Ezra Klein makes a good point in this piece in which he acknowledges the VA revelations for the scandal they are --- nobody should be denied needed health care --- by showing the vast numbers of people affected by Republican governors' cynical decision to refuse the Medicaid expansion. It encompasses millions of people, many of whom will suffer and die as a result of this craven political act.
But Ezra leaves out the salient issue for Republicans: they revere the military for all its traditional masculine virtues so veterans deserve health care. Poor people (who are not veterans or elderly white people) do not. This is the simple equation that guides their philosophy:
If you don't have health care through gainful employment or fail to buy it yourself from an insurance company, you are obviously being irresponsible. (And no, the government shouldn't help you with those premiums --- no Obamacare for you!) Therefore, you deserve what you get. Life is black and white to these people, at least in the abstract. When it comes to their own lives or people they know, it's obviously a different story. The extenuating circumstances, life's harsh blows, bad timing and bad luck explain why a particular person might need some help. But they are also very harsh with people who develop bad habits or fail to live up to their behavioral standards. And they assume laziness and sloth among most people of color so unless they have ascended to the highest levels of society, like Condi Rice or Marco Rubio, they assume they also deserve what they get.
The bottom line is that conservatives can't exercise empathy, by which I mean that while they can see themselves in an unfortunate circumstance, they are unable to extrapolate from that possibility the fact that others in those unfortunate circumstances deserve the same compassion and assistance. I guess that would mean these people aren't "special" and that's something they really cannot live with.