There is a famous thought experiment called the trolley problem, and it goes like this: A runaway trolley is headed toward five people bound on the tracks. You are standing before the switch that could divert it onto another track, where it would kill only one person. Do you pull the switch?
The problem is a way of grappling with the moral responsibility of actively killing a person for some larger end, a problem that lurks behind much of the role of the state, from policing to Harry Truman dropping the atomic bomb on Japan. The trolley problem is the most flattering possible way to think about the conservative movement’s fanatical commitment to repealing Obamacare. That is, if you ignore the obvious elements of partisan spite, callousness, and self-deception, one can posit a commitment to abstract moral principles about the role of the state. Conservatives’ abstract principles, like most people’s, can come attached to specific costs. If they pull the switch and repeal Obamacare, or if they persuade five Republican Supreme Court justices to cripple it, they will spare America from the evils of mandates, taxes, regulation, and what they imagine to be European socialist horrors. They will also kill what are now identifiable human beings.
One of those human beings is David Tedrow, who, in a harrowing first-person account published in the Washington Post, writes of his fight with non-alcoholic cirrhosis, crediting Obamacare with saving his life. “Without insurance and the subsidy I would simply die,” writes Tedrow, “because I could not afford my drugs and my body would reject my liver.”
Last night I linked to the story on Twitter, writing, “The Republican Party is trying to kill this man.” The description was slightly hyperbolic in the sense that killing Tedrow is not the Republican Party’s goal — they would be perfectly happy if, after they have repealed Obamacare, a generous philanthropist stepped in to save Tedrow’s life — but rather the direct and inescapable result of their behavior. He is collateral damage in the service of a larger goal, like the populations of Hiroshima and Nagasaki, or the imaginary stranger on the railroad track.