Photo: Daniel Acker/Bloomberg via Getty Images

Conservatives have made a series of specific predictions about the effects of Obamacare — overall costs would rise, insurers would flee the exchanges, premiums would go up, the ranks of the uninsured would not even fall. All these predictions have failed. And yet conservative opposition to the law has not diminished. If you want to know why this is, listen to these secretly recorded comments from Iowa Republican Senate candidate Joni Ernst, via Radio Iowa and Greg Sargent. Here Ernst, speaking candidly to supporters, gets to the root of conservative opposition:

“We’re looking at Obamacare right now. Once we start with those benefits in January, how are we going to get people off of those? It’s exponentially harder to remove people once they’ve already been on those programs…we rely on government for absolutely everything. And in the years since I was a small girl up until now into my adulthood with children of my own, we have lost a reliance on not only our own families, but so much of what our churches and private organizations used to do. They used to have wonderful food pantries. They used to provide clothing for those that really needed it. But we have gotten away from that. Now we’re at a point where the government will just give away anything.”

That’s the fundamental belief that motivates most, if not all, the conservative opposition: Health care should be a privilege rather than a right. If you can’t afford health insurance on your own, that is not the government’s problem.

I happen to find this belief morally bizarre. People who cannot afford their own insurance either don’t earn much money, or have health risks, or family members with health risks, too expensive to bear.

All of us non-socialists would agree that there ought to be some things rich people get to enjoy that poor people are deprived of. Access to health care is a strange choice of things to deprive the losers of — not least because one of the things you do to “earn” the ability to afford it is not just the normal market value of earning or inheriting a good income, but the usually random value of avoiding serious illness or accident.

Indeed, very few Republicans have the confidence to make the case openly that the inability of some people to afford the cost of their own medical care is their own problem. But that is the belief that sets them apart from major conservative parties across the world, and it is the belief that explains why they have opposed national health insurance every time Democrats have held power, and why they have neglected to create national health insurance every time they have.