Congressman Roger Marshall, Poor People, and Obamacare

March 5, 2017

Congressman Roger Marshall, Poor People, and Obamacare

I read Republican Congressman: Repeal Obamacare Because Poor People Don’t Want to Be Healthy by Jonathan Chait for New York magazine with interest for several reasons. First, Mr. Chait writes very smartly about health care policy. Second, health care policy and Obamacare repeal fascinates me. Finally, hearing Rs ‘splaining poor people always entertains me.

In this case the congressman comes with credentials. He’s Roger Marshall, M.D. He was an obstretrician, and he’s a first-termer in Congress. He ran against and defeated Congressman Tim Huelskamp (Rep. – Kans.) easily in the Republican primary, and won the general election more easily. He’s the moderate to Congressman Huelskamp.

Here’s what Congressman Marshall said:

Just like Jesus said, ‘The poor will always be with us.’ There is a group of people that just don’t want health care and aren’t going to take care of themselves.

The he added these choice words:

The Medicaid population, which is on a free credit card, as a group, do probably the least preventive medicine and taking care of themselves and eating healthy and exercising. And I’m not judging, I’m just saying socially that’s where they are. So, there’s a group of people that even with unlimited access to health care are only going to use the emergency room when their arm is chopped off or when their pneumonia is so bad they get brought [into] the ER.

The congressman knows precious little, former practice in obstetrics aside. Let’s start at the very beginning. The Kansas Medical Assistance Program permits required co-payments when Medicaid participants obtain services. If the Medicaid patient cannot pay the provider must provide the services, but the very ability to demand payment surely leaves some proud, poor people at home. (It’ll shock some people, for sure, but having to say “I don’t have enough money” shames some people, even those who are honest and just plain poor.)

As for preventive medicine, it costs money. My drugs, for hypertension, cholesterol, and a dicey esophagus, cost $98 per month. For me it’s just a tad more than rounding error. For someone who makes a fraction of my income, it’s a fortune, and I’m a pretty healthy guy. For a significant health condition, prices are much higher.

Eating healthy? Here’s The Grocery Gap, an excellent piece about how difficult and expensive buying healthy can be for poor people. (I learned about this issue on the Associated Colleges of the Midwest urban Studies Program in Chicago, more than 40 years ago.) Aside from the delivery problems, Big Ag maximizes profits when it sells sugar and processed foods. Carrots, cauliflower, and cukes? Not so much.

Exercising? Poor people work two and three jobs to get by. I guess Congressman Marshall assumes, with income from so many sources, that poor people must have money to join a gym. And pay a sitter for the kids, so that mom and dad can work out while their children, in a well-lit house, do their homework.

Tim Hueslkamp was an odious example of the Far Right. He went down last fall because Governor Sam Brownback instituted a supply-side experiment which totally crapped out, leaving a failed state between Oklahoma and Nebraska. Alas, Congressman Marshall offers nothing more.

Now, we arrive at Jesus and judging. This man, this congressman, can’t tell us poor folks don’t care about their health without invoking Jesus, as if the poor people he takes out after don’t accept the gospel. Then there is the lack of judging. “And I’m not judging, I’m just saying socially that’s where they are.” Right-O Congressman, you’re not judging anyone!

For decades I’ve heard lots of noise from my Wingnut friends about what’s wrong with poor folks. Eat better. Exercise. Go to the doctor. Be rich and white like me. Wait. What? Right, I haven’t ever heard that last directive … in so many words, but it’s the implicit message I get from all of them.

I’ve dealt with lots of poor people in my law practice, and in my philanthropic endeavors. They’re like rich people, mostly, but for the fact that they have no money. Some are honest, and some lie. Some work hard, and some are lazy. Some are nice, and some are a**holes. Etc.

Shame on you, Congressman Marshall, for slurring poor people to further the Koch Bros. et al.  agenda.


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