A top White House official tried to defend the American Health Care Act (AHCA)— the GOP’s response to Obamacare — earlier this week by implying that health care systems shouldn’t help someone who “sits at home, eats poorly and gets diabetes.”
According to the Washington Examiner, Mick Mulvaney of the Office of Management and Budget delivered the line on Thursday while speaking to the LIGHT Forum at Stanford University. Mulvaney was asked whether he agreed with the “Jimmy Kimmel test” — or the idea famously forwarded by the late-night show host that “No parent should ever have to decide if they can afford to save their child’s life.” Kimmel made the quip while delivering an impassioned account of his newborn son’s struggle to survive a congenital heart disease.
“That doesn’t mean we should take care of the person who sits at home, eats poorly and gets diabetes,” Mulvaney said. “Is that the same thing as Jimmy Kimmel’s kid? I don’t think that it is.”
Mulvaney said he agreed with the idea in principle, but with one a very specific caveat: taxpayers shouldn’t help people who fall ill because of, ostensibly, their own actions.
“That doesn’t mean we should take care of the person who sits at home, eats poorly and gets diabetes,” Mulvaney said. “Is that the same thing as Jimmy Kimmel’s kid? I don’t think that it is.”
Mulvaney was attempting to defend the AHCA, which was narrowly approved by House of Representatives this month without a single Democratic vote. In its current form, the bill would essentially allow insurance companies to price people with pre-existing conditions out of the health insurance marketplace. Meanwhile, so-called “Trumpcare” includes a $880 billion cut to Medicaid, which stands to result in roughly 24 million Americans losing their health insurance because of premium increases.
Mulvaney’s statement was widely panned by progressives as compassionless, but diabetes advocates also noted that it is also inaccurate: The American Diabetes Association was quick to condemn Mulvaney’s remarks, saying they are “extremely disappointed” and describing his statement as “misinformed.”
“Mr. Mulvaney’s comments perpetuate the stigma that one chooses to have diabetes based on his/her lifestyle,” the statement read. “We are also deeply troubled by his assertion that access to health care should be rationed or denied to anyone. All of the scientific evidence indicates that diabetes develops from a diverse set of risk factors, genetics being a primary cause. People with diabetes need access to affordable health care in order to effectively manage their disease and prevent dangerous and costly complications. Nobody should be denied coverage or charged more based on their health status.”
“All of the scientific evidence indicates that diabetes develops from a diverse set of risk factors, genetics being a primary cause. People with diabetes need access to affordable health care in order to effectively manage their disease and prevent dangerous and costly complications.”
Indeed, poor diet and lack of exercise does not appear to have been the cause of diabetes for professional athletes who suffer from the disease, such U.S. soccer star Jordan Morris.
What’s more, Huffington Post health care reporter Jonathan Cohn pointed out that health care systems that attempt to segregate patients by medical condition (or, presumably, how they acquired their condition) often hurt all people with illnesses, because the practice “almost inevitably leads to shabby care for the sick, regardless of how they got that way.”
“Roughly two-thirds of the states operated [condition-segregated health care systems] before the Affordable Care Act took effect, and they inevitably offered coverage that was less affordable, less available or less comprehensive than standard policies,” he said.
The idea that the needy somehow contributed to their own plight — and that more privileged Americans shouldn’t be required to care for them — is an old conservative argument traditionally applied to economics. In 2013, Republican and then-congressman Stephen Fincher attempted to justify cutting food stamps by misquoting a Biblical verse, declaring “Anyone unwilling to work should not eat.” Rep. Jodey Arrington (R-TX) repeated the exact same verse earlier this year to justify increasing the work requirements for unemployed adults on the food stamp program.
Now the same idea is reemerging — often with religious undertones — as a way to cut ostensibly underserving sick people out of health care systems. In March, Rep. Roger Marshall (R-KS) argued against Medicaid expansion by arguing that society will always have sick people.
“Just like Jesus said, ‘The poor will always be with us,’” Marshall told Stat News in March, citing scripture in a way that arguably belies its original intent. “There is a group of people that just don’t want health care and aren’t going to take care of themselves.”
“Just, like, homeless people. … I think just morally, spiritually, socially, [some people] just don’t want health care,” he added. “The Medicaid population, which is [on] a free credit card, as a group, do probably the least preventive medicine and taking care of themselves and eating healthy and exercising. And I’m not judging, I’m just saying socially that’s where they are. So there’s a group of people that even with unlimited access to health care are only going to use the emergency room when their arm is chopped off or when their pneumonia is so bad they get brought [into] the ER.”