For me, this is the number one reason why the GOP should not be in power. Mitch McConnell has signaled that the best solution to the health care crisis is for those of us with pre-existing medical conditions is to be bankrupted by medical bills…or just die.

The senior senator from Kentucky, who himself enjoys government-subsidized insurance as a federal employee, told the National Review on Tuesday that the party would do little to help the 129 million people who could be denied insurance because they suffer from a pre-existing condition should the law be repealed. “I’m not convinced that issue needs to be addressed at the federal level,” he said, before praising Republican governors for refusing to implement a provision of the law that expands health coverage to lower-income residents through the Medicaid program.

During the interview, McConnell also confirmed that he planned to repeal Obamacare’s main provisions — like the individual mandate — through reconciliation, a process that allows the Senate can pass budget-related bills with a majority vote:

MCCONNELL: Repeal of Obamacare will be the first item up in the Senate if I am majority leader. If we have a president who will sign the bill, we will do everything we can to get it off the books, and we’ll be looking for every angle that could be pursued. There has been a lot of talk about reconciliation. The Chief Justice said this is a tax, and we take him at his word, so that certainly makes this eligible for reconciliation. But that may not be the only avenue that we pursue.

The foolish smokescreen of whether it is a penalty or a tax is absurd. The fact is any solution is going to cost a buttload of money — as if we aren’t already paying billions for the broken patchwork system already in place.  The question is not only how to contain costs, but to provide everyone with basic health care options that don’t place their homes or financial future in jeopardy. The GOP has spent all its energy just demonizing one attempt when they’ve provided nothing.

The feeble Obamacare isn’t the solution by any stretch of the imagination, but we won’t get anywhere with a policy of letting “the market” decide the fate of people who have the misfortune to have a pre-existing condition and 1) not have any health insurance, 2) lost their job and after COBRA ran out, are left without insurance, or 3) have a job, are under-insured with a crappy policy, and just one major illness away from financial catastrophe. That’s millions of people Mitch McConnell just flipped the bird at. The American people, from his POV aren’t entitled to the same level of health care he enjoys on our dime.

But we all know this hypocrisy knows no bounds. I kind of appreciate the bottom-line sociopathy of Fox News medical contributor Dr. Marc Siegel. He probably speaks for a good number of people who aren’t as candid; he believes that health care should be doled out with morality guidelines attached.

During a discussion about how medical providers will respond to the law, Siegel argued that some physicians won’t accept newly insured patients with pre-existing conditions who “eat all the wrong foods” and “gain weight” because “they are not paid enough”:

TOM SULLIVAN (HOST): Right now you can say I don’t accept Medicare or Medicaid? Right?

SIEGEL: Tom, that the untold story. There has been no consideration to the fact that many physicians do not take insurance. Many surgeons don’t take insurance…The more Obamacare floods the gate, the less they will take insurance. If they’re not getting paid and an insurance company says, I have to cut somewhere.

They are forcing me to cover all pre-existing conditions, which sounds great. Let’s take care of everybody’s pre-existing condition. You lie on the couch for 30 years, you never exercise, you gain weight, you eat all the wrong foods, you get diabetes and now you have Obamacare. But the fact is, doctors don’t have to play ball with it. If they are not paid enough they won’t play ball with it.

I’m trying to figure out how Siegel decides which diabetes patients are worthy of being covered — no type II, only insulin-dependent, only skinny diabetics? What if there’s a family history of it not connected to obesity? Where do you draw the line? What about diseases that aren’t connected in any way to “lifestyle” but are expensive to treat — many auto-immune diseases can only be well-controlled with expensive medications. Would Siegel have a panel decide some are entitled to the drugs and not others? It’s a slippery slope, but I think Siegel’s viewpoint is not a fringe one. I think a lot of people harbor a resentment toward the sick who may have contracted illnesses related to behavior — such as lung cancer due to smoking. Are we as a society saying that treating the patient is not deserving of health care, rather than focusing on how to reduce smoking overall?

It’s more complicated when it comes to the explosion of diabetes (type II, your body makes insulin but doesn’t use it well) related to diet, exercise and hereditary factors. One has to eat, and one chooses what we ingest. Americans in general like to eat — and are encouraged to do so in advertising — foods laden in fat, salt and sugar. And they taste good and are cheap. Healthy foods are readily available in higher income level areas, so the health disparity is markedly based on socioeconomic factors. Rather than address the Processed Food Industrial complex and its effect on the American diet, both government and society tends to blame the human being for being fat, weak and lazy. I don’t see that solving the actual problem, since it’s pretty clear we’re all getting fatter no matter whether a carrot or stick approach is being used. Attitudes like Dr. Siegel’s are a good example of why it’s going to be difficult to refocus attention on reducing health risk factors in the population when there’s such a personal animus toward the sick based on a judgment about their character.

(H/t Scott Rose)