Jonathan Chait is exactly right about the unspoken conservative position on health-care reform:

Opponents of the law have endlessly invoked “socialism.” Nothing in the Affordable Care Act or any part of President Obama’s challenges the basic dynamics of market capitalism. All sides accept that some of us should continue to enjoy vastly greater comforts and pleasures than others. If you don’t work as hard as Mitt Romney has, or were born less smart, or to worse parents, or enjoyed worse schools, or invested your skills in an industry that collapsed, or suffered any other misfortune, then you will be punished for this. Your television may be low-definition, or you might not be able to heat or cool your home as comfortably as you would like; you may clothe your children in discarded garments from the Salvation Army.

This is not in dispute. What is being disputed is whether the punishments to the losers in the market system should include, in addition to these other things, a denial of access to non-emergency medical treatment. The Republican position is that it should. They may not want a woman to have to suffer an untreated broken ankle for lack of affordable treatment. Likewise, I don’t want people to be denied nice televisions or other luxuries. I just don’t think high-definition television or nice clothing are goods that society owes to one and all. That is how Republicans think about health care.

Or at least, that's the position Republican legislators are implicitly defending. Perhaps they've forgotten how they actually think about health care, preoccupied as they are with how they think about anything Obama can take credit for. Either way, it's their shame. If the Supreme Court dismantles health-care reform this week, there will be serious consequences for those who, for whatever reason, lack the privilege of access to nonemergency health care.

Anyway, read Chait—he's right on.

Steve Thorngate

The Century managing editor is also a church musician and songwriter.

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