It was startling to see physician and Senator Rand Paul claim the other day that people on disability were faking bad backs and anxiety to get on the dole and cheat the taxpayers. These are real ailments, sometimes totally debilitating, as anyone who has suffered from either can tell you. Severe back pain can make it impossible to work at any job, even those which only require sitting. Anxiety disorder is a terrible condition that can even make some people unable to even leave their house. What kind of medical doctor would deny such a thing? (If you answered, "one who will willingly trade his professional integrity for political points" you'd be right.)

But this is actually part of the GOP's ongoing quest to degrade "entitlements" and make America's health care system the worst in the world for anyone who isn't wealthy. Their ongoing attack on Obamacare opened up a window to their underlying philosophy about affordable health care. (They're not for it.) And now they are taking legislative aim at the Supplemental Security Income portion of the Social Security System. This is the program that makes it possible for people with disabilities to live without begging on the streets. Despite the fact that the congress has always routinely pushed money back and forth between the retirement and disability portions of the program as the need occurred, the Republicans in congress have decided that they no longer support doing such a thing. The result, if they have their way, would be to cut the meager stipends of millions of disable Americans within the next year.

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They claim that the program is rife with fraud and that far too many people are able bodied and just refuse to work. (They haven't used the term "disability queen" queen in public yet, but you can be sure they've thought it.) Representative Tom Price, another erstwhile medical professional committed to proving that trusting a Republican doctor to treat you is like asking a convicted robber to house sit, said:

“There are a number of studies that demonstrate that a lot of people who are on the program are no longer eligible. People get well, people do other things and other opportunities become available from a medical standpoint to treating whatever disability they have to make it so that they can contribute to a greater degree.”

That's a convenient story but it's just not true:

About 8.9 million people receive disability benefits from the fund and its eligibility guidelines are stringent. Beneficiaries must have worked at least one-quarter of their adult life and five of the last 10 years. They must be unable to work because of a severe medical issue that has lasted five months and is expected to last at least another year. Roughly a quarter of recipients have a mental impairment, some have muscular or skeletal problems and others have diseases like diabetes, Lou Gehrig’s disease, congestive heart failure and cancer. A majority of them are 55 or older and many die within a few years of first receiving the insurance, according to CBPP.

Think Progress noted that the reports of disability fraud are actually extremely low and noted:

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The severity of the disabilities of those who get benefits is underscored by the fact that one in five men and nearly one in six women die within five years of being approved.

Once on the rolls, payments are far from cushy: they average $1,130 a month, just over the federal poverty line for a single person, and usually replace less than half of someone’s previous earnings. Very few beneficiaries are able to work and supplement that income: less than 17 percent worked at some point during the year in 2007, but less than 3 percent of those people made more than $10,000 annually.

Apparently, even that's too much. The government needs to crack down on these lazy moochers and put them to work. Back in the day they used to sell pencils and apples on street corners, amirite? And in third world countries you see plenty of horrifically disabled people making a tidy living by begging. They show the kind of gumption we are denying our paraplegics and mentally ill by molly coddling them with a poverty level stipend.

These Republican officials are not alone in holding this philosophy. Recall this confrontation between a Tea Partyer and a disabled citizen during the health reform debate:

A man with a sign saying he has Parkinson’s disease and needs help sat down in front of the reform opponents. Several protesters mocked the man, calling him a “communist,” with one derisively “throwing money at him.” “If you’re looking for a handout you’re in the wrong end of town,” another man said.

He added, "nothing for free, over here you have to work for everything you get." The lovely gentleman who threw a dollar in his face put the begging principle in stark terms yelling "I'll decide when to give money!"

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The immediate future of the health care reforms will be decided this June by the Supreme Court as they take up King vs Burwell (also known as the "Typo Of Death" case.) In the meantime, as that argument is on hold the right is moving against the safety net from this other direction. Basically, they are challenging the the definition of modern medicine itself:

Fox News Radio host Tom Sullivan told a caller who said she suffered from bipolar disorder that her illness is "something made up by the mental health business" and just "the latest fad." When the caller told Sullivan that she "would not be alive today" if she hadn't received mental health treatment, Sullivan wondered if "maybe somebody's talked you into feeling and thinking this way." Sullivan, who is also a frequent Fox Business contributor and guest anchor, began his January 28 program by complaining that people with mental illness have figured how to "game the system" by receiving disability benefits. "They're mostly government employees and they know how to do it," he added. Sullivan also defended Sen. Rand Paul's (R-KY) controversial and false statement that "Over half the people on disability are either anxious or their back hurts."

Obviously, that is nonsense. But it's becoming quite common on the right to suggest that illnesses are not real, that people are faking them anyway and that those who are sick are lazy parasites who should find some way to make a living. We have Republicans, some of them medical doctors, publicly declaring that fellow citizens who have been unlucky enough to have an accident or contract a debilitating illness need to be harshly scrutinized by the government to ensure they aren't stealing that generous $1,000 a month.

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I think we probably need to consider the alarming idea that this is going to be the right's overall approach to dealing with health care. They have no real ideas for how to deliver affordable health care to every citizen and they have no methods for controlling the spiraling costs of the former system. In order to maintain their "free-market" health care philosophy they are going to have to make it clear that you must get rich if you expect to live through catastrophic illness or accidents. If you are sick, it's up to you to figure out how to pay for your care and shelter. That's the only solution available to them.

As a libertarian theorist posited in the Washington Post last week,"people could die and that's ok":

[It] is an acceptable price to pay for certain goals — including more cash for other programs, such as those that help the poor; less government coercion and more individual liberty; more health-care choice for consumers, allowing them to find plans that better fit their needs; more money for taxpayers to spend themselves; and less federal health-care spending.

I'm going to guess that more money to help the poor is an unlikely "choice" that people who want less government coercion and more individual liberty are going to make. But the rest of that sounds like it's right in the current Republican wheelhouse. If you get sick and can't make enough money by begging, well, you can console yourself with the knowledge that other people have more freedom, less government, and more money to spend on themselves. And that's what life, liberty and the pursuit of happiness are all about. Well, maybe not life. But two out of three ain't bad.