Constructive and civil debate — like the one Obama initiated just four weeks ago on deficit reduction? The speech in which he accused the Republicans of abandoning families of autistic and Down syndrome kids?
This reflects an inability to recognize of acknowledge the brutal effects of the Republican plan to slash Medicaid. Medicaid is a bare-bones program that provides very basic levels of medical services for people in nursing homes, poor children with special needs, and people facing extreme poverty. Jonathan Cohn provides some reporting insight as to what is at stake here:
I'll never forget the first time I visited the St. John's Well Child and Family Center about seven years ago, because it's the first time I heard about a grisly intruder pediatricians sometimes find in young children's ears: Cockroaches.It's a problem endemic to poorly maintained, low-income housing, of which there is quite a lot in the South Central neighborhood surrounding St. John's. And it's one reason the staff there are so aggressive about confronting the health hazards of their patient population. Instead of merely treating problems like asthma, lead poisoning and, yes, insects crawling into the ear canals of sleeping children, St. John's also offers home environmental assessments—complete with instructions for tenants on how to clean up hazards and, where possible, to pressure slumlords into fixing dilapidated properties.
St. John's was a more modest enterprise back then: just a handful of clinics operating on a shoestring budget. When I returned last week, I could see it had grown. Thanks to a combination of philanthropy and increased federal funding, under both the Bush and Obama administrations, it has expanded to 10 clinics with an annual budget of $25 million, serving a predominantly Latino and African-American population in what remains one of the nation's most medically under-served communities.
And the future seems more promising still. The Affordable Care Act will pump more money into these clinics, both directly by giving them subsidies and indirectly by giving more of their patients insurance.
That's what the Republicans are doing away with. I'm usually not a huge fan of emotional appeals, and Jonathan's column admirably steers clear of bleeding-heart-ism. But it's just analytically true that the Republican budget imposes severe hardship on poor and vulnerable people. And there's a deep backlash against even relatively anodyne attempts to point this out -- as if Obama is obliged to collaborate with Republican attempts to cover up the vicious results of their program. Ryan's budget really is at odds with what most Americans would consider to be basic decency. Virtually every House Republican voted for it, and they deserve to face the consequences of it.