What It’s Like to Watch the Senate Debate Whether Your Life is as Valuable as a Tax Cut for Trump

Ian Millhiser

Ian Millhiser Senior Constitutional Policy Analyst, Think Progress

Every other Saturday morning, I inject $2,269.61 worth of pharmaceuticals into my leg. If I don’t do so, my immune system will slowly eat holes in my small intestine. Eventually, it will start leaking digestive fluid into my abdominal cavity until I literally devour myself from the inside.

I’ve experienced an intestinal rupture before, and can assure you that the pain is unimaginable. Unless you’ve laid on a gurney screaming for morphine before, there’s nothing I can say to convey what it is like. I wouldn’t wish that pain on history’s worst tyrants. I wouldn’t wish it on Mitch McConnell.

I tell this story because the Senate is poised to vote on a bill that will plunge thousands of people similar to me into economic ruin. Many of us will not survive if Trumpcare becomes law. Unable to even afford opiates to ease the pain, some of us could die excruciating deaths.


See that? That’s almost $2,300 worth of medicine. Or two weeks of life for me. CREDIT: Photo courtesy of the author.

The drug that keeps me from this fate is called Humira, and it is one of capitalism’s great miracles. AbbVie, the company that makes Humira, sold $12.5 billion worth of the stuff in 2014, more than any other drug in on the market today. A box of two 40 mg Humira shots costs $4,539.21.

To me, it’s worth every penny. So long as I can afford it, it keeps my medical condition almost entirely at bay. I eat what I want, probably drink too much, and travel freely. I have a black belt in Shaolin kempo and an absolutely enormous German shepherd who loves to wrestle with me. If you met me, you’d have no idea that I have a potentially life-threatening condition.

Fortunately, I don’t have to pay anywhere near $4,500 for my Humira shots, as I’ve got great insurance that covers nearly all of that cost. So long as I keep this job, my insurer will pay to keep me alive.

And even if my bosses do decide that they are sick of seeing my face around the office, I’m probably going to be fine. I’ve got a law license, and I’ve got enough savings that I’ll be able to keep my health insurance for a little while thanks to a federal law known as COBRA.


That’s me looking haggard and gross after a workout I’m capable of doing because I have health insurance. CREDIT: Photo courtesy of the author.

But I can’t help be aware that not everyone is quite as fortunate.

A few years before Obamacare became law, a Harvard study determined that nearly 45,000 American adults died in a single year because they did not have health insurance. Many of them had conditions much like mine, which require expensive, lifelong treatments. I will probably live even if the Affordable Care Act is repealed and replaced with something like the previous versions of Trumpcare. Tens of thousands of others will not be as fortunate.

And, somewhat selfishly, I can’t ignore the very clear message the Senate will send to me if it approves Trumpcare. The bottom line is that, if push came to shove and my life depended on my ability to secure a health plan on an Obamacare exchange, the president and the lawmakers who lead both houses of Congress would rather spend that money on a tax cut for Donald Trump.

There is something quite clarifying when your government tells you that it no longer cares if you live or die. And make no mistake, that’s what Mitch McConnell wants the Senate to tell thousands of Americans today.

Ian Millhiser is a Senior Constitutional Policy Analyst at the Center for American Progress Action Fund and the Editor of ThinkProgress Justice. He received a B.A. in Philosophy from Kenyon College and a J.D., magna cum laude, from Duke University. Ian clerked for Judge Eric L. Clay of the United States Court of Appeals for the Sixth Circuit, and has worked as an attorney with the National Senior Citizens Law Center’s Federal Rights Project, as Assistant Director for Communications with the American Constitution Society, and as a Teach For America teacher in the Mississippi Delta. His writings have appeared in a diversity of legal and mainstream publications, including the New York Times, The Los Angeles Times, U.S. News and World Report, Slate, the Guardian, the American Prospect, the Yale Law and Policy Review and the Duke Law Journal; and he has been a guest on CNN, MSNBC, Al Jazeera English, Fox News and many radio shows.

Posted In: Allied Approaches

Union Matters

Freight can’t wait

From the USW

From tumbledown bridges to decrepit roads and failing water systems, crumbling infrastructure undermines America’s safety and prosperity. In coming weeks, Union Matters will delve into this neglect and the urgent need for a rebuilding campaign that creates jobs, fuels economic growth and revitalizes communities.

A freight train hauling lumber and nylon manufacturing chemicals derailed, caught fire and caused a 108-year-old bridge to collapse in Tempe, Ariz., this week, in the second accident on the same bridge within a month.

The bridge was damaged after the first incident, according to Union Pacific railroad that owns the rail bridge, and re-opened two days later. 

The official cause of the derailments is still under investigation, but it remains clear that the failure to modernize and maintain America’s railroad infrastructure is dangerous. 

In 2019, 499 trains that derailed were found to have defective or broken track, roadbed or structures, according to the Federal Railroad Administration’s database of safety analysis.

While railroad workers’ unions have called for increased safety improvements, rail companies have also used technology and automation as an excuse to downsize their work forces.

For example, rail companies have implemented a cost-saving measure known as Precision Scheduled Railroading (PSR), which has resulted in mass layoffs and shoddy safety protocols. 

Though privately-owned railroads have spent significantly to upgrade large, Class I trains, regional Class II trains and local, short-line Class III trains that carry important goods for farmers and businesses still rely on state and local funds for improvements. 

But cash-strapped states struggle to adequately inspect new technologies and fund safety improvements, and repairing or replacing the aging track and rail bridges will require significant public investment.

A true infrastructure commitment will not only strengthen the country’s railroad networks and increase U.S. global economic competitiveness. It will also create millions of family-sustaining jobs needed to inspect, repair and manufacture new parts for mass transit systems, all while helping to prevent future disasters.

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There is Dignity in All Work

There is Dignity in All Work