Yesterday, Steve Benen at the Washington Monthly pointed out that Paul Ryan had a piece at the American Spectator Web site. In it, Ryan writes:

The American character itself and the principles of free market democracy which protect and preserve it may be lost beyond recovery if Congress chooses the wrong path to health care reform

Ryan’s core argument is that even though healthcare falls into the inalienable right category, government shouldn’t provide healthcare no more than it should build homes for its citizens.

Before I explain why reading Congressman Ryan’s argument makes me very, very angry, I’d like to unpack it just a bit.

Conservatives are all over the map, claiming that government shouldn’t run healthcare. But so far as I can tell, the legislation working its way through Congress doesn’t suggest anything of the sort. As I understand it, there is a proposal to modernize office technology so that different doctors treating the same patient have instant access to that patient’s records so that duplicate tests and treatments are eliminated, saving time and money. Also, there is a proposal for prohibitions to keep companies from refusing policyholders on the basis of pre-existing conditions and from dumping previously health, premium-paying people after they get sick. So far, so good, right? That’s not the government providing healthcare. That’s the government making requirements of the healthcare industry. Going back to Ryan’s house-building argument, the government regulates who builds my house and how they build it. I assume the Congressman is okay with that.

But now we’re going to get into a couple areas where I think the Congressman has the biggest objection to the reform.

First, the wealthy are being asked to pay extra to provide insurance coverage for people who cannot pay premiums for themselves. The conservative wealthy, and those who are their bitches, always freak out when they hear their taxes are going to increase. But if they stopped to think, and to breathe for just a second, maybe they would understand that if poor people have health care insurance, they will be more likely to go to the doctor when they are sick. This is not only better for public health in general, but it will keep insurance premiums down, since all of us who are paying for insurance premiums aren’t also paying to cover emergency room visits for those who cannot pay. Also, if workers go to the doctor when they’re sick, they get better faster, and back to work faster.

Let’s review. People will get care when they need it, which will lead to people being healthier, which means they’ll be more productive at work, which means business owners will make more money. In addition, premiums for everyone will be lower, because we’re all sharing the risk, which means middle class families will have more money to spend at those same businesses, which means business owners make more money. So, maybe we can file the “Don’t Raise My Taxes” argument under cutting off your nose to spite your face.

The second area that I think really gets Congressman Ryan’s American Character going is a public health insurance plan. This is where conservatives start screaming about Canada and Europe and socialism and fire and brimstone. Or whatever. This is the government running your healthcare! Be very afraid!

Now, I know that the Republican party isn’t getting too many Mensa invitations these days so I’m going to take a minute to explain the concept of insurance for their benefit. See, there are certain unpredictable risks inherent in living. You might have a car accident. Your house might catch fire. You might accidentally call someone a big, fat liar and they might sue you. Or, you might get sick. These are things we don’t have any control over that have the potential to ruin us financially. So, we pay a small premium to an insurance company, which in turn agrees to cover our losses if and when one of these risks becomes a reality. While we hear about these sorts of things happening all the time, as a percentage of our population, they are really quite rare. That’s why the insurance industry is generally rolling in cash.

The property, casualty, and life insurance industries are rolling in cash despite the fact that they are heavily regulated and cannot, for example, decide to cancel your policy just after you’ve had a car accident but before they’ve had to cover your loss. Not so for the medical insurance industry. If you get sick, they can drop you. They have to get really creative to do it, but they can. Also, they can raise your premiums and raise your deductibles and deny you coverage for certain drugs or certain treatments.

Why? Because they all do it and if we want insurance, we have to go along. Our only other option is to stop paying the premiums and hope we never get sick.

If there was a public health insurance plan, the goal of the administrators of that plan would not be to make money. Sure, the underwriters and claims folks would still have to make sure that they were collecting enough premium to cover their losses. But they wouldn’t have to be collecting enough premium to pay for the CEO’s kids’ private schools or his fancy house in the Hamptons. If enough people decide they’d rather have public insurance, the private companies are going to have to lower their premiums and provide better coverage. Or they can go out of business. I don’t really care either way, but the market will figure it out. If the government plan sucks, people will stay with private insurers. That’s the funny thing about the free market. People are free to make their own choices.

Okay, so here’s a test. Can you spot the sentence in the paragraph above that explains how the government will be running your healthcare?

Yeah, me neither. The government will be competing to collect premium with the private insurance companies. We’re all still going to be treated by doctors. Joe Biden is not going to be sticking a tongue depressor down your throat and asking you to say “Ahhh.”

Paul Ryan, in all his wisdom, says

Government has a duty to secure [healthcare] rights, but this obligation is normally met most effectively by establishing the legal and economic conditions for free markets that expand the opportunity and prosperity of all. When markets apparently fail to meet these needs properly -- today's health care delivery is an example -- government should begin not by filling the need itself but by looking to and correcting its own interventions and making competitive free markets more effective.

Yeah, Congressman? Consider the public health insurance plan a way to make the competitive free market more effective. The government-run healthcare system is a boogey man.

Okay, so here’s the part that gets me really, really angry.

Free citizens must avoid seeing themselves as passive victims of a government over which they have no control. Persons who assume the burden of responsibility for their actions, successes, and failures develop traits such as courage, fairness, initiative, charity, self-restraint, industriousness, enterprise, and above all prudence, the wisdom which directs each toward the right means needed to flourish as a mature person.

A very short description of the American character would be: this ensemble of moral qualities that make it possible for persons to live under self-restraint, without dependency, in personal relationships with others in community under God.

I’ve written before about my mother and her struggle with Alzheimer’s, but until recently I never really got into details about the story of my mother’s life. Last week, I wrote about her healthcare story here.

In that story, I spent a little time talking about how my mom and dad pretty much did everything right. The came from working class homes. They started out with nothing. They worked and saved and worked and saved. My mom went to school. My dad started his own business. They worked and saved and worked and saved some more.

Then, my mom got sick. She lost her job. She lost her insurance. My dad had to take care of her full time. For about eight years, they spent their savings on treatments and prescriptions and on getting by. After that, they were out of money. Once the disease started, there was no way back for my mom. But instead of spending the remaining years of her life happy and safe, first both my parents were desperately worried about how to survive. Then, my mom’s brain was gone and my dad had to worry about it all on his own.

My mother lived on this earth and in this country for sixty-five years. She busted her ass to save enough money to make a comfortable middle class life for her family. She was courageous and fair. She had initiative. She showed charity and self-restraint and industriousness. She was enterprising. Above all, she was prudent and wise.

My mother had more American character in one hair on her head than Paul Ryan will ever have. So, fuck him. Fuck all of them. I don’t want pity, concern, sympathy, or empathy. I want them to do their fucking jobs.

Healthcare reform needs to pass and it needs to pass now.