I’m going to have a live conversation on Substack with John Ganz today. I’ve never met him before, but I get a lot of value from his writing. (His Jock/Creep Theory of Fascism is extremely useful, as are his historical parallels about Volk movements.)
We’ll be live here at 12:30 p.m. Eastern.
1. Medicaid
Warning: This is a two-parter. Tomorrow we’re going to have a pretty heavy discussion about why America is a good place, and worth fighting for. But today? Today I’m giving you the opposite case: That people are terrible and deserve what they get.
I want you to talk about this in the comments, but please be mindful that I’m only giving you the first half—so don’t get committed to your position. I want you to have an open mind before the big conversation tomorrow. 🙏
We start today in Curtis, Nebraska, where the town’s only medical clinic is shutting down. The people of Curtis are angry. At who? You’ll never guess:
The only health clinic here is shutting down, and the hospital CEO has blamed Medicaid cuts in President Donald Trump’s signature legislation. But residents of Curtis—a one-stoplight town in deep-red farm country—aren’t buying that explanation.
“Anyone who’s saying that Medicaid cuts is why they’re closing is a liar,” April Roberts said, as she oversaw lunch at the Curtis Area Senior Center.
The retirees trickling in for fried chicken and soft-serve ice cream will be hit hardest when the clinic closes this fall, Roberts fears. Seniors who sometimes go in multiple times a month to have blood drawn will have to drive 40 miles to the next nearest health center. Sick people, she worries, will put off checkups and get sicker.
Arriving for lunch, retired Navy veteran Jim Christensen said he’d read an op-ed that “tried to blame everything on Trump.”
“Horse feathers,” he said, dismissing the idea.
Only the best people.
The Curtis health clinic is run by a nonprofit organization called Community Hospital. Its facilities serve 30,000 mostly poor, mostly rural Americans. The clinic in Curtis was already losing money; Community Hospital looked at the budget projections for what would happen after the Republicans’ “One Big Beautiful Bill” was enacted and realized the clinic would eat up even more resources, putting the organization’s entire mission at risk.
They chose to close the Curtis clinic, tying off the losses so that they could keep other facilities open. The nonprofit could no longer subsidize the people of Curtis’s lifestyle.
Let me put this in terms that up-by-your-bootstraps, personal-responsibility Republicans will understand:
The residents of Curtis are “takers.” They rely on welfare doled out by the productive parts of America. They have existed for decades as beneficiaries of this arrangement, propped up by the charity of organizations such as Community Hospital and the tax dollars from people in high-productivity urban areas. But the “makers” are no longer able to float them. So the takers will have to start absorbing the consequences of their choices.
The funny part in all of this is that the people in Curtis think that they are the “makers” and that the “takers” are some nebulous group of others they’ve never met.
Many [Curtis residents] know that Trump’s bill will impose work requirements for Medicaid recipients, which seems reasonable to them, and some think—inaccurately—that the legislation was designed to end Medicaid coverage for undocumented immigrants. . . .
[Jo] Popp, a three-time Trump voter, thought the president was cutting wasteful spending and didn’t think he caused the closure.
What are we supposed to do with people like this? People in dying towns who suck up national resources and not only aren’t grateful—have they ever said “thank you” once?—but believe that they’re the aggrieved party?
What are we supposed to do with people who, when faced with personal, real-world consequences, refuse take responsibility and instead sink further into victimhood?
What are we supposed to do when the takers outnumber the makers and achieve massive political power?
And if you think the people of Curtis are bad . . .