Republicans usually defend their health-care position with an array of buzzwords like choice, patient-centric, or competition. In a CNN interview, Representative Mo Brooks, an Alabama Republican, makes the case for Trumpcare in much starker terms: It will free healthy people from having to pay the cost of the sick. “It will allow insurance companies to require people who have higher health care costs to contribute more to the insurance pool that helps offset all these costs, thereby reducing the cost to those people who lead good lives, they’re healthy, they’ve done the things to keep their bodies healthy,” explained Brooks. “And right now, those are the people who have done things the right way that are seeing their costs skyrocketing.”
Watch Alabama Rep. Mo Brooks make the case for Trumpcare on CNN.
It is certainly true that the Republican health-care plan will spur insurance companies to charge more money to people with expensive medical needs, and less to healthier people. (It will also transfer hundreds of billions of dollars from the poor, who will get reduced Medicaid and tax credits to buy insurance, to the rich, who will receive a large tax cut.) The idea that morality dictates healthy people pay less, and sick people more, has been floating around the margins of conservative health-care thought. John Mackey, the libertarian owner of Whole Foods, made this case in a 2009 Wall Street Journal op-ed denouncing Obamacare:
Rather than increase government spending and control, we need to address the root causes of poor health. This begins with the realization that every American adult is responsible for his or her own health.
Unfortunately many of our health-care problems are self-inflicted: two-thirds of Americans are now overweight and one-third are obese. Most of the diseases that kill us and account for about 70% of all health-care spending—heart disease, cancer, stroke, diabetes and obesity—are mostly preventable through proper diet, exercise, not smoking, minimal alcohol consumption and other healthy lifestyle choices.
When Democratic Senator Tom Harkin in 2010 proposed that it was time to stop segregating Americans on the basis of health status, the conservative health-care analyst Jeffrey H. Anderson scoffed, “Having people pay their own way is apparently an injustice akin to segregating them by race or creed.”
Of course, you can’t pay your own way if you’re too poor or sick to afford your own projected medical costs. Indeed, sometimes people who are healthy at the moment find one day they are not, or they have a sick child, or maybe they simply want to have a baby. (The cost of bearing children is another one Republicans want to be borne entirely by those doing it.) The Republican plan expresses one of the core beliefs shared by movement conservatives, and utterly alien to people across the globe, right and left: that people who can’t afford the cost of their own medical care have nobody to blame but themselves.