It took a gut-check to decide what to say in my phone messages a couple of days ago to Senators who were considering voting to shred our healthcare system through the Graham/Cassidy bill.  It was humiliating to have to ask, “Please don’t leave us to suffer untreated medical conditions.”  “I hope you won’t send my family and millions of others into financial ruin.”  “Please don’t cause the deaths of tens of thousands of people who will lose their health insurance.”  

While I felt sure about the wrongness of the bill, nearly 50 Senators had an actual moral framework under which support for this bill was possible.  The belief system that supported a bill like this was a belief that free market forces based solely on profit ought to be the drivers for all industries, including healthcare.  Stuff costs money, including healthcare.  If you don’t have money, you don’t get any.  It’s a tidy operating system.  It brings death and suffering, but it’s very logical.  

Death and suffering would not actually have been an incidental part of the bill’s outcomes. Some in-depth analysis of this has been done on the number of people who die as a result of losing health insurance coverage.  Estimates are that between 28,000-100,000 people would die per year if this year’s earlier attempt at an ACA repeal had been successful, and Graham/Cassidy would likely have cut many more people off from healthcare when Medicaid funding sunsets in 2026.  

Neither would the death and suffering have been unintentional.  The votes our Senators considered taking were among the most premeditated actions available to a human being.  They had access to the same data I did.  And since I worked through my horror and submitted my plea on their voicemail system, they had been told about it, at least by me.

It is almost too hard to accept that leaders in this country would do this, but there have been a lot of hard things I have had to learn to accept lately: that an American presidential candidate would work with Vladimir Putin on his election campaign, and that a majority of Congress would protect him nonetheless.  And that our political establishment as a whole would not immediately and categorically reject Trump’s staffers that have Nazi and white supremacist ties.  

I have more room to accept unthinkable truths now.  With it comes more room to put multiple unthinkable truths together to see patterns.  

Senate Republicans worked hard to try and pass a bill that would have caused the deaths of 28,000-100,000 people per year.  Every year. Overwhelmingly, these will be deaths among people who are sick and/or disabled.  

Now consider how in the entirety of World War II, German Nazis murdered approximately 275,000 disabled people.  

The thing is that Nazis beliefs used to be a topic for historians to discuss.  But Charlottesville happened here in August and our President refused to convincingly condemn them.  Nazis have to be talked about in the present tense now.  Nazis believe that disabled people don’t deserve to live.    

I have seen the anguished and enraged Facebook posts of Republican voters who feel unfairly treated by such a comparison. From their perspective their progressive friends ‘call them Nazis’ just for supporting the President.  They think it’s an undeserved insult. How could legacy American ideals like free markets be equated with Nazism?

We are seeing now just what free market fundamentalism would really mean when applied to health care. It is a part of our intellectual inheritance, but it doesn’t work as a dogma. We are morally responsible for the choices we make. Deciding to leave millions of sick and disabled Americans without health care is not just amoral, it would be immoral.

Is it wrong to talk about the Nazi record of murdering disabled people in the context of the health care bill we just defeated?  Nazi comparisons have long been considered an illegitimate way to inflame any debate.  But since Charlottesville and the welcoming of white supremacist activists at the White House by Trump, discussions of Nazi politics are fair game. Indeed, it is our responsibility now that Republicans have left the door open to them that we be alert to where their policy goals crop up.

It is a great relief now to be able to finish this piece knowing that the votes were not there in the end to pass this disastrous piece of legislation, but it was close.  What remains, however, is a political landscape in which we have to constantly be on guard for where white supremacist and nazi ideology is influencing our policy.