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Posted by on Oct 15, 2012 in 2012 Elections, At TMV, Economy, Featured, Health, Law, Media, Politics, Society, USA Presidential Election 2012 | 15 comments

Let ‘Them’ Go to Emergency Rooms

I have heard Mr. Romney’s claim that nobody in our country dies because he or she has no health insurance: “We don’t have people that become ill, who die in their apartment because they don’t have insurance.” Au contraire, “…you go to the hospital, you get treated, you get care, and it’s paid for, either by charity, the government or by the hospital,” he says.

In an interview with CBS News’ “60 Minutes” a few weeks ago, Romney also pointed to emergency rooms as an adequate form of health care for people without insurance:

“Well, we do provide care for people who don’t have insurance,” Romney told interviewer Scott Pelley. “If someone has a heart attack, they don’t sit in their apartment and — and die. We pick them up in an ambulance, and take them to the hospital, and give them care. And different states have different ways of providing for that care.”

Romney is not the only influential Republican to claim such grandiose, charitable excellence in our health care system. Back in 2007, former President George W. Bush, threatening to veto an expansion of the federal Children’s Health Insurance Program, said, “People have access to health care in America.”

Having heard and read about so many Americans being bankrupted by the cost a serious illness or accident, about so many Americans not receiving adequate preventive — or any other kind of adequate medical care — because of lack of funds and lack of insurance, I knew in my own mind that such statements were inaccurate or, at best, misleading.

However, not having an intimate knowledge of our health care laws — both federal and at the state level — I did not have enough information to refute such outlandishness.

In “Death by Ideology” in today’s New York Times, Paul Krugman claims that such statements “clearly demonstrate that Mr. Romney has no idea what life (and death) are like for those less fortunate than himself,” and calls the idea that everyone gets urgent care when needed from emergency rooms just plain “false.”

Krugman says:

Yes, hospitals are required by law to treat people in dire need, whether or not they can pay. But that care isn’t free — on the contrary, if you go to an emergency room you will be billed, and the size of that bill can be shockingly high. Some people can’t or won’t pay, but fear of huge bills can deter the uninsured from visiting the emergency room even when they should. And sometimes they die as a result.

More important, going to the emergency room when you’re very sick is no substitute for regular care, especially if you have chronic health problems. When such problems are left untreated — as they often are among uninsured Americans — a trip to the emergency room can all too easily come too late to save a life.

That is what I thought, too.

Krugman concludes:

So let’s be brutally honest here. The Romney-Ryan position on health care is that many millions of Americans must be denied health insurance, and millions more deprived of the security Medicare now provides, in order to save money. At the same time, of course, Mr. Romney and Mr. Ryan are proposing trillions of dollars in tax cuts for the wealthy. So a literal description of their plan is that they want to expose many Americans to financial insecurity, and let some of them die, so that a handful of already wealthy people can have a higher after-tax income.

I look forward to hearing from those who agree with Krugman, as well as from those who support Romney’s and Bush’s claims that poor Americans do have access to adequate health care in America — in emergency rooms.

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  • ShannonLeee

    Preventative care is such an important part of any health care system. My government mandated and regulated privately run health care insurance company allows me to get a one hour neck and shoulders massage every 2 months because it has been scientifically proven that that sort of preventative care does wonders for your health…and longevity.

    6 massages a year… as part of my health care preventative coverage, because it saves them money in the long run… and they care because I will be insured for life over here.

    Long-term care
    Short-term profits

  • DORIAN DE WIND, Military Affairs Columnist

    Thanks, SL.

    I would add to important preventive care examples:

    Breast cancer screening

    Colorectal cancer screenings

    Diabetes screenings

    Prostate cancer screenings

    Cardiovascular screenings


    How many emergency rooms will do this “for ya”?

  • dduck

    No, the ER is NOT the place for adequate health care. Either side has to come up with a plan that allows the kind of care ERs don’t provide AND ERs should not cause added waiting times and dilution of services for EMERGENCIES any of us may have from time to time. In my visits to the ER, I have seen several people getting care for colds and the doctors verified that.

    BTW: I think there may be an increase of walk-in clinics (NYU is starting one in my neighborhood and there is a Beth Israel one a few blocks away), which I think is a good thing and perhaps could be used as part of a comprehensive plan.

    Please don’t jump on the keyboards to say I support Mitt’s perceived attitude on this subject.

  • DORIAN DE WIND, Military Affairs Columnist

    Please don’t jump on the keyboards to say I support Mitt’s perceived attitude on this subject.

    I won’t, if you won’t 🙂

  • EEllis

    I can’t speak for everywhere but in Texas we have these things called county hospitals. Anyone can go and get treated for a urgent condition and pay nothing. Will you get a bill? Honestly it depends on how much you make but the poor and the indigent don’t pay anything. If you get cleared by the county for free health care , they call it the gold card, then there are any number of clinics that will accept you as a patent for routine care and they get reimbursed by the county. As far as I’m concerned the biggest issue isn’t with availability of healthcare it’s access. Try being poor with the nearest county hospital 50 to 100 miles away. All the medicaid in the world won’t help and if you were close you could get by without it thru the county system. It doesn’t help to be insured if no one you have access to takes that insurance.

  • Rcoutme

    EE: I saw somewhere that those hospitals (in Texas) are treating one million patients per hospital. Is that correct? If it is, I can not imagine the backlog the health care providers have.

  • Jim Satterfield

    Ah, EEllis, Rcoutme beat me to it. I had seen the claim about those hospitals and clinics in a comment thread on another site and did some research and found the same facts that he did. The system is horrendously overloaded and the Republican run state government has no interest in helping provide more resources for them.

  • EEllis

    Are the hospitals in Houston busy? Yes but horrendously overloaded? I don’t believe so. Besides there are no shortage of clinics in the area that take non emergency case which was the point of my statement. As to crapping on the State Govt for not doing more, that is what the voters want. Overwhelmingly so.

  • Jim Satterfield

    I agree with Krugman. I honestly think that many in our country are in complete denial about where are country is and where it is headed. They want the solutions of the early twentieth century that they actually believe worked (Back in those days you heard virtually nothing in newspapers about the plight of those in poverty unless it was to condemn them. Hmm, sounds familiar.) applied to the early twenty-first century, a place more radically different than most of them recognize. If we want the cost curve bent the free market isn’t going to take care of it without encouragement. This encouragement is condemned by most conservatives as socialism, whether it takes the form of publicly paid for hospitals and clinics or rules and regulations that will affect how private sector insurance and health care deal with their customers and the government. In fact some of the things we should really do would seem to fall outside the purview of health care.

    How about subsidized broadband, including major help for the fiber infrastructure to expand? What does this have to do with health care? Imagine centers providing tele-medicine services, including video calls with nurses or specially trained nurse assistants. Clinics could provide devices and the education on how important it is to use them daily that would measure heart rate, blood sugar and blood pressure, immediately notifying someone in the health care system when something is wrong with a patient with chronic conditions or if they aren’t using them so they can be reminded. None of these approaches would work with people who have no connection. The broad band could also use VOIP to take the place of a separate subsidized phone service.

  • DORIAN DE WIND, Military Affairs Columnist

    Read about that great Texas health care for the poor here, here, here and here

  • rudi

    Even with insurance, benefits are capped over a fixed amount. Try dealing with brain cancer(gliablastoma), the treatment can cost 6 to 7 figures.

  • EEllis

    And lets get some more info on Texas health care. The first link Dorian gave actually said Texas ranks good in both maternal and child health care. One of the big factors in our “Bad” health care is that we have so many uninsured. I’m one of those but due to the number of doctors in Houston I’m able to pay for my health care at still reasonable rates without help or insurance. Less than half the Hospitals in Texas are for profit and the vast majority of those are in metropolitan areas so rural and country hospitals are almost all public or not for profit. We have some of the highest ranked hospitals in the world including the #1 ranked cancer treatment hospital in the US. The biggest issue isn’t those in the cities who can find health care, tho it may take some effort, it’s in the rural areas where there isn’t even a hospital nevermind other medical resources.

  • roro80

    “We have some of the highest ranked hospitals in the world including the #1 ranked cancer treatment hospital in the US.”

    I’m curious, EEllis, if you — who admits to not having insurance — would be able to be treated there if (heaven forbid) you needed to be. There is no doubt that for those with really good insurance, this country has amazing outcomes and resources. I’m sure maternal and child health care is great for those who can afford it. I get excellent, excellent health care, all around (my job even reimburses for things like gym memberships and excersize equipment), but I have some of the best insurance money can buy, and will quite honestly probably never have any problem paying even my ER copay ($100). For my sister, who is insured fairly well and also has a $100 ER copay, but is quite poor and has numerous health conditions (which is one of the reasons she’s poor), the copay means she often doesn’t go, even for dire emergencies. I’ve had to tell her husband that I would reimburse them for the copay if she ever had an emergency that they couldn’t afford, just get that girl the care she needs…

  • EEllis

    I’m sure maternal and child health care is great for those who can afford it.

    Actually Texas was rated good in maternal and child health care overall not just for insured.The best cancer hospital in the country is MD Anderson and it is a non profit hospital. MD Anderson provided an estimated $215 million in uncompensated care for more than 47,500 patients with cancer in Fiscal Year 2011. They also staff a cancer program at LBJ Hospital, a county hospital which provides much of the direct care for the poor, providing the Hospital doctors, nurses, and other staff ant no cost to them. So here in Houston I would have a good chance of receiving top notch care regardless of my financial status. Sure I may have to lower my income to qualify for certain programs but If I’m that ill I don’t think it would be a huge issue, heck I’m not making huge money now or I would be insured, but there is high quality care available here for everyone. That does not hold true everywhere. In big cities you can find any service you need. It’s in areas that lack physical access to services that concern me. Doesn’t matter how much insurance you have if you can’t get to a doctor.

  • ShannonLeee

    my copay is €10. I catch a cold…10. I need heart surgery 10.

    We do have the same problem that EE is talking about as far as people in far away places. They have doctors to go to, but the quality of those doctors is not very good. Most large towns have uni clinics, which are stocked with doctors that are just as good or even better than what you get in the US.

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