Let Them Die, and Decrease the Surplus Population

An open letter to Paul Ryan and other politicians who aim to destroy and defund essential health care services.

Dear Mr. Ryan,

I am writing to you because your policies would have me lose my healthcare, along with millions of Americans. I am confident that my views on this issue are shared by many Americans, both Democrat and Republican, who will lose access to healthcare under your leadership.

First, I’ll state the obvious: we know you wouldn’t be defunding the ACA if it were called RomneyCare (which is what it actually is). We can see through you.

Quote from articleBut mostly, I am writing because I am heartbroken by the disturbing subtexts I see underneath so much of what you and other Republicans say: punishment, shame, and segregation.

In 2014, you told a story (which turned out to be false, but we know you don’t care about such things) about a boy who turned down the free lunch offered by his school in favor of one in a “paper bag,” like all the other kids. In the fictional story, the boy said that if he had a lunch in a paper bag, it meant someone “cared” about him. You managed to turn this simple anecdote into an argument against the supposed laziness of parents who require assistance, the unlikely equation (by a child!) of “paper bags” to the love and affection of middle-class parents, and, most revealing, you shared your ultimate take on the situation: the idea that impoverished children who receive assistance have “empty souls.”

You positioned yourself as the compassionate one, the Republican who knew better. You are the one with the anti-poverty initiative. Instead, you are just one of hundreds who coalesced behind a known fascist who openly celebrates the destruction of American lives. Let me be clear: the person with the empty soul is you.

Health care and poverty assistance are not the same thing. But you seem to think of them in the same way: you seem to believe that poverty or ill health are deserved outcomes. Your anti-poverty proposals are based on the myth that people can bootstrap their way off public assistance. Those poor people wouldn’t be poor if they worked harder. Those people wouldn’t be sick if they hadn’t done something to make themselves that way. Study after study (after study!) shows that this just isn’t the case. There are no bootstraps, just like there are no welfare queens — and people do not deserve their own sickness. If you believe otherwise, you’ve been reading too much of that fake news.

Punitive responses are often fear based. “If I don’t do xyz, I won’t end up like them.” It’s a belief that allows you to ignore the fact that most of these situations are accidents of birth and luck. Given that you subscribe to it so fervently, the best I can tell is that you are absolutely terrified of ending up poor or devastatingly ill. So let me ask you, Mr. Ryan: which frightens you more — being sick and/or poor, or being sick and/or poor with no tangible means of escape?

When you write policy with your own fears in mind, and then punish millions of people for living a life you wouldn’t want for yourself, your “politics” have become abject cruelty.

America doesn’t have the worst health care of any developed nation. We have the worst outcomes, because our care is held hostage by a stratified, profit-driven system that assigns the best care only to those who are deemed worthy of it. The ACA was the best attempt in recent memory to fix this inequality. Making this system worse — your “high risk pools,” for example (they don’t work, and you know it) — will segregate society by isolating the sick and keeping them down by telling them it’s their fault. Only the healthiest, wealthiest, and by default, the whitest, will survive. From this, I can only infer that inequality is exactly what you want.

This holiday season, you’ll visit with your healthy family, exchange gifts, attend Christmas mass. You’ll share handshakes and hugs with your mirror-like circle of family and friends. Congratulations will be given and received for the ostensible good you will do for our country, and together you will read and recite the words of Jesus.

But you and I know the truth. You’re not listening to the words of Jesus at all. When I think of you and your Republican lawmaking friends, I think of an entirely different set of words:

“Are there no prisons?”

“Plenty of prisons…”

“And the Union workhouses.” demanded Scrooge. “Are they still in operation?”

“Both very busy, sir…”

“Those who are badly off must go there.”

“Many can’t go there; and many would rather die.”

“If they would rather die,” said Scrooge, “they had better do it, and decrease the surplus population.”

Illustration by John Leech, c. 1843.Oh, how I wish you could be visited by three ghosts this Christmas. But I suppose the voices of the American people will have to do, because you will hear from us. Letter by letter, phone call by phone call, one voice at a time until you have heard from everyone whose lives you have altered with your policies; until you have been haunted by the voices of those who died so you could balance a budget; until you are face to face with your bootstrap lie more times than you can count.

My husband and I are self employed, with well managed pre-existing conditions. As it happens, we are not on any sort of government assistance. Like most Americans, the aspects of the ACA that benefit us the most aren’t the subsidies — they’re the provisions of the law that allow us access to insurance in the first place.

If you have your way, we will have to shut down our business to seek employee based health care, or we will be thrown into your “high risk pool,” where we will undoubtedly receive sub-par care which could leave us too ill to work (and then we would need assistance). In other versions of your plan, we would have no health care at all, which could have all sorts of consequences. Our American dream is possible because we are healthy, but you would turn it into a nightmare.

I don’t have any conciliatory messages of hope or reconciliation or forgiveness to offer you, because it should be the other way around. I am saddened at the idea of being governed by the latest in a very long line of men whose idea of  “what is best for the country” means gleefully stripping away my chance at a better life.  And I am angry on behalf of the families of all those who will die without access to life saving care and assistance.

Like millions of Americans, I believe that you do not care about us, but you have the chance to prove us wrong. You have already secured your name in the history books, Mr. Ryan. Now is when you determine what will be written about you.