As the Republican Party begins to define itself for the 2024 presidential election, Republican philosophies on healthcare are coming into focus. It’s not that the government is here to help you. But it should be allowed to get in the way.
Wednesday night’s debate, which featured eight leading non-Donald Trump candidates as Republican candidates, spent little time on healthcare, aside from lengthy exchanges on abortion, and boxers. Rachel Cohen covered in detail.
But when you combine the abortion controversy with other moments in which medical care briefly took center stage, the party’s position on federal power in the medical field begins to take shape. When it comes to abortion, medical care for transgender people, and even mental health care, candidates blithely flexed government powers to dictate treatment conditions.
But when it comes to using the same powers to protect people during a global pandemic, or to provide health insurance to low-income people, they don’t want governments involved.
Republican candidate wants to use state power to limit healthcare
Abortion – Fox host Martha McCallum picks up ‘losing’ political issue for Republicans since Supreme Court overturns Law vs Wade — Former South Carolina Governor Nikki Haley led to a controversial exchange that urged fellow candidates to go head-to-head with Republican voters: a nationwide abortion ban, given the political realities of the U.S. Senate would be difficult to pass.
Haley was largely an outlier, but North Dakota Gov. Doug Burgham also argued that the issue should naturally be left to states under the Tenth Amendment. Former Vice President Mike Pence and South Carolina Senator Tim Scott have vehemently called for a 15-week nationwide abortion ban. Scott argued that decisions about abortion policy should be taken from the states. Elected legislators who are closest to affected pregnant women and who conservatives have traditionally argued should determine abortion policy cannot be trusted to set abortion policy on their own. .
“You can’t allow states like California, New York, and Illinois to allow abortions on demand until the day you give birth. That’s immoral. It’s unethical. It’s wrong,” Scott said. received applause from an audience of Republican primary voters. (For the record, fact checkers have repetition Fixed Republicans have made similar claims in the past, criticizing only 1% of abortions after 21 weeks.)
“We need a president of the United States who will advocate and fight for a limit of at least 15 weeks,” Scott continued.
The premise of the anti-abortion movement is to involve the state in life-changing medical decisions that are handled privately between doctors and patients. Despite the evidence of the economic and health impact of abortion restrictions, and despite the political loss Republicans have suffered since the Supreme Court denied abortion the enshrined right to privacy. , egg, Scott and others reaffirmed their determination to keep the state in its position. The crowd roared.
The myriad of conservative laws passed in the past few years to limit transgender rights and access to gender-affirming care, mentioned only obliquely in the discussion, convey the same message. I was telling you. Florida Governor Ron DeSantis touted his own track record of “losing”.[ing] Gender ideology from our K-12 schools. North Dakota Gov. Doug Burgham defended signing a bill banning certain students from participating in school sports. In his closing remarks, Scott vowed, “If God made you male, you would play sports against males.”
As Kaitlyn Burns wrote for Vox in 2021, healthcare itself has transformed itself around the theme of gender diversity and gender-affirming care. Historically, people who identify as a different gender than the one they were assigned at birth have been viewed as having a disability that needs correction. More recently, most doctors have come to believe that such patients should be treated more humanely and aggressively. Allowing them to undergo a social transsexual (change of name or pronouns, use of a different toilet, etc.) is taken for granted. Medical interventions for young people are handled on a case-by-case basis.
But as Republican candidates’ comments in the debate made clear, Republican candidates have little interest in even allowing transgender youth to transition. And in state legislatures across the country, parties have tried to limit this kind of medical care as much as possible.
“Trans advocates point out that these bills fit comfortably into the larger Republican plan to seize power of minorities for the purpose of enforcing their preferred gender power relationships,” Burns wrote. Ta. It is the state, not individuals or doctors, that determines the conditions of medical care.
In one of the night’s most shocking developments, businessman Vivek Ramaswamy has called for the reopening of “mental health institutions” that the state has closed for decades to cut costs. I tried, but mostly failed. — Investing in more humane home and community-based services. He envisioned housing more people with mental health problems in these institutions as one of the most important ways to combat crime.
“The same time we closed mental health facilities, violent crime skyrocketed. Do we have the backbone to bring them back?” “I think it should. As president, I will.”
I have was interviewed People who were subjected to the cruel treatment that was common in old mental hospitals. A new mental health paradigm focuses on treating people on the spot. The United States has struggled to build an adequate mental health system given the scale of the country’s needs, but some frontline workers believe that a return to the system could be the key to solving the mental health crisis. Few would argue that there is.
But Ramaswamy, the biggest Republican primary sensation outside of Trump so far, does. He tacitly acknowledged that “drugging people with Zoloft and Seroquel in psychiatric facilities” was part of the program (but that’s not all. He also made up the American Also wanting to return to patriotism, faith and family who believes to do) characters).
It demonstrated an astonishing willingness to use state power to sabotage the ability of certain people, especially those historically marginalized, to achieve health and well-being, and that was the consistent pattern of the night. was the theme.
Republicans still don’t want government to help people get health care
What positive actions candidates will take to improve people’s health was commonly ignored in the first debates of the 2024 election campaign. No candidate presented an agenda for health care reform because Republicans are still in the wilds of health care policy after failing to repeal and replace the Affordable Care Act.
But on a few special occasions, it became clear that while the Republican candidate was quite comfortable interfering in certain health care decisions, he was also using the same governmental powers to control access to health care. It still opposes providing assistance to those in need and protecting those whose health is at risk in emergencies. public health emergency. They will still cling to the surface of small government and individual liberties in certain circumstances.
The most obvious moment was when Mr. DeSantis asked a series of questions about the economy and emphasized his intention to sidestep a public health deal on COVID-19.
“Why are we in this mess? The main reason is how the federal government dealt with COVID-19 by shutting down the economy. That should never have happened,” he said. “In Florida we got our country out of lockdown. We kept our country free and open. I will never allow it.”
DeSantis’ pandemic record is complicated, and I covered it in detail earlier this year. Simply put, yes, the state enjoyed an early economic recovery as pandemic restrictions were lifted, but it also performed moderately in terms of health outcomes. DeSantis also pushed for embracing vaccine skepticism beyond lifting lockdowns, including empowering vaccine skeptics to state medical commissioners. Experts who have watched the administration’s response closely believe Mr. DeSantis’ flip is detrimental to public health and, above all, politically calculated.
But the governor who signed 6 weeks abortion ban and Prohibition of gender-affirming care for minors Impose new requirements on such care for adults, and place the state firmly at the center of individual medical decisions, while unwilling to use the same powers to ultimately curb the spread of the virus. said proudly. killed Over 1 million Americans, including 80,000 Floridians.
Another brief moment on another subject reinforced the same idea. When Haley tried to blame the Republican Party for its role in the recent increase in government spending, she cites an increase in Medicaid enrolment following the enactment of emergency policies that allow people to stay on the program’s roster. did.
“Our Republican Party did the same to us. When we passed the $2.2 trillion coronavirus relief bill, 90 million people got Medicaid and 42 million people got food stamps.” ,” she said. “Nobody told me how to fix it. I’ll tell you how to fix it. They need to stop spending.”
Her point was clear. Even during the pandemic, it was a problem that so many people enjoyed government benefits and didn’t have to worry about health insurance. As it happens, the government is lifting its emergency policy. millions of americans As a result, you will lose your health insurance.
No one asked the Republican candidates what they could do to address the dramatic increase in uninsured rates that would result. As Wednesday night’s debate made clear, they don’t think it’s the government’s job.
But if you are a certain kind of person who needs a certain kind of treatment, they are willing and willing to put the state between you and your medical care.
