Anti-Health Care Reform Sign (photo: Fibonacci Blue / flickr)

Sometimes it seems like the term “American exceptionalism” could refer only to a politico-economic theory that says, “Screw everybody except me.”

It is hard to explain the hard Right’s hatred of health care reform any other way. Despite their phony spin about a government “power-grab” and such, what motivates them is a need to define themselves in terms of the anguish of others. They can’t be exceptional if others aren’t demonstrably unexceptional. If they have to enforce the distinction, so bet it, even if that means untreated ill health and the unnecessary death of others.

Of course, they sometimes dress up their excesses in a paradoxical,  pseudo Darwinian or Randian almost-theory: everyone will do better if I, the exceptional one, do better than everyone – an outcome they use government to guarantee.

It comes disguised as some kind of argument over the role of government. According to the Right, the Left wants big, intrusive government. The Right wants small, stay-out-of-our-lives government. However, when the people who make this claim have no problem with government mandating the invasion of bodies with trans-vaginal probes, it’s hard to take their anti-government rhetoric seriously. Likewise with their affection for domestic spying and their obsession with government regulation of sex between consenting adults. That government is good that’s big enough to harm the people they don’t like.

Sooner or later they come up against something their Us-Versus-Them dualism can’t survive – radical climate change, for instance. The Exceptional Ones might like to believe they inhale rarefied air and drink from Olympian springs, but they drink the same water and breathe the same air we do. They live upon the same small planet near the same small sun in the same small corner of a galaxy that’s only one of billions. When that home can’t sustain life, their lives will go unsustained with the rest of ours.

Of course, it may not be idle paranoia to view growing global anti-democratic movements as an effort by the elite to buy some time at the expense of the rest of us. The elite may want to guarantee themselves the few remaining inhabitable spots. If there are going to be life-and-death resource wars, better to have laws already in place that funnel those diminishing resources to the Exceptional Ones.

The Supreme Court decision on health care reform will give us another unhappy opportunity to see this exceptionalism play out. The Court said the federal government may not withhold existing Medicaid funding from states that don’t participate in Medicaid expansion. Taxpayers in those states that don’t participate will see other states receive more of their federal taxes. In addition, local taxpayers will pay much higher insurance premiums and tax bills for local public hospitals – the places those millions denied Medicaid must go if they are to receive any care at all.

This means, literally, that taxpayers will pay to see their neighbors suffer. It’s one thing to vote for exceptionalist policies that punish others. It’s another thing altogether to happily pay for unnecessary suffering and death of one’s neighbors.

And pay they will. According to the Republican state Comptroller in Texas, hospitals there deliver $10.2 billion in care not compensated by insurance or direct payment. From the Comptroller’s Health Care web page:

Roughly two-thirds of the cost of uncompensated care is borne through higher insurance premiums paid by insured patients and their employers. Various federal, state and local government programs pay the remaining third.

And:

Emergency room care for people without insurance is largely uncompensated, or unpaid, by government programs or any other third party. But someone has to pay for this treatment. In the case of public hospitals, local taxpayers end up bearing much of the cost through their local property taxes.

Whatever else it does or doesn’t do, the Affordable Care Act might eliminate the spectacle of health care ticket scalping.

A single-payer system would be morally superior and economically more efficient. Whatever the faults of ACA, however, they are not as described by the outraged Right.

To be fair, many conservatives are there because that’s the team they’ve chosen to root for. They’d be as appalled as any other person if they knew they were being told to pay to enforce suffering on others. They are unaware of the facts and unwilling to look again at the issues because they are the political equivalent of sports “homers.” Their team does no wrong. They’ve bought their leaders’ talking points, and that’s that. Others, I’m afraid, are not so innocent.

The exceptional and the unexceptional, in the end, will thrive or perish together. No pretend play will make a human being the self-sufficient island he or she wants to be. Rising sea levels will cover the pretend islands, too.