Wealthy, entitled, and oblivious (Gage Skidmore)

One of the universalities of the Republican party, especially among its top practitioners of the political arts, is the absolute inability to grasp that your own experiences are not necessarily indicative of those of average people. Those people over there aren't rich? They must be lazy. Those people don't have good health care? Don't be silly, I've got wonderful health care.

A minor case of this is Mitt Romney identifying with the "unemployed," as if his experience as a beach-house-renovating millionaire running for president has much in common with the millions out there who can't find work. A more demonstrative case is pretty much everything Herman Cain ever says.

Cain has said on numerous occasions that he would not have survived cancer had the Obama health care plan been in effect. He got excellent care, you see, and supposedly the new health care plan would have fouled that up in some unspecified way, probably involving "death panels" or the like. But, as Stephanie Mencimer writes at Mother Jones, Herman Cain's chances of surviving his cancer were greatly increased because he was rich. Other Americans don't get that level of treatment.

Cain devotes a whole chapter of his new book to his battle with cancer. He never once mentions insurance companies not paying for treatment, skimping on reimbursement, or disqualifying his claims. He never mentions having to fend off threats that his coverage will be revoked. He never has trouble paying the bills or getting to the hospital or into the best treatment programs. Instead, Cain's health care story is a happy tale of selfless doctors and the brilliance of the private sector. The sort of treatment Cain received would have put many people into bankruptcy, even if they had health insurance, thanks to caps and co-payments and other tricks insurance companies use to shift costs onto patients. Cain has never mentioned just what sort of health insurance he had during his cancer treatment, or what he has now.

And:

These omissions are glaring because as a 65-year-old stage IV cancer survivor, Cain would be all but uninsurable if he tried to get insurance now on the private market.

And:



[H]e was told that he should go to a specialized cancer center rather than a hospital, namely the M.D. Anderson cancer center in Houston. Not everyone who wants to go to such a top-flight facility gets to go there, however. Plenty of people with private insurance have died waiting for an insurance company functionary to approve such treatment. [...] Cain called his friend T. Boone Pickens, the oil magnate, who used to be on the board of the center and was a big donor to the cancer center. Pickens made a call and Cain was in.

And:

[W]hen Cain, a multimillionaire, needed a second opinion about his cancer surgery, he went to see a doctor in Savannah. After giving him a full workup, Cain writes, the doctor "didn't charge me a dime—and he supported me in my Senate campaign."

And:

He was able to go home a week early because, although he was still weak, one of the companies on whose board he sits dispatched its private plane to fly him back to Atlanta so "we did not have to endure the stress of commercial travel."

Herman Cain did not merely have good health insurance. And Herman Cain was not merely rich. Herman Cain got to a specialized cancer center because he was connected; got free health care, because he was connected; was sent home on private jet, thanks to the largess of a corporation he was connected to.

It is, in short, nearly the farthest possible thing from the average American experience that you can imagine. It is nearly parody, it is so far removed from the concerns over money, and insurance, and haggling over getting the proper care, and trying to meet copays, and trying to avoid insurance cutoffs because they have spent too much, or you have been sick too long, or you have changed jobs and so are not even allowed to see your old doctors, and so on, and so on, and so on. Recovery on a private plane? Calling your good friend T. Boone Pickens to get you bumped ahead of other cancer patients? Getting a goddamn second opinion from another doctor as campaign contribution?

What I worry about is that Cain literally seems to have no notion that other cancer patients might have different experiences from that. He may recognize they are not all friends with T. Boone Pickens, but surely they have other wealthy benefactors to fall back on? They may not have insurance, or have inadequate insurance, or have what they thought was perfectly adequate insurance, until the denials of claims started rolling in, but surely that would not affect the quality of their care, yes?

This is what is astonishing about each of these presidential candidates; they live in dioramas of their own making, completely isolated from the rest of the world. They can spout platitudes about America this and America that, but the America they are talking about is an America that exists as mere construct of a sheltered, ideologically obstinate mind. Can Herman Cain even grasp a world in which a lifetime of hard work is not automatically rewarded with wealth—much less a world in which life and death is decided not just by fate, but by the desired bottom line of some nameless insurance company sub-office?

There's nothing in the health care plan that would affect Herman Cain's ability to buy exceptional insurance, or to pay untold gobs of money towards his own care. Not a damn thing. As a wealthy American, he will continue to receive substantially better care than other people simply because he can afford it, but it does not seem like Cain recognizes that his experiences are, in fact, privileged. For the vast majority of Americans, the American health care system looks nothing like the health care system available to Cain. Average Americans, in fact, die from treatable diseases on a regular basis, all for lack of insurance, money to pay for medications, or insurance company policies that prevent them from receiving doctor-recommended treatments because the company simply doesn't want to pay for such things.

You know: death panels.

