Republished with permission from Thom Hartmann
Here we are again, my friend, watching the age-old story play out before our eyes. The Republicans are preparing to hand out trillions in tax cuts to their billionaire benefactors, and how do they plan to pay for this latest giveaway to the oligarchy? By ripping healthcare away from 13.7 million Americans, including millions of our most vulnerable seniors who depend on Medicaid for their very survival.
But this isn’t just about healthcare policy. This is about the fundamental question that’s defined America since the New Deal: Are we a society that believes in the common good, or are we returning to the brutal Social Darwinism of the Gilded Age?
Let’s remember how we got here. For most of our post-war history, America operated on a simple principle that both parties understood: we take care of each other. This wasn’t socialism or communism; it was basic human decency codified into law.
When Lyndon Johnson signed Medicaid into law in 1965, he wasn’t just creating a healthcare program. He was affirming that in the wealthiest nation in human history, no American should have to choose between medical care and bankruptcy, between their medication and their mortgage, between living and dying because of the size of their paycheck or bank account.
But then came the Reagan Revolution, and with it, the poisonous idea that “government is the problem,” that the market is a god who must be obeyed (and is owned and run by the morbidly rich), and that every person should fend for themselves in the raw jungle of unregulated capitalism.
That’s when we began dismantling the social contract that made America great.
Here’s what the corporate media won’t tell you: Medicaid isn’t just for the “undeserving poor”; it’s the backbone of our system of long-term care for American seniors.
Our beloved Medicare doesn’t cover nursing home care: Medicaid does. In fact, Medicaid pays for 63 percent of all nursing home care in this country.
Think about a grandmother who worked her entire life, paid her taxes, raised her children, and contributed to her community. When she needs long-term care, it’s Medicaid that’s there for her. Not the private insurance industry that spent decades collecting her premiums. Not even Medicare. Just Medicaid. That’s it.
Republicans want to cut nearly $800 billion from Medicaid to pay for their tax breaks for Musk, Trump, and their billionaire friends; they’re working out the details this week in the House of Representatives.
This would be the greatest upward redistribution of wealth in American history, and they’re using our grandparents’ healthcare as the piggy bank.
That type of a massive cut will throw at least 8 and as many as 15 million American Americans, most seniors, out into the streets or eliminate their health coverage. They want to turn American families into financial victims of the for-profit healthcare system that eagerly awaits their arrival because it treats human suffering as a profit center.
This is what oligarchy looks like. This is what happens when a small group of ultra-wealthy individuals capture the government and use it to enrich themselves at the expense of everyone else. It’s not capitalism: it’s feudalism with a stock market.
When you gut Medicaid, you don’t just hurt individuals, you destroy entire communities. Rural hospitals, already hanging on by a thread, will close by the dozens. We’ve already lost 200 rural hospitals in the past decade because roughly a dozen states refused to expand Medicaid under Obamacare. How many more can we afford to lose?
These aren’t just statistics. These are communities where people have lived for generations, where children grow up, where families build lives. When that hospital closes, when seniors can no longer get care, when pregnant women have to drive three hours to give birth (more than half of all babies’ births in America are paid for with Medicaid) that’s not just healthcare policy. That’s the systematic destruction of American communities to enrich a handful of billionaires.
And it’s not just Medicaid. The Trump-Musk regime is simultaneously sabotaging Social Security, pushing out 7,000 public servants who helped Americans sign up for and claim their earned benefits. They’re declaring people dead who are very much alive, cutting them off from their Social Security, their bank accounts, their very ability to survive in modern society.
This is intentional. This is designed. They want to break these systems so badly that Americans will give up on the idea of government working for regular people, and instead accept that only the wealthy deserve security, healthcare, and dignity in their old age.
So here’s the fundamental question: What kind of society do we want to be?
Do we want—as Republicans preach we should—to be the kind of country where your worth is determined by your bank account? Where getting cancer means you might lose your home? Where growing old means living in fear of bankruptcy? Where the accident of your birth ZIP code determines whether you live or die? Where simply getting an education burdens you financially for the rest of your life?
Or do we want—as Democrats have worked to create since the 1930s—to fully become a society where we share the risks and rewards, where healthcare and education are human rights, where growing old doesn’t mean choosing between medicine and food?
This isn’t just about left versus right. This is about oligarchy versus democracy. This is about whether we’re going to let a handful of billionaires and massive insurance corporations dismantle the social contract that previous generations fought and died to establish.
We are the richest nation in the history of the world. We have the resources to take care of every American. The question is whether we have the political will to make our billionaires pay their fair share, to tax wealth the way we tax work, and to remember that we’re all in this together.
Our seniors didn’t fight in World War II and build the greatest economy in human history so that their grandchildren could watch them die in poverty. They fought to create a country where everyone—everyone—has a shot at the American Dream.
That’s the America worth fighting for. That’s the social contract worth defending. And if we don’t fight for it now, who will?
The choice is ours, America. But we better make it fast, because Republicans and their billionaire owners are coming for our Medicaid, they’re coming for our Social Security, and they won’t stop until they’re defeated or they’ve turned America into a feudal state where the many serve the few.
Is that the legacy we want to leave our children? I don’t believe it. We inherited a “Government Of the People, By the People, For the People.” Will we let them turn it into a government “Of the Billionaires, By the Billionaires, For the Billionaires”?
The time to choose—and to let our elected officials know our choice—is now.

Thom Hartmann
Thom Hartmann, one of America’s leading public intellectuals and the country’s #1 progressive talk show host, writes fresh content six days a week. The Monday-Friday “Daily Take” articles are free to all, while paid subscribers receive a Saturday summary of the week’s news and, on Sunday, a chapter excerpt from one of his books.