lead to huge, long-term quality of life problems even if it doesn’t kill you.

      • tsam100

        Which will affect the quality of life for children, parents, siblings, extended family…also place more burdens on schools, hospitals, other service providers…

        • D. C. Sessions

          Quality of life issues are easily solved by increased mortality.

        • ColBatGuano

          But that pales in comparison to the beautiful, beautiful tax cuts!

      • including non-health-related issues like bankruptcy

      • It’s probably also worth noting that those long-term quality of life problems will still end up shaving years off many people’s lives.

        • D. C. Sessions

          True, it will shorten their lives and reduce their overall economic productivity. The good news is that thanks tot he advance of technology the US GDP is not really dependent on those individuals. Those lost to health issues can simply be replaced by others currently unemployed, so production won’t drop.

          Since all of the so-called “safety net” will be contingent on employment, the losers who get ill or injured [1] won’t divert any resources from higher priorities such as finance-sector bonuses while they’re dying.

          [1] By the way — will there be time this year or next to repeal and replace OSHA and similarly counterproductive regulations?

          • Lot_49

            And really, the so-called “Clean Air Act” and “Clean Water Act”—it’s all fixed now, so let’s get rid of those superfluous regulations and get back to business!

            • JR in WV

              Clean Water Act doesn’t apply in Wilmington NC, nor in Charleston WV, nor in Flint MI, nor… well, lots of places. Drink at your own risk!

      • JKTH

        Definitely true. It’s just easier to say “people will die” than “people will lose a lot of quality-adjusted life years.”

    • N__B

      Did the CBO include the degradation of care from rural hospitals closing?

      • Denverite

        Nope.

        • N__B

          So the numbers we’ve been seeing on mortality are too low. Lovely.

  • patrick II

    I see various tv talking heads and dem supporters of aca talking about how many people would lose insurance. I do not see enough of them talk about how many lives will be lost, or bankruptcies caused or people living with painful but operable conditions (such as a torn meniscus or herniated disc). Health Insurance is a means to an end — healthy people not living in fear of losing everything they have because of an illness — health insurance is not the end. So I am very glad to see this post by Scott, and wish more people would talk in these terms. Even if it might cause some hurt feelings on the other side.

    • Hondo

      What? Hurt feeling on the other side? Forget to use the sarcasm font?

  • sanjait

    It’s equivalent to the number of fatalities that occurred on 9/11 happening every 1-2 months, as a direct result of the bill’s cuts to healthcare expenditures.

    What strikes me as even more shocking is to consider how this increased mortality is occurring in the non-elderly population. It takes a huge downgrade to overall public health for an additional few tens of thousands of annual deaths to occur.

    • tsam100

      Which will mean we need to invade (throws dart at map) Turkmenistan! WMD! Mushroom clouds! Choo choo trains with chemical weapons! Anthrax! Pineapple on pizzas!

    • D. C. Sessions

      Rome wasn’t burnt in a day. The older undesirables will have to wait their turn; all of that FICA income that’s currently being wasted on them can be better used to offset more tax cuts once the current round are done.

  • aab84

    Well, everyone knows not having access to health care increases your chances of death. What this bill presupposes is . . . maybe it doesn’t.

  • LeeEsq

    They aren’t trying to kill people, they are trying to sacrifice people. Moloch demands sacrifice and not murder. Obviously this makes little difference to the victims but it makes a big difference to the priest.

    • Well, to be fair, it’s not technically their fault if people choose food over health insurance. Priorities, and all that.

  • zoomar

    What would happen to him if he vetoed the bill?

    • jim, some guy in iowa

      a real House investigation into his Russian connections?

  • hellslittlestangel

    Eh. One 9/11 (3000 deaths) is a tragedy. Fifty 9/11s is a statistic.

    • N__B

      “Tragedy is when I cut my finger. Comedy is when you fall into an open sewer and die.”

  • bexley

    I’m sure they’re willing to not kill people in return for a tax cut too. So long as taxes are cut who cares what spending goes down. That’s not my department says Wernher Von braun Mitch McConnell.

    • Downpup E

      That reporters, after all these years of bad faith & bullshit from McConnell treat him seriously, is a pretty solid condemnation of the entire industry.

      • Brad Nailer

        I’m still waiting for somebody on TV to remind us that Neil Gorsuch doesn’t belong on the Supreme Court.

        • Archibald Mirenopteryx

          Unfortunately, he does – the Senate voted him in, in the same way they completely refused to vote on Obama’s nominee.

          That’s always been within the perogatives of the Senate, but it was one of our unspoken norms that they acted like a co-equal branch with the executive when it came to Supreme Court nominations. Now they are pretty much the sole power, which means that any seat that comes up when the Senate and the Presidency are split will stay open until that changes.

          The real problem is their side – particularly the evangelicals – treats Supreme Court openings as life or death existential crises and votes accordingly. Our side…doesn’t. And until that changes, the right will control the Supreme Court in perpetuity.

    • D. C. Sessions

      I’m sure they’re willing to not kill people in return for a tax cut too.

      Well, they do have some principles. Not killing people will have to be made up by a larger tax cut.

  • They’re not trying. They ARE killing people for a tax cut.

  • DamnYankees

    The greatest. policy. achievement. ever.

  • Also, you know, people are justifying spending billions on developing robot cars over fewer deaths than this.

    • efgoldman

      people are justifying spending billions on developing robot cars over fewer deaths than this.

      Strictly economic; robo-autos lead to robo-trucks lead to millions of jobs saved = profit!!
      The deaths are just an incidental consequence/cost of doing business.

      • Yup.

      • Downpup E

        Robo trucks = Lousy imitation trains

        The truck drivers that do final point delivery are way beyond machine imitation
        The foolishness that they imagine for long distance is just an artifact of lousy rail design

  • Wm Kiernan

    But what you’re not taking into account is the fact that almost none of those 208,500 Americans who are going to die as a result of this law are rich people. So from Mitch McConnell’s or Paul Ryan’s point-of-view, there is really no down side at all. And on the up side, think about it – a $700-billion tax cut for millionaires! So beautiful, so precious.

  • MariedeGournay

    Killing is their business….and business is good.

    • Hondo

      Republicans: Killing is their business….and business is good.
      If I was into bumper stickers, that would be a good one.

  • waspuppet

    Yet somehow it was — is — fine for Republicans to scream like toddlers that any Democratic/liberal notion regarding foreign relations that doesn’t involve bombing brown people was gonna KILL US ALL and that that’s what we wanted.

    No one went to the fainting couch over that. I wonder why.

  • D. C. Sessions

    As I mentioned previously, this lowball estimate has Ryan and McConnell accomplishing every two years what took Johnson and Nixon four times as long: killing 50,000 Americans.

    Other studies indicate 300 vs. the cited 800. In that case we might get a Vietnam body count every seven or eight months! Just think: by the time Trump’s second term ends, we might actually manage to kill as many people as Jefferson Davis and his co-conspirators. Certainly as many Americans as died in the two World Wars.

    Better yet, this approach is much more precisely targeted. The wars unfortunately Senator’s, Admiral’s, or plutocrat’s son and didn’t kill nearly so many of the female brood stock. This catches nobody of consequence and if anything is even more efficient at getting rid of the breeders and their spawn of next-generation undesirables.

    Hear, hear! Wonderful work, Gentlemen! What will you do for an encore?

  • Yixing’s Fluffer

    GOP 2016: F-ck yer feelins’!!!
    GOP 2017: The Democrats’ overheated rhetoric is a threat to our proud tradition of civil discourse.

    • Sly

      Americans 2016: Man this year sucks I can’t wait for it to end.
      Americans 2017: Please call your Senators and ask them not to kill us all.

    • SatanicPanic

      No one from the Party of Trump (POT), ever gets to talk about civil discourse ever again. If I hear this in real life I plan on immediately grabbing my phone and searching for “Trump Access Hollywood Video” and letting it play for them.

  • at least they didn’t propose 2nd Amendment Solutions to cap lifetime spending .

    “Hi, I’m from Aetna. And I’m here to pop a cap in your gramma!”

    • hellslittlestangel
      • Cheap Wino

        What’s funny about that, after the moronic NRA thing, the not very bright doctor mentions why not let communities provide their own health plans. Um, yeah. It’s the start of a really good idea. In fact, why not ratchet up the effectiveness of that idea and let the federal government provide a health plan for everybody? I love it when right wingers don’t realize that their ideas actually support progressive policy.

    • D. C. Sessions

      That’s an excellent suggestion, and adding it to the Senate bill after the break is bound to swing some of the right-wing holdouts.

    • That sounds like a pretty good SNL sketch in the making

  • Karen24

    You know the worst part of this? It’s not even a tax cut for millionaires. My husband and my mother each have about a million cash tucked away in investment accounts, but they won’t get more than a paltry couple hundred dollars off taxes. The overwhelming majority of the money goes to BILLIONAIRES — people who spend our kind of total wealth on shoes each year.

  • DrDick

    The GOP is the Party of Death, and has been since Goldwater.

  • Lot_49

    “Analysts who say health insurance doesn’t affect mortality are wrong,” per the Vox subhead. Actually people who assert that health insurance doesn’t affect mortality are propogandists. Or liars.

  • bluicebank

    I believe even a callous, rich Republican fails to understand the law of unintended consequences. If a significant fraction of the population is without health care, the odds of an epidemic increase. The longer people delay or even avoid medical attention after contracting a communicable disease equals a greater number who are infected.

    So while the selfish may not care about the poor, they forget that disease knows no class boundaries. Anyone want a Spanish Flu epidemic? How about a TB outbreak? I would argue that supporting universal health care can be not just compassionate, but inherently selfish. I may not care a whit about others, but I care about myself. And I want poor and rich alike to go straight to the hospital if disturbing symptoms of illness appear. Because I don’t want to walk around in a surgical mask.

    • jim, some guy in iowa

      “penny-wise, pound-foolish” describes a *lot* of the libertarians & conservatives (yes a distinction with very little difference) of my acquaintance

      • tsam100

        Even that–one way or another, bare minimum health care ends up getting paid by people with insurance or the government. You can’t see it directly, but we do pay for that shit.

        • D. C. Sessions

          And usually with a surcharge for all of the bass-ackwards handling.

    • brendalu

      Maybe when the valets and wine stewards start calling in sick they’ll notice a problem.

      • Hondo

        Better: It would be fitting for someone working in food service at a high dollar restaurant, who previously had insurance but loses it because of all this, can’t go to a doc, can’t afford the day off, so has to continue working, and spreading their disease to every table served. Vengeance is a dish best served with stomach flu.

  • randy khan

    Sharing this is an obviously good idea, and putting it on Facebook attracted my pet troll, who I hadn’t seen in a while, so that was a bonus.

  • Racer X

    So it seems pretty certain that it can be proven that this law will indeed cause seriously bodily harm and/or death.
    Then wouldn’t it follow that in some states that a person with a pre-existing condition that would be threatened by this law would then have no duty to retreat from any place where they have a lawful right to be, and that they may use any level of force if they reasonably believe the threat rises to the level of being an imminent and immediate threat of serious bodily harm or death?

  • Brendan O’Shea

    I absolutely love the “New ACA replacement looks promising” line right above that image of Ryan with the whiteboard

  • e.a. foster

    during the republican debates some one shouted out that if people couldn’t afford health care it was O.K. that they died. That is most likely how many of the Republican elites feel. Those who can’t afford health care don’t count. Now it may come as a surprise to some of those Republicans that many who can’t afford health care are Veterans and people who voted for Trump, but alas, they still won’t care. For these Republicans all that matter is that the financial elites should have tax cuts. Now what would be entertaining is if they did an opinion poll amongst these financial elites and asked them if their tax cuts were worth the deaths of their fellow citizens, many of them children. In my opinion, in their haste to curry favour with their financial supporters and financial elites they forgot to ask them if they wanted a lot of dead kids. it would appear the Republicans don’t care how many children die. Lets see how they feel when people start dropping off the bodies at the offices of these Republicans.
    If the Republicans are so dumb as to think the lack of health care won’t contribute to deaths they ought to compare the death rate of children in European countries, Canada, Cuba, and Japan to the U.S.A. and any number of other countries which do not provide health care for their citizens. Or better yet let some of those Republican politicians and their families go without health care and medication for a year and test their theory. after a few of them die perhaps the rest will get the message.
    Canada adopted a national health care policy and fewer people died. We live longer. There is a lower mortality rate amongst children and it isn’t just because we live in the north.
    Oh, well many who voted for Trump and his ilk will now see what they have wrought. Perhaps next election they will vote for something which will benefit themselves and their children.

    • Rob in CT

      during the republican debates some one shouted out that if people couldn’t afford health care it was O.K. that they died

      That was in the 2012 primary debates (in SC?). Ron Paul was asked the question, I think, and multiple people in the audience took up the chant “let them die, let them die!” which was… nice.

      I’d love to have the Canadian system, though that model wouldn’t necessarily be as good in the US (the provinces run it, right, which here would mean the states, which means that it would probably suck in heavily R states).

  • TimJ

    According to Fox News you are inciting violence by pointing that people will die as a consequence of the Republican health care plan.