Ayn Rand would be proud of GOP approach to health care – The Herald-Times (subscription)

WASHINGTON The law, in its majestic equality, forbids the rich as well as the poor to sleep under bridges, to beg in the streets and to steal bread.

The novelist Anatole Frances mischievous observation came to mind when the Congressional Budget Office released its analysis of the Republican cut-taxes/gut-Medicaid bill and its defenders went into a continuous loop talking about freedom. Conservatives are fond of saying that freedom isnt free. This is entirely true, especially when it comes to health care.

Republicans speak of the wondrous things that will happen if they succeed in slaying the monster known as Obamacare.

House Speaker Paul Ryan offered this rush of animated words to conservative radio host Hugh Hewitt: You need to have an individual market where people care about what things cost, where people have real freedom, where those providers of health care services, be they insurers, doctors or hospitals and everybody in between, compete against each other for our business based on value, based on price, based on quality, based on outcome.

Left-wingers are often cast as dreamy utopians, but its Ryan and his allies who pretend they can create a capitalist paradise in health care something that not one wealthy capitalist country has ever done because the health care market is not like any other.

Older people, for example, are not an ideal market for private insurance companies. Thats why we have Medicare. Lower-income people cant afford to pay the full cost of a decent insurance policy. Thats why we have Medicaid, and why the Affordable Care Act subsidizes policies from private insurance companies.

Slash Medicaid and take away the subsidies and, presto, the ranks of the uninsured mushroom.

Defenders of this proposal try to argue that health care is radically different from coverage. They must think the American people are dunderheads.

Coverage is not the end, Mick Mulvaney, director of the Office of Management and Budget, said on MSNBCs Morning Joe Tuesday. People dont get better with coverage. They get better with care.

Well, sure, but try taking your kids to get care from a pediatrician if you dont have insurance coverage.

Ryan urges people to read his bill. If you do, youll realize how many of its pages are devoted not to health care but to tax cuts. According to the CBO, the bill takes $1.2 trillion out of helping people get health care (including $880 billion from Medicaid) and then hands out about $600 billion of that in tax cuts, mostly for the well-to-do and various interest groups, the beleaguered tanning industry being my favorite. This could also be called the Make Inequality Worse Act of 2017.

In his youth, Ryan was a devotee of Ayn Rand, whose philosophy is nicely summarized by the title of her book The Virtue of Selfishness. She would be proud of her one-time disciple. She excoriated the draining, exploitation and destruction of those who are able to pay the costs of maintaining a civilized society, in favor of those who are unable or unwilling to pay the cost of maintaining their own existence.

In other words, government should never take money from the better-off to help lesser souls. In the glorious future created by Ryans bill, they will now be even freer to try maintaining their own existence without health insurance.

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Ayn Rand would be proud of GOP approach to health care - The Herald-Times (subscription)