GOP "Let Him Die" Flare-Up Demonstrates Need For Reality Check

Over the course of the last two weeks the Republican nominees for president have had a chance to strut their stuff in two national debates. Just as prominent as the comments of candidates attending the debate, the behavior and reaction of debate audiences has been making headlines nation-wide.

During the MSNBC/Politico debate last week, the audience cheered when debate hosts noted that Rick Perry had overseen a record 234 executions in his term as governor of Texas.

Perhaps more shocking was the audience reaction to a question concerning health care insurance on Monday’s CNN Tea Party debate. In a hypothetical question, debate moderator Wolf Blitzer asked Rep. Ron Paul (R- Texas) whether a 30-year old man who chose not to purchase health insurance should be allowed to die if he cannot secure treatment for a serious accident. Before Paul could answer the question, shouts of “Yes,” cheers, and applause erupted from the audience in response to Blitzer’s morbid outcome.

This reaction was yet another unsettling snapshot of the Tea Party electorate’s worldview. What’s worse, Blitzer’s question was overly friendly to libertarian talking points, ignoring the realities that many in the audience seemed all too quick to forget.

Firstly, Blitzer’s hypothetical insurance buyer was a 30-year old man who could afford insurance but chose not to. This is miles removed from the reality that millions of uninsured people are not uninsured by choice. A 2009 study by the Employment Policies Institute estimated the number of uninsured individuals unable to afford insurance at 22 million Americans. That’s 22 million citizens who don’t have the choice of Blitzer’s hypothetical insurance buyer. Are they left to die in the streets as well?

Second, Blitzer’s uninsured man came to the debate conveniently alone. Being that the average age of marriage in the United States is comfortably below 30 for both men and women, it is safe to assume that reality won’t necessarily reflect Blitzer’s hypothetical. Moreover, with the average number of children hovering around two per family, the audience’s reaction to Blitzer’s question becomes significantly more macabre.

What if we expanded the scenario to a more realistic hypothetical? Imagine that the 30-year old man had invested intelligently and responsibly, putting a down payment on a house he could afford in a reasonable neighborhood for his wife and children. Unfortunately, with the housing market crash, imagine that his mortgage is freshly underwater through absolutely no fault of his own. Now let’s imagine that the wife stays home to take care of the young children (as nearly 25% of married women with children do). If they bear any resemblance to the majority of uninsured families in America (even those earning 400% over poverty level), their total financial assets will be below $4,100. For reference, hospital bills under $10,000 accounted for less than 10% of total care billed to the uninsured.

Finally, let us take another look at Blitzer’s hypothetical. What if this 30-year old married father of two failed to purchase insurance (either through an inability to afford it or through a conscious decision not to)? What would happen if he were left to die in the street? What would happen to his wife? His children?

It is inescapably ironic that an ideological framework that vehemently protests the teachings of Darwin seems to hold Social Darwinism in such high esteem.

Paul’s suggestion of “turning to charity” is the popular talking point in response, but one that suffers from a lack of empirical support. It is worth noting Paul’s home state of Texas suffers from the highest percentage of uninsured residents in the country.

Total charitable giving in 2010 was just under $300 billion, which included all forms of charitable giving. Of those $300 billion, less than 8% (some $23 billion) went to “health-related organizations.” By comparison, the estimated cost of uninsured health care provided annually is up to $73 billion. 

Would usage rates change if individuals were forced to be choosier about seeking health care? Sure. Would individuals donate more money to charity if they paid less in taxes? Maybe. Will the relative increase in charity be enough to cover situations like Blitzer’s hypothetical man? Unlikely.

The danger in playing with ideological hypotheticals is that the platitudes used to answer them often perpetuate the misinformation that causes so many of the problems in our modern political discourse. How else does one square the rage over non-existent government “death panels” with the hand of the market dictating death on those less fortunate? Is the mythical libertarian cure-all of “personal choice” really the answer? What about those who have no choice? What about their children?

While some candidates were quick to distance themselves from the audience’s reaction after the debate, it was telling that no candidate on stage raised their voice to disavow the audience’s reaction.

Now look, I understand that it is primary season and that candidates are going to try harder to appeal to the party fringe in order to secure the candidacy. But, at the end of the day, the chosen candidate will have to explain his or her positions to the general electorate and those explanations will have to be based in fact and reality, not ideology.

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