Dwain Northey (Gen X)

Of course it’s not surprising. Not even a little. In fact, if it were surprising, that would be the real shock—a glitch in the ideological matrix. The party that earnestly insists corporations are people (very sensitive people, apparently, who cry if taxed) has always been perfectly consistent in believing that actual people should fend for themselves, preferably with less money and more character-building hardship.

So naturally, unions are bad. Why would a group of workers band together to negotiate better wages, benefits, and protections when they could instead enjoy the rugged individualism of negotiating one-on-one with a multinational corporation and its fleet of lawyers? Nothing screams “freedom” like a warehouse worker sitting across from a trillion-dollar company saying, “I was hoping for healthcare,” and being countered with, “Best I can do is a motivational poster.”

Which brings us, seamlessly and predictably, to healthcare. Specifically, the deep and abiding urge to get rid of ACA subsidies. Because if there’s one thing people struggling to afford rent, food, gas, childcare, and student loans clearly have too much of, it’s help paying for medical care. Subsidies are obviously a moral hazard—people might start getting ideas, like seeing a doctor before their appendix explodes.

Enter the Health Savings Account, the policy equivalent of telling a drowning person to invest in a better swimming pool. HSAs are brilliant, really, if you already have money. If you don’t, they function more like a philosophical exercise: imagine having spare cash. Picture it. Meditate on it. Surely the act of envisioning savings will one day manifest healthcare through vibes alone.

The logic is flawless: what people with no money desperately need is… a special savings account for the money they do not have. Preferably paired with a high-deductible plan so they can enjoy the thrill of paying thousands of dollars out of pocket before insurance does literally anything. It’s healthcare, but gamified—can you survive the year without getting sick enough to bankrupt yourself?

And let’s not forget the core fantasy holding all of this together: that individuals can negotiate better healthcare prices than large groups. Yes, absolutely. A single patient with a fever and a credit card is obviously in a stronger bargaining position than millions of insured people pooling risk and negotiating as a bloc. Hospitals are famously flexible when you say, “Before you stitch me up, can we talk pricing?”

This is the same worldview that tells us unions distort the market, but monopolies are just efficiency; that collective bargaining is coercion, but corporate lobbying is free speech; that healthcare is too complex for government, yet simple enough to be solved by Dave from accounting with an HSA app.

So no, none of this is surprising. It’s perfectly on brand. Corporations get personhood, people get bootstraps, and healthcare becomes a moral test instead of a public good. If you survive without help, you’ve earned it. If you don’t, well—that’s just the market speaking.

Really, really not surprising at all.