In fairness to the American right, their ideological mooing against extending health care to most Americans, and along with it both the health benefits and the enhancement to economic security that come with it is only the latest form of progress they have responded to with obstructionist dyspepsia, not anything terribly special.

On the issue of health care for Americans specifically, it must be remembered that the years of Republican hegemony, George Bush safe in his high chair inside the oval office and Republicans in control of the houses of congress, was a period of historically intense increase in the cost of health care, many multiples the rate of inflation. Personal bankruptcies due to inconceivable medical charges began to account for half of bankruptcies overall. Horror story after horror story of denied coverage of medical bills once a premium-payer was actually sick appeared everywhere, tales of denied coverage for pre-existing conditions and the consequent health and economic debacles rampant. For forty to fifty million uninsured Americans health care was financially inaccessible. Add to these, all the other indignities Americans faced with their atavistic health care system, twice as expensive, and largely inferior in results to universal systems everywhere.

And Republicans in control of everything did: Nothing. Proposed no reform, offered no remedies, made no speeches, not so much as even pretended it was an issue worthy of their attention or concern. Why? Well, how much of the answer is based in individual character, and how much is the result of ideology (clearly they often overlap) can only be determined by political psychologists, if such a thing exists, but the answer remains: Because they don’t care.

In light of this dereliction, this inertia, this egregious failure during their time in power, their ideological, and personal revulsion for wholesale reform of a deplorable health care status quo elevates their adamantine resistance to the Affordable Care Act to a degree of moral turpitude almost too depraved and filthy to contemplate.

But let’s contemplate it anyhow. Attempting to understand this contemptible negligence is akin to attempting to wrap your head around people who believe the nation is a lesser place because of Social Security. That they’re the same people is the non-shocker here, of course, and that it is a group that includes those unfriendly to, if not determinedly hostile to Medicare as well. Neither at the time of the inception of Social Security, and later Medicare, did the ideologues in opposition find poverty rates for elderly citizens in the range of thirty to fifty percent prior to Social Security troubling or persuasive of its need, nor the existential struggle of seniors to obtain and afford health care in a private system in which the old and the sick were turned away or priced out, like many of todays uninsured, compelling enough to elicit as much as a burp of concern, much less reform of the kind provided with Medicare.

Their present day ideological counterparts who detest Social Security, Medicare and the Affordable Care Act likewise find the reduction, and in some cases abolition of earlier hideous circumstances (since Social Security, poverty rates for the elderly are no higher than those for the rest of the population, and clearly Medicare has made medical care widely available to senior citizens) not persuasive of their moral and practical necessity, and the prospect of easing the personal and societal consequences of a pervasive lack of health care not compelling as a problem worthy of addressing.

The basis of their historical opposition to progress is always some variation of the assertion that most of humanity is a haplessly inferior blob, and that anything other than a stringently top-heavy, feudalist set-up has to be verboten, lest the moochers suck the deserving dry. Governmental solutions, no matter how efficacious involve swimming in the pool with the undesirables, which they consider both a scam against their acquisitions, and an affront to their ideological probity, and a great moral and philosophical injustice to boot.

Their vision of civilization actually isn’t one, morality residing in the eye of that great abstraction they like to call ‘the market’, replacing god almighty herself, deciding who shall live and who shall die, who is worthy and who is not. Put all other moral considerations in the category known as “extraneous,” for Europeans, and other human progress worrywarts to ponder. Market mysticism isn’t just for Ayn Rand fanboys anymore: it’s for rank and file Republicans too.

In giving credit where credit is due, unlike former aficionados of superior races and such, who considered exterminating the contaminating groups as the way to go, today’s more enlightened Randians espousing the cause of the dominant, superior breeds (‘makers’ and ‘producers’ I believe they like to call them) settle for merely casting the detritus aside, letting them perish of negligence, the contaminating group either a majority, or hovering around, let’s say 47% of us all.

Republicans are prone to portraying the benighted foreigners in Europe and Scandinavia, and Japan and Canada, citizens of the rest of the first and even second worlds as dolts and zombies and communistic sheep or village idiots for their more efficient, more effective universal health care systems, hoping to make you believe (along with insurance companies who provide them such largesse) all the foreigners are enduring varying shades of medical dystopia, though in reality, they understand the foreigners are on to something. Likewise, they understand once Obamacare is fully operational Americans will rue that America waited so long for a better system.

You may wonder how decent human beings could not be troubled that millions of Americans could not go to a regular doctor, that lifesaving health care for millions of fellow citizens was economically unattainable, and the status quo a growing drain on our nations resources. All I can venture is that it may be instructive of the moral numbing capacity of ideology, of the ability of dogma and indoctrination to supplant conscience, and of course, intelligence.

So your question now, I have no doubt, is whether these current advocates for the destruction of Social Security and Medicare, the vituperative antagonists to the provision of health care for all of America’s citizens will roast to a char in some of the hottest flames produced in the bowels of hell in the long career of Satan. And the answer is an unequivocal, yes.