Another day, another heartless pronouncement from a high-powered Republican politician in Washington, D.C. about healthcare. This time, it was a Trump's budget director Mick Mulvaney suggesting sick people don't deserve health care because of the bad choices they've made. You know, because all illnesses besides congenital heart diseases come as direct consequences of poor decisions, or something. No matter how untrue that statement is, or how cruel it is to base a nation's health care plan on it, this is the belief that Mulvaney, the Office of Management and Budget director, expressed during a speech at the the Leaders in Global Healthcare and Technology forum.
This came after someone asked him about the "Jimmy Kimmel test," referring to how the comedian opened up about his newborn son's heart condition and said that cost shouldn't come into play when it comes to a parent protecting their child's life. In response, Mulvaney fell back on the conservative talking point that the American Health Care Act's (AHCA) high risk pools provide plenty of money to cover people who are sick — but he seemed to divide sick people into two groups: those who deserve care, and those who don't. Healthy people, he implied, shouldn't have to "take care of the person who sits at home, eats poorly and gets diabetes.”
"We have plenty of money to provide that safety net so that if you get cancer you don’t end up broke,” Mulvaney also said. So, basically, he believes that some illnesses are deserving of care — but only if you couldn't have done anything to prevent them. What if it's skin cancer, and you spent your childhood playing in the sun without enough sunscreen? What if it's lung cancer, and you were a smoker for a few years in college? Would those high risk pools refuse to cover you, while at the same time providing for the person who got lung cancer strictly from second hand smoke? Or does the decision to go out to restaurants before widespread smoking bans also put you in the undeserving category?
It's bad science to say that people's behavior always determines their health, but bad science hasn't stopped the Trump administration in the past. Even diabetes, Mulvaney's example of a disease that comes from poor life choices, has various risk factors, including genetics. Education and income also have proven effects on health, but that's not something that the conservative viewpoint likes to take into account. Republicans have often suggested that poor people are poor because they deserve it — and now, apparently, a lot of sick people are sick because they deserve it, too.
If this viewpoint sounds callous, it's because it is. Unfortunately, it's one that anyone who supports the AHCA and its changes to coverage for people with pre-existing conditions is at least tacitly embracing. The U.S. is one of the richest countries in the world, and it has enough money and resources to provide health care for everyone, no matter their ailment and financial ability to pay for their care. No sick person deserves to stay sick — but at least Mulvaney and all the rest of them are now admitting that they disagree with that.