That’s how many people would die every year to give a tax break to each of the 400 richest people in America under the new Republican “health” bill. All in all, hundreds of thousands could die over the next ten years to make the wealthiest among us even wealthier.

That number is based on the bill that passed yesterday, published estimates of the bill’s impact on public health and the economy, and some simple arithmetic.

In 1970, a writer named Richard Matheson wrote a short story about a married couple who receive a mysterious box with a button on it. They’re told that they’ll receive a large sum of money if one of them presses the button ― and somebody they don’t know will die.

That’s pretty much the story of the so-called “health bill” the Republicans passed yesterday. It’s not really a health bill; it’s a wealth bill. It transfers even more of our national wealth to the already prosperous. In return, it will cause the death of people that Donald Trump and the well-heeled Republicans in Congress probably don’t know.

What economist Gene Sperling wrote about its predecessor, which failed to pass in March, is true of this version as well. It’s “about rationing care to fund tax cuts for the U.S.’s highest earners.”

Sperling summarized the tax implications of this bill in March: the bill’s two main tax cuts only apply to people making more than $200,000 a year, and 80 percent of those savings will go to people making more than $1 million.

Each of the top 400 earners in the country—who receive an average of $300 million per year in income—would get an average tax cut of $7 million per year.

That’s the money part of the equation, but this bill has another major output: death. What follows are rough estimates, but they’re based on real-world experience.

Using Massachusetts data, ThinkProgress estimated that 16,867 per year could initially die, with the annual total rising to 28,916 by 2026. I assumed ten years of even growth in those numbers and came up with an estimated total of 222,892 deaths over a ten-year period.

Working from Medicaid data, Professors David Himmelstein and Steffie Woolhandler estimated that this bill would result in the deaths of 43,956 people every year.

Neither of these methods factored in the new bill’s loophole for Americans who receive health insurance through their employer. The new bill would allow each state to set its own rules for deciding which health benefits are “essential” to providing good coverage.

(In other words, the bill robs state governments of the right to determine what kind of health coverage is best for their residents. So much for state’s rights conservatism.)

Employers who operate in more than one state would be allowed to choose which state’s rules to follow. That’s likely to cause additional deaths, too, by making some kinds of needed care unaffordable.

What They Think Your Life Is Worth

How much is your life worth to the Republican Party?  Since no studies have been published on the deaths that might be caused by the employer plan change, I’ll use the higher of the two published estimates above, the Himmelstein/Woolhandler number (although it should be noted that this, too, is a low-end estimate). That gives us a total of 439,560 deaths over ten years.

As Michael Hiltzik wrote in the Los Angeles Times, this bill “would provide the wealthiest taxpayers with an immediate tax cut totaling $346 billion over 10 years.”

Dividing that ten-year tax cut by the ten-year estimated death toll, we estimate each death provides $787,151 in tax breaks for the wealthy.

That kind of money would hardly buy you a walk-in closet in one of those new Hamptons supermansions.

Sperling has already noted that the country’s 400 highest earners will each receive an average annual tax cut of $7 million. That comes to nearly ten dead people every year for each of these ultra-rich individuals ― just so they can become even richer.

Like the characters in Matheson’s story, these wealthy individuals probably won’t know any of the people who’ll die if this bill passes. They don’t tend to mingle with the sort of folks who rely on health insurance to stay alive. They will never know their names.

But ten dead strangers will be with them wherever they go: riding in the back seat of their golf carts, looking over their shoulders as they nibble duck confit off each other’s plates, standing knee-deep in the surf and staring at them as they enjoy an evening cocktail on their private beaches.

Everyone who would get a big tax break under this bill could soon be faced with a utilitarian moral decision: should they pocket this money or use it to help defeat the politicians who caused these needless deaths? If they keep the money, they’re sanctioning the cynical calculus that says others must die for their further enrichment.

If they want to avoid this blood money’s moral taint, however, there are some excellent political groups out there who could use the money.

Republicans have yet to pass this bill in the Senate, and they seem understandably wary. Maybe the GOP’s millionaire senators sense, with a cool prickling down their necks, that spectral strangers could soon come knocking at their doors. But it’s more likely that that prickling sensation comes from the thought of losing their next election.

Trump and the other Republicans who support this bill share something in common: their personal tastes may be expensive but, for them, the lives of most Americans are insignificant and cheap.

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