Some Urgent Thoughts About the Health Care Bill

Post image for Some Urgent Thoughts About the Health Care Bill

July 24, 2017

In these commentaries, I’ve tried to stay impersonal. The facts speak both for themselves and for me. However, I want to say something about how I feel about the things I am thinking about. I will do this by proxy, because I want also to say something about my perspective, the lens through which I see things.

The proxy is the voice of Victor Klemperer, who was a mid-level German academic living in Dresden from 1916 through the end of the war. Mr. Klemperer kept a diary in which he recorded Germany’s struggle to find some sort of acceptable identity after the defeat in 1917; he observes the rise and fall of the Weimar Republic, and the emergence of Nazism and the horror which he, a Jew, barely escaped. All is observed with a scrupulous regard for facts. The diary is mostly about daily life, but also about the politics of the period. Klemperer had great insight. The diaries, published in English after his death in 1960, as “I Will Bear Witness,” are considered one of the best primary sources about the period.

In 1918, social and political revolution convulsed Germany. The Kaiser abdicated and fled. Revolutionary forces from the left and the right, vied for power. In that year, Klemperer wrote:

The newspapers now bring so much shame, disaster, collapse, things previously considered impossible,

I certainly know the feeling. Klemperer “dully,” as he puts it, withdraws. Yet he doesn’t. He keeps his diary, right up to the end.

The Weimar Republic came under attack from the conservatives who deplored its ideals about social justice, universal health care, decent housing, voting rights for all, even workers, and respect for the individual. The tolerance and artistic freedoms of post-war Germany were seen by Germans in the conservative parts of the country as an expression of urban degeneracy. The social welfare burdens were enormous. There were hundreds of thousands of war widows, orphans, and injured soldiers needing long term care. The Russian Revolution had displaced similar numbers of Eastern European Jews fleeing the pogroms of the Czarist armies. But the Weimar social welfare programs, including health clinics for the poor and the immigrant, cost money and the rich resented paying taxes to support those programs. And always there was the underlying hatred of “the other,” the fear of polluting the race with the blood and ideas of the Jew.

The social welfare burdens were enormous. There were hundreds of thousands of war widows, orphans, and injured soldiers needing long term care. The Russian Revolution had displaced similar numbers of Eastern European Jews fleeing the pogroms of the Czarist armies. But the Weimar social welfare programs, including health clinics for the poor and the immigrant, cost money and the rich resented paying taxes to support those programs. And always there was the underlying hatred of “the other,” the fear of polluting the race with the blood and ideas of the Jew.

Weimar feared raising taxes so it printed money which led to the inflation disaster that was compounded by the stock market crash of 1929. By 1930 the Republic was ungovernable. The right, Nationalists who wanted to repudiate the Versailles treaty and make Germany-great-again, along with the traditional-values conservatives, formed a volatile mixture waiting to have a match put to it. They were locked in immovable opposition to the left with its expensive social programs, inclusive democratic politics, support for labor unions, equal rights for women, which by 1920 included the right to vote and hold office. In the last years of the Weimar republic laws simply could not be passed. The right and the left were frozen in a partisan death grip.

In the last years of the Weimar republic laws simply could not be passed. The right and the left were frozen in a partisan death grip. Violence took over. In 1933, Hitler, whose Nazi party had never won a majority in national elections, persuaded the other conservative parties in the Reichstag that he was one of them and arranged to be appointed chancellor.

I see so many similarities with our times: immigration and refugees; class divisiveness, poverty vs. wealth; urban centers vs. the hinterland, whether rust-belt or coal country; “family values;” hatred of the other-than-white; fear of the dominant culture being absorbed by Latinos or blacks; fear of Muslims; fear of democracy, of the voting power of women and non-whites; fear of women.

And because I see these similarities, I think I should point them out. The history of 1918-1945 Germany is the lens through which I view the Trumpian present. Barbara Tuchman called the past a “Distant mirror.” I acknowledge that this is my mirror. It has been with me a long time. I published a book in 1985 about the Holocaust. I see destructive tendencies in human nature that are on the rise again.

I want, however, to make it clear that I am not making a sloppy comparison. Donald Trump is no Adolf Hitler. He is not nearly as intelligent, as politically shrewd, as energetic, as disciplined, as committed, or as ruthless. Hitler had an overarching vision of the sort of world that he would like to create—a racialist paradise without Jews. Race was at the core of his vision.

Trump appears to have no ideology other than to create a world in which very rich people can do whatever they want. But since he would create this world in his own image, it resists being translated into ideology. Trump is ignorant, venal, sadistic, lazy, childish, stupid, and corrupt. He has violated the oath he took to protect the Constitution. He is a vile and gross man, but he is not Hitler. I would make the same comparison about the Republican Party of Ryan and McConnell. They are not Nazis, not fascists. But they do not have the best interests of the country as their first priority either.

I do not doubt that Trump would like to have the absolute power that Hitler had. What he would do with it, we cannot know. But he doesn’t yet and that brings me to the subject of the Senate health care bill that has just been defeated, but then, as I write, revived again.

The intent and potential effects of the Senate bill cry out for a look back to pre-1933 Germany, to use that distant mirror. The intent has been clear from the beginning: The Senate bill, by reducing the Federal support for Medicaid, would have given a massive tax cut to the very rich. In Trump’s zero-sum world this meant striking a cruel blow on the very weakest citizens of the United States, on the poor, the chronically ill, the disabled, those with hereditary health issues, and the mentally ill. Those people, most of whom are unable to find work and get health insurance through an employer, would suffer most. Not long ago, Kelly Ann Conway, wealthy loyal Trumpist, said “if you want health insurance, get a job.” Tell that to a 62-year-old woman confined to a wheelchair by multiple sclerosis.

The cruelty of the Ryan/McConnell bills is quite astounding. Millions of Americans would effectively have no health care, unless they could find charity, and would sicken and die slowly. Examine the Republican logic: the disabled, either from accidents or conditions like MS, are no longer productive and have become a financial burden on the state. Chronic illnesses like diabetes or alcohol/drug related conditions are the result of social degeneracy, of choices made by unworthy people. Mental illness is proof of weakness. Hereditary conditions indicate genetic degeneracy. None of these people are productive members of the state, so throw them off the boat and let them sink.

Given that Trump and McConnell are trying again, we should make the Republican senators aware that the health care model they are advocating has its origins in the radical opposition to the Weimar Republic’s social programs. By 1920, society was being thought of, metaphorically, as a body and the social order began to be evaluated in somatic terms. The notion of “inferior” beings gains traction, the phrase “a life unworthy of life,” passed easily among conservative politicians and doctors. A life that was a financial burden on society, on the rich who paid more taxes, was called a “ballast existence.”

After the Nazis took control and Germany became a one party state, these attitudes were formalized, given legal legitimacy, in programs of involuntary sterilization for people judged chronically poor or mentally inferior or degenerate. Then, in 1939, came the program of involuntary euthanasia, Aktion T4, carried out by doctors who selected people who were deemed “incurably ill.” This ends, of course, in the Holocaust, in which the “vermin” or “parasites” that had attached themselves to the healthy Aryan body were removed and destroyed.

We have not come to anything quite like what happened in Germany. The Senate bill was defeated by intense lobbying by doctors, hospital administrators, by caregivers, and by the very people who would have been most affected. This is the kind of effort that the Indivisible groups are best at. The fact that it came so close astounds me. It is notable that the three Republican women in the Senate were the core of the “no” votes. One said, “I didn’t come to Washington to hurt people.”

A clear difference between Germany in the 1920s and the United States today is that violence has not yet become a political weapon that people perceive as normal. Hitler would not have tolerated the resistance; his thugs, the Brown Shirts, would have beaten both the doctors and the disabled. But again, we are not so very far from that. Trump has shown a clear predilection for the use of violence, but so far the Republicans have, at least, held that in check. Paul Ryan said beating up a reporter is not acceptable, but then, smiling broadly, he welcomed the man who had done it, the new congressman from Montana, into the august chambers of the House of Representatives.

Tweet about this on TwitterShare on Facebook6Share on Google+0Email this to someone

Previous post: