Sen. Bernie Sanders has offended Sen. Orin hatch. In a tweet, Sen. Sanders charged that the Republican healthcare bill now going through Congress would, if passed, kill thousands of people. Sen. Hatch’s office counter-tweeted, “The brief time when we were “not” accusing those we disagree with of murder was nice while it lasted. twitter.com/berniesanders/…” Ah, the good old days when Democrats and Republicans could debate their differences with civility and mutual respect, without saying mean things about each other. (I digress, but can’t resist commenting on the weird use of quotation marks around the word “not.” Maybe Hatch is learning his Twitter punctuation from our Tweeter-in Chief.) Current Exhibit No. 1 for this decline in civility—Bernie Sanders.
Sen. Hatch’s self-righteousness is misplaced, however. The problem is: Sanders is right.
For one thing, Sanders never used the word “murder.” Hatch misrepresented Sanders’ statement in order to deplore it.
More importantly, there is an abundant body of social scientific studies that demonstrate a causal link between health insurance and decreased mortality in the United States. While the methodologies of these studies differ, as do their precise quantitative findings, without exception they find that not having health insurance increases your risk of death. In a large enough population of uninsured, that means that thousands of people do, indeed, die from not having health insurance. One widely cited 2009 study by a research group at Harvard found that about 45,000 Americans annually died for not having health insurance. This estimate is higher than most. An earlier study found only 18,000 “excess deaths” from lack of health insurance in the year 2000.
It happens that this last estimate of 18,000 is based on an uninsured population of 23 million, which coincidentally is the very number of people who, according to the Congressional Budget Office, would become uninsured as a result of the House-passed Republican bill. Some Republicans question the CBO’s estimate, so for the sake of argument, let’s just cut it in half. That means that based on a rather conservative estimate of increased mortality and a very conservative estimate of newly uninsured, the Republican bill would increase mortality by 9,000 souls annually. So, Sanders was on solid ground: the Republican bill would indeed kill thousands of people, annually.
Does that mean that the Republicans are proposing to murder 9,000 people? Again, Sanders didn’t say that—he deliberately used uninflammatory language. And the fact is, we generally think of murder as a deliberate, direct act against a known victim. An increase in mortality is just a statistic. The indirectness of the causal link and the anonymity of the victims insulate the Republicans’ policy choice from the charge of murder. You can reasonably argue that this is a distinction without a difference, but it is a distinction that people usually make implicitly.
Still, If Sen. Hatch wanted to be honest with himself and with us, he would acknowledge that, yes, his bill would increase mortality, but this cost in human lives would be worth it because of the other wonderful virtues of the bill—increasing people’s freedom of choice, liberating “job creators” from excessive taxation, etc. etc. But let’s be fair, that kind of candor is too much to expect of any politician.