Conservatives in the house and the senate are trying to get rid of the Affordable Care Act's individual mandate, the requirement that everyone must purchase health insurance or pay a fine. When you get rid of that, you reduce the number of relatively healthy people who would have been in insurance pools, so that those who remain have greater needs and have to pay higher premiums.
Liberals who think we need the individual mandate tend to talk the language of compassion. "These poor, benighted people are sure they won't need medical care, but they could be blindsided by some catastrophic illness or accident or crime. So they may be in trouble down the line, in addition to those who may wind up with no health insurance, because they can't afford the premiums." But there's another way to talk about the problem with getting rid of the individual mandate. Conservatives--and they're the ones in power, so we have to care about how they think--tend to care a lot about people being freeloaders and deadbeats and welfare queens and moochers. We're supposed to work hard and pay our own way, not depend on others. In fact, it strikes me that this indignation over dependency is one of the most deep-seated elements of the Republican outlook. And so if we can talk about the individual mandate in terms of dependency, that would presumably be very convincing to many Republicans. They'd have a reason to retain the individual mandate that didn't involve caring about people and their health problems.
But surely there is a reason to insist on the individual mandate that has nothing to do with compassion, and everything to do with indignation. People who decide not to get health insurance, but wind up with a catastrophic medical problem, do wind up being deadbeats and freeloaders and all the rest--if you want to use that very colorful, judgmental language. They wind up using the health care system that they didn't care to pay for, before they needed it. There it will be, all ready for them, and they will not have paid their fair share for it. Not only will it be available, not at all to their credit, but if they're sent bills post facto, they may never be able to pay them. Conservatives should be appalled, considering they are appalled by all sorts of other dependency and freeloading and irresponsibility.
Of course, you don't want to be disingenuous, speaking a language you don't actually take seriously. But liberals can talk this talk--if fact, they do so on occasion, just not so much in the context of the Obamacare debate. You're speaking this language if you think everyone ought to have their kids vaccinated, instead of counting on the herd immunity that's conferred when most other people have their kids vaccinated. If you can get indignant about non-vaccinating parents, you can get indignant about people who don't plan for unexpected health problems and get themselves health insurance.
Why on earth do conservatives not see the similarity between their old enemies the welfare queens and deadbeat dads and the like, and the healthy folks they want to liberate from having to purchase health insurance? I think they don't see it because the prototype of an uninsured person is a healthy, white, male independent contractor. They like the feisty independence of these people, but this can easily be reframed. Feisty independence? No, these are just freeloaders, people letting others create the system of care they themselves may ultimately need.
Sure, I'd rather speaking about care and compassion, but let's frame the issue about the individual mandate in the way that resonates with the people who have the votes!