Photo Credit: Gage Skidmore/Wikimedia Commons
Last week, Representative Dan Crenshaw (R, TX-2) sent out a quietly heartbreaking press release. It notified constituents and colleagues that Crenshaw would be temporarily out of commission as doctors work to save his one partially-functioning eye.
OK, you may not like Crenshaw very much: I don’t. He is a Trump baby, elected in 2018. He was one of the firebrand Republicans who fueled conspiracy theories about the election. He joined the Texas Attorney General’s lawsuit to throw out legally cast ballots in the battleground states that Joe Biden won in 2020. Then, when everything went to $hit from $hinola on January 6, 2021, Crenshaw backpedaled and chastised GOP colleagues who had encouraged the mob to storm the Capitol.
Perhaps you also know Dan as a guy who has never met a gun or gun owner he didn’t love and who wears a jaunty pirate eye patch, instead of a prosthetic eye, a physical reminder of the eye he lost to an IED in Afghanistan as a decorated Navy SEAL. Crenshaw’s 2020 campaign featured a three-and-a-half-minute “Mission Impossible” parody film, in which a fictional bionic eye plays a signature role in helping him scan Texas for other patriots. The film portrays him, not as a politician, but as a futuristic secret agent—the kind that QAnon conspiracists believe have infiltrated the American government to defend “their freedoms.”
But the press release about the deteriorating condition of Crenshaw’s remaining eye is no fantasy. It is a terrifying problem that threatens about 28,000 Americans every year: a detached retina.
When a retina detaches, you go from fine to crisis mode in seconds: there is no warning, nothing you could have done to prevent it, and your eye requires expensive emergency care. “A few days ago,” Crenshaw wrote, “I noticed some dark, blurry spots in my vision, which seemed out of the ordinary. I went to get this checked out by an ophthalmologist on Thursday, and they discovered that my retina was detaching.”
People who have irreversible eye damage as Crenshaw does often talk about the “bad eye” and the “good eye.” But as Crenshaw explains, he doesn’t have a “good eye;” he has “half a good eye” remaining from the two he was born with. “The blast from 2012 caused a cataract, extensive tissue damage, and extensive damage to my retina.”
People whose eyes have been damaged by disease or an accident face a lifetime of dread and medical trade-offs as they try to preserve and optimize what vision remains. For example, there are certain kinds of medical treatment they might need at the front of the eye (the cornea and lens, where light comes in), which risk destabilizing the back of the eye (the retina and macula, which transfer visual information to the brain.) Unlike the cornea, which can take a beating, or the lens, which a doctor can replace with a bionic part, often done as part of cataract surgery, the back of the eye is delicate and has little capacity to repair itself or recover lost functions.
Worse, surgical repairs can make the back of the eye more fragile. Crenshaw is now recovering from a procedure in which his retina has been reattached (again) and a gas bubble injected into the eyeball to keep the repair stable (this is called a pneumatic retinopexy.) Often, it works, but sometimes it doesn’t. Crenshaw will have to lie on his face without moving for over a week, completely blind, waiting to see if the surgery was successful. “Thank you in advance for your thoughts, prayers, and support,” the press release concluded.
I do hope his eye heals. There are no political differences in the world that should prevent any of us from sending genuine thoughts and prayers to Dan Crenshaw. While people continue to have rich and full lives while blind, Crenshaw has feared this moment since he woke up from an induced coma in a military hospital almost a decade ago.
But as we all know, this kind of medical care requires more than thoughts and prayers. It requires expensive medical care, which Crenshaw receives from the Veteran’s Administration hospital in Houston. Depending on the injury’s complexity, pneumatic retinopexy takes about 30 minutes and is billed at between $5,000 and $10,000. Because of Crenshaw’s military service and his access to excellent health insurance as a Congressperson, it cost him either nothing or next to nothing.
But that wouldn’t be the case for you or me: not all health insurance plans pay for complex eye surgery. Although Affordable Care Act (ACA) plans cover vision care for children, the basic plans most Americans can afford do not cover adults. If your insurance plan does cover eye surgery, the deductible can be as high as $6,000.
There are larger implications too. Sight-saving surgery, as any unexpected medical bill can, puts a working-class, or even a middle-class, family in immediate economic jeopardy. In 2019, almost a decade after the ACA was passed, 66.5% of bankruptcies were still caused by the burden of unanticipated medical bills, many incurred by people who had insurance.
In addition, blindness is not just a life-changing disability or a source of debt: it also puts a person, who may be a primary family wage earner, at immediate risk of lifelong poverty. In 2016, 4,037,600 Americans age 16-64 were technically or legally blind. A staggering 70% of this population was unemployed, and SSI disability payments for the blind top out at a little less than $2200 a month.
But why should Dan Crenshaw be thinking of this at such a stressful moment in his life? Because he has consistently opposed the expansion of publicly subsidized health insurance for ordinary Americans, has opposed mandatory coverage for people with pre-existing conditions, and believes that government should leave health care to the tender mercies of the free market. Crenshaw has voted:
- No on appropriating $10 billion to expand and strengthen the ACA, primarily by reducing and strengthening out-of-pocket costs. (H.R. 1425, June 29, 2020)
- No on permitting HHS to negotiate with drug companies to lower the cost of pharmaceuticals. (H.R. 3, December 12, 2019)
- No on fast-tracking federal approval of more affordable generic drugs, expanding funding for states to establish health insurance exchanges, nullifying an agency rule related to short-term, limited-duration coverage, and expanding ACA outreach. (H.R.987, May 16, 2019)
- No on preventing the Trump administration from amending the requirements for ACA waivers to include “experimental plans for health care coverage.” These schemes include faith-based care programs and so-called “personalized health care” that cost very little—and pays for very little too. (H.R.986, May 9, 2019)
- No on a resolution condemning the Trump Administration calling on federal judges to invalidate the constitutionality of the ACA. (H.R.271, April 3, 2019)
Instead, Crenshaw favors low-cost schemes that mimic health insurance, such as healthcare sharing ministries, in which members receive coaching about how to live a healthy and moral life but no reimbursement for treating actual diseases. In other words, members are encouraged not to get sick and urged to think about what they have done wrong if they do.
Right before the 2020 election, Crenshaw proposed his own version of this bait-and-switch scheme. In October, he sponsored a bill for what he called “personalized health care.” This scam proposed to exempt Americans from the ACA’s insurance mandate (and thus, protection from a medical catastrophe) by allowing doctors to charge a monthly fee for primary care services.
Such a plan would, Crenshaw proposed, do the important work of “keeping communities healthy and preventing a culture of `sickness.’” This statement appears on a site for Delta Direct Care, a corporation that offers coverage for as low as $75 a person and $140 a family. It pays for little but doctor’s visits—no tests, no hospitalizations, no specialists, no emergency room fees, no pneumatic retinopexies. The website is upfront about this and recommends that customers obtain “a high deductible insurance plan” or a job that offers health insurance.
In other words, Crenshaw is touting a healthcare service that, given his medical history, he would almost certainly never purchase for himself or his family or imagine as a solution for their health care needs.
Of course, Crenshaw doesn’t have to imagine this: he can care for his family and himself with two taxpayer-funded health insurance plans, one that he receives as a veteran and one as a Congressperson (kind of like single-payer insurance, right?) And if my tax dollars save his sight, I will consider them well spent. He does have my thoughts and prayers.
But he also has my money.
Claire Bond Potter is Professor of Historical Studies at The New School for Social Research and co-Executive Editor of Public Seminar. Her most recent book is Political Junkies: From Talk Radio to Twitter, How Alternative Media Hooked Us on Politics and Broke Our Democracy (Basic Books, 2020). This post originally appeared on her Substack.