Normally, you'd just readjust your understanding of what you're talking about. After all, you're human, this sort of thing happens. It's impossible to go through life without getting something all balled up. You just slap your forehead, laugh, and get on with your life.
Unless, of course, you're a Republican. Especially a Republican in elected office. Then you aren't wrong. Ever. Invading Iraq is still the smartest thing anyone's ever done for the cause of freedom, for example. If someone points out the facts -- no WMD, no ties to al Qaeda, no "imminent threat" to the United States -- you just jam your fingers in your ears and shout, "La! La! La! La! I can't hear you! La! La! La! La!" Because it's absolutely impossible for you to be wrong. If there's a disagreement between reality and an elected Republican, reality automatically loses. Every time.
Kansas Rep. Lynn Jenkins found herself in this situation recently when, during a town hall meeting, one of her constituents confronted her with the impossible; the American system of healthcare delivery was failing her. It's an article of faith that the US has the "best healthcare in the world" -- mostly because it's America and everything we have is the best in the world -- and saying otherwise is just unpatriotic. The only thing wrong with the US, in Republican eyes anyway, is that taxes are too high for rich people. Otherwise, perfect.
Jenkins found herself the target of an unfair and un-American attack by reality, when a member of the audience told her about her situation. "I'm a 27 year-old single mother. I work full-time," constituent Elizabeth Smith told her. "I do not have health insurance. My employer does not provide health insurance to me and I cannot afford it privately. Why shouldn't my government guarantee all of its citizens health care?"
See, in Republican World, the only uninsured are young people -- like Smith. So far, so good. But the reason these young people aren't insured isn't because they can't get insurance, but because they don't want it. See, young people these days believe they're indestructible; ah, the folly of youth. Elizabeth Smith, single Kansas mom, couldn't possibly be uninsured. Not if she wanted to be, anyway. So Jenkins proceeded to set her straight:
Jenkins: Thank you. I’m sorry, maybe you missed my opening remarks, but absolutely. That’s why we have Medicaid in the current system and that’s why under the alternative proposal we have an option for low-to-modest-income people to be able to afford health care and then we’ve got the SCHIP program for children. I think we’ve got all of the bases covered.
Audience member: She’s not covered under SCHIP!
Jenkins: OK, if you’re not then you’re the perfect example for why we need reform and why we need it now but we have to do it right and if we can do an alternative proposal, as I’m suggesting, give you the money to go buy it in a reformed marketplace where it is affordable, that’s my preference rather than to saddle the nation with yet another government program when they can’t afford the government run programs we have.
Elizabeth Smith: I want an option that I can pay for. I work. I pay my bills. I’m not a burden on the state. I pay my taxes. So why can’t I get an affordable option. Why are you against that?
Jenkins: A government run program (laugh) is going to subsidize not only yours (laugh) but everybody in this room. So I’m not sure what we’re talking about here.
Jenkins: I think it comes down to the whole discussion of...
(The crowd erupts. At this point, it's safe to say even they aren't buying Jenkins position...)
Lynn: OK folks. Let’s be respectful. UH-OH (talking over crowd). We’re gonna make time for everybody. We’re gonna all listen to each other respectfully, even if we disagree. I think we can agree we need reforms, again it’s just how we gonna do it. I believe people should be given the opportunity to take care of themselves with an advanceable tax credit to go be a grown-up and go buy the insurance.
Be a grownup. See, that's the "indestructible young person" theory coming back. She seriously can't wrap her head around the fact that this woman can't get health insurance. Elizabeth Smith claims to be falling through the cracks in a world that Lynn Jenkins seems to believe doesn't have any cracks. We've got Medicaid and SCHIP, after all. In her defense, she admits that "we need reform," but then she advocates something that's most definitely not reform. Tax credits don't change the industry, they change the industry's customer base. In Republican World, it's not insurance companies that are the problem, it's you. You need to be reformed. You're not being a grown up.
The crack Smith fell through isn't the only crack in the system. In 2007, an America Journal of Medicine study [PDF] found that most bankruptcies in the US are caused by medical emergencies. Of those, most were insured.
Telephone interviews identified 639 patients whose illness contributed to bankruptcy: the debtor or spouse in 77.9% of cases; a child in 14.6%; and a parent, sibling or other adult in 7.5%. At illness onset, 77.9% were
uninsured; 60.3% had private insurance as their primary coverage; 10.2% had Medicare; 5.4% had Medicaid; and 2% had Veterans Affairs/military coverage. Few of the uninsured lacked coverage because of a preexisting condition (2.8%) or the belief that coverage was unnecessary (0.3%); nearly all cited economic reasons.
How's a tax credit going to fix that? How's making coverage more affordable going to fix that? When 60.3% of those bankrupted by medical costs have private insurance anyway, how is covering more people going to make any damned difference at all? Healthcare consumers don't need to be reformed, the industry does.
But that's contrary to Republican myth. That 0.3% who are uninsured by choice make up nearly 100% of the uninsured under GOP math. They aren't being grown ups and that's the problem. The insurance industry is perfect, because America is flawless. If you think healthcare has problems, then that means you hate America.
Given the facts, it's hard to see how Republicans can think they're right on this issue. But when you try to set them straight, all you get is, "La! La! La! La! I can't hear you! La! La! La! La!"
They're committed to being wrong.
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