In debates over healthcare it is not uncommon to hear both mainstream conservatives and “libertarians” insist that healthcare is not right, and therefore those who cannot afford it are shit out of luck.
Some of these folks don’t even shy away from coming out and saying “let them die.”
Of course this is an immoral worldview, but conservatives have a wide variety of excuses for peddling it. In general, they will defend their claims with vague references to “freedom” and “personal responsibility,” often rationalizing letting fellow Americans die by essentially writing mental fan fiction whereby those poor Americans become undeserving. They’re lazy, they have too many kids, etc. Hey whatever helps you sleep at night, right?
But there’s another problem with the whole “let ’em die” attitude, and it extends beyond the realm of healthcare into the broader question of the welfare state itself. As it turns out, we do have historical experience with societies that lacked any sort of significant welfare state. Sadly, there are few Americans alive today who can personally remember that era, and Americans in general have next to no understanding of the Gilded Era. And Victorian Britain? Forget about it.
The important lesson we can get from the history of such times and places is that the sink-or-swim, let ’em die attitude simply does not work, because as it turns out, people really prefer living to dying. To see what I’m getting at, we must first envision how the conservative attitude plays out in their own heads.
In the conservative worldview, the government doesn’t waste money on helping unemployed people or those who need healthcare and can’t afford private insurance (or the prices hospitals arbitrarily set in collaboration with said insurance companies).
This, of course, is supposed to lead to lower taxes, making the government run more efficiently! More Americans get to keep more of their paychecks, and businessmen feel so generous that they create more jobs and raise wages. People who are poor, knowing there is no safety net, have an incentive to work hard and be extra productive, and if they do not- they’re screwed and it’s all their own fault. There’s an element of social Darwinism to it, because the lazy and inept get culled from the herd.
The only problem with this, however, is that in real life people aren’t poor due to their personal decisions or qualities but rather due to the fluctuations of the labor market, commodity prices, injuries or illnesses, generational poverty, sudden divorces, etc. More importantly, nobody who suddenly comes down with an illness or whose relative does simply throws up their hands and says: “Well I guess I should have worked harder so I could have afforded healthcare!” Same thing when it comes to food and shelter. People fight, unsuccessfully perhaps, but they fight nonetheless to survive.
Have you ever noticed how developing countries often tend to have problems with crime of all sorts in their major urban centers? When society orients itself to serve the super-rich and upper-middle class with no significant concern for the poor population, the latter doesn’t just go off into the forest or desert to die. They eke out a living in slums or favelas and they survive. That being said, these areas tend to be rife with crime, crime which can often claim victims among the middle and upper classes. So it was with urban centers in the United States for decades. Ditto Victorian Britain. Same with Moscow in the “Wild 90’s” or some parts of Ukraine these days.
The main takeaway here is that the cost of a laissez faire, “let ’em die” society far outweighs almost any form of bureaucratic welfare state. Most Americans don’t know shit about how their own welfare system works (or doesn’t) anyway, but what’s worse is that they have no idea what happens if you got rid of what’s left of the system. In their mind they put away that extra money they save in taxes and start their own business. In reality, whole areas of cities if not cities themselves turn into dens of crime and murder, the very thing that conservatives are constantly in fear of. If you deny people the ability to survive and get ahead via legal means, a certain portion of them will inevitably take what they need by any means necessary.
This is why the whole debate about healthcare and welfare needs to change. It’s not about “caring for the poor” or being compassionate. To be sure it is about those things on a certain level, but that doesn’t do enough to drive home the imperative. These things must be properly portrayed as an investment in America and its society, an investment in the American people. And this investment is necessary because without it, there is an alternative too terrible to consider and there is precedent to back that up (for this I highly recommend getting this book). Even if someone wants to stick by their immoral position that the poor or those who can’t otherwise afford healthcare should be left to their own devices, this degenerate person should be reminded that their ideal scenario would not play out in the real world the way it does in their head, and for that reason alone their proposal must be dismissed as utterly unworkable.
It matters not what you think these healthcare or welfare recipients are like or whether you think their decisions in life are the right ones. For one thing, you don’t actually know their situation, and what is far more important is that this person or their relatives aren’t driven to carjack you one day because they lack access to the basic necessities of life. If you value wagging your finger at hypothetical “unworthy” poor people you imagined in your head (and a lot of Americans tend to picture that person incorrectly) more than you value living in a developed country with a healthy society, well then perhaps you’re the one whose expendable.