Senator J.D. Vance has positioned himself as a maverick Republican.
he”Anti-establishment” “Anti-elitismA populist who believes the American social order is “biased towards the minority,” he criticizes traditional economic conservatism. ideology It “subordinates human life and society to the false ideal of a market that exists independently of our society.” His concept of a fair economy is: According to Catholic social teaching Specifically, it calls for “caring for the world’s weak and poor without treating them as victims” and “protecting children and families and providing them with what they need to thrive.” Republican National Convention SpeechVance suggested Trump has similar priorities, praising him for narrowing “the gap between the few who enjoy power and comfort in Washington and the rest of us.”
But many of the Republican candidates’ actual policies show little sign of market skepticism or concern for those left behind.
This is especially true of Trump’s newly unveiled health care plan, at least as it was unveiled on the campaign trail. Disclosed A new “anti-establishment” Republican plan to improve America’s health care system would deregulate health insurance markets, allowing insurers to deny coverage to people who need it most.
The Republican candidate’s depressingly familiar health care plan says two things about the party’s emerging populism: First, its rhetoric is far more innovative than its governing priorities, and second, even if it does favor the “many” over the “few,” it doesn’t favor the weak over the strong.
President Trump’s health care policies favor healthy people over sick people
During last week’s presidential debate, Trump acknowledged that he doesn’t have health care.Planning ConceptThe admission was politically costly, as the candidate who had pledged to replace Obamacare 10 years As he is still considering alternatives, he may not be the most diligent or decisive commander in chief.
But actually revealing what the right (still) believes about health policy may be even more harmful. Vance’s statement On Meet the Press Sunday is recommended.
During the show, NBC’s Kristen Welker asked Vance to explain if Trump plans to change anything about the American health care system, and if so, what it would be. The Republican vice presidential nominee responded, “Of course, Trump has a plan to fix the American health care system, but a lot of it hinges on deregulating the insurance markets, Kristen, so people can actually choose a plan that makes sense for them.”
Vance went on to say that Trump would protect people with pre-existing conditions and ensure everyone has access to the doctors they need, but did not specify how Trump would do this. More importantly, one of the specific policies Vance detailed was making health insurance unaffordable for people with chronic illnesses. Below are the relevant portions of Vance’s response:
[Trump would] Implement deregulation policies and allow people to choose the health care plan that’s right for them. Think about it: a younger American doesn’t have the same health care needs as a 65-year-old American. And a healthy 65-year-old doesn’t have the same health care needs as a 65-year-old with a chronic illness.
We want to make sure that everyone has access to insurance, and the best way to do that is to promote more choice in our health care system and not have a one-size-fits-all approach that puts the same people in the same insurance pool, the same risk pool, making it harder for people to make the right choice for their family.
Vance’s upbeat rhetoric here conceals the unequal moral priorities of his plan.
It’s true that young, healthy people have different health care needs than older, sicker people, and before Obamacare’s regulations, young, healthy people could sometimes get less expensive insurance that was tailored to their (currently) limited needs.
But this came with a social cost: by excluding people with pre-existing conditions, insurance companies were able to offer cheap health insurance to people who least needed it. In Vance’s terms, insurance companies created a low-risk pool: by including only people who were unlikely to need expensive treatment in their plans, they could profitably offer low-premium insurance to young, healthy people.
Meanwhile, in the individual insurance market, sicker and older Americans were either unable to purchase insurance or were forced to pay significantly higher premiums to cover high medical costs. Some state governments tried to alleviate some of these costs by subsidizing high-risk pools, but participants still paid premiums. Insurance premiums are much higher It was below normal market price and often the most needed treatments were not covered.
The Affordable Care Act effectively forced the healthy to subsidize the sick. Insurance companies were required to include people with pre-existing conditions in their insurance plans and cover all necessary medical procedures. To ensure that insurance companies made a profit and that insurance remained affordable (at least to some extent) for everyone, the government offered insurance subsidies to consumers.
In the end, premiums became a little more expensive for some healthy people, but much cheaper for the elderly and seriously ill. If we believe that we live in a society where collective obligation takes precedence over individual freedom, this seems like a good trade-off. Forcing a healthy 27-year-old to pay a little more for insurance is better than forcing a 55-year-old with cancer to give up on treatment or go into deep debt to pay for chemotherapy, especially since the former could find himself in the same predicament at any time.
Notably, Americans have already accepted this arrangement as common sense when it comes to employer-based insurance, which is a small majority of the population. A company’s older or sicker employees do not generally pay higher premiums than their younger or healthier colleagues. Instead, everyone pools risk, and those in better health subsidize those who are less well off.
But for the small minority of Americans who buy insurance on the individual market, Vance wants to dismantle this coercive solidarity. He aims to expand insurers’ entrepreneurial freedom and consumer discretion, at the expense of the poor. Some might say this is a lot like policies that “subordinate human life and community to the false ideals of the market.” Vance clearly disagrees.
Vance and Trump support elite populism
Vance’s vision for health care helps illuminate the nature of the right’s burgeoning “populism.” On trade and immigration, Vance’s ideology may emphasize a statist notion of the common good over the free market. But on most economic issues, his iconoclastic rhetoric betrays a loyalty to conservative orthodoxy, and thus “Ruling ClassSomeone Vance likes to ridicule.
Vance was Trump’s running mate. Corporate tax cuts The rest of Trump’s economic agenda is pretty vague, but if his first term is any guide, it’s also Restricting workers’ collective bargaining rights, Lowering workplace safety standardsand try Kick millions off MedicaidVance sees no need to criticize any aspect of the record.
All of this leads Vance to say,Neoliberalism” he said, hoping to serve the many, not the few.
My guess is that he gave a hint about his intentions the day before the appearance. Meet the Press.
Vance’s main focus in recent weeks has been a fictitious attack on the Haitian immigrant community in Springfield, Ohio, and the pets of its longtime residents. On Saturday, the left-wing commentator Crystal Ball I objected. Vance’s hateful rhetoric contributed to a bomb threat in Springfield.
Vance responded to Ball’s criticism by saying: Blame her She believes that “20,000 cheap laborers should be sent to small towns in Ohio.” To Vance, Ball’s intolerance of the demonization of Haitian immigrants proves that she is not in fact a “populist” but rather, perhaps unconsciously, a supporter of “neoliberalism.”
The latter term is used to describe a range of beliefs, but when used pejoratively, neoliberalism means above all a commitment to unrestrained capitalism.
For Vance, deregulating insurance markets at the expense of the vulnerable is not neoliberal or anti-populist, but arguing that politicians should not spread inflammatory lies about immigration is.
Populism thus construed is not about supporting the weak against the strong: the “few” it targets are not the economic elites (whom it wants to lavish with tax breaks and regulatory preferential treatment), but rather certain categories of disadvantaged people.
Foreign-born immigrants from poor countries make up a small percentage of the U.S. population — and they are also the primary beneficiaries of the ACA’s regulatory reforms. 2017 Report According to the Kaiser Family Foundation, “In any given year, the healthiest 50% of the population account for less than 3% of total health care costs, while the sickest 10% account for almost two-thirds of the population’s health care costs.”
When Vance suggests that the interests of native-born Americans should absolutely take precedence over those of Haitian immigrants, or when he argues that healthy people should not have to bear the insurance risks along with sick people, he is strictly speaking arguing for the many, not the few. (Of course, the idea that immigrants and native-born Americans cannot mutually thrive is at odds with nearly the entire history of our country, and the idea of denying health care to the elderly and sick is deeply unpopular.)
The Republican candidate’s problem with the free market is that it can erode privilege rather than strengthen it. To the invisible hand, Haitian workers are morally indistinguishable from American-born workers. To Vance, however, American-born workers who want to improve their status through hard work and risk are heroes, while Haitian immigrants who want to do the same are “cheap labor” and a social menace.
To be sure, Vance has at times argued for anti-inequality, “populist” policies. But by aligning himself with Trump, he has whittled his populism down to a reactionary core. Republicans support the majority over the minority only to the extent that they support the disadvantaged over the underprivileged. Vance can call it “anti-establishment” post-neoliberalism. I call it establishment conservatism.
