A Kansas Representative Said Poor People Don't Want To Take Care Of Their Health

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There are plenty of reasons why someone might not have health insurance. Maybe they got laid off and lost their employer-provided health insurance. Maybe they aren't aware of the Medicaid options their state offers. Or maybe they simply can't afford it. But Rep. Roger Marshall has a different theory: According to the Kansas Republican, poor people don't want to take care of themselves, and that's why they don't have health insurance. Problem solved! By which I mean, problem ignored.

"Just like Jesus said, 'The poor will always be with us,'" said Marshall, a former obstetrician, in an interview with Stat on Friday. "There is a group of people that just don’t want health care and aren’t going to take care of themselves."

He continued:

Just like homeless people ... I think just morally, spiritually, socially, [some people] just don't want health care ... The Medicaid population, which is a free credit card [sic], as a group, do probably the least preventive medicine and taking care of themselves and eating healthy and exercising. And I'm not judging, I'm just saying socially that's where they are. So there's a group of people that even with unlimited access to health care are only going to use the emergency room when their arm is chopped off or when their pneumonia is so bad they get brought [into] the ER.

Whew. Where to begin with this?

It probably goes without saying that Marshall wants to repeal the Affordable Care Act. But the sheer number of new signups under the law directly undermines both Marshall's opposition to the ACA and his theory that people who can't afford health insurance don't want it: As of November 2015, around 8.9 million low-income Americans had acquired health insurance under Obamacare's Medicaid expansion, according to state estimates aggregated at ACAsignups.net.

Marshall also says that poor people are "only going to use the emergency room when their arm is chopped off." The most charitable interpretation of that comment is that he thinks more Americans should take advantage of preventative care, so they don't have to wait until they've lost an arm to seek medical attention. But if that's the case, why in the world would he want to repeal a law that drastically expanded access to preventative care?

All of this raises an intriguing alternative possibility, one Marshall might want to consider: Perhaps, poor people don't have health insurance because they can't afford to buy health insurance. A radical theory, yes, but one that's supported by the data — and basic common sense.

There are very few things that all human beings have in common, but the instinct for self-preservation is one of them. Our ancestors' drive to keep living is why all of us are here right now. To suggest that poor people somehow lack this instinct is both factually absurd and morally abhorrent. It's hard to imagine why anyone would say that, unless they had already decided to blame poor people for being uninsured and then set out to justify their position.

Rather than criticize low-income Americans, maybe Marshall should consider ways he'd like to change or improve upon the ACA.