Covering the Front and Back Pages of the Newspaper
September 26, 2012
POLITICS: Romney and Obama Sing From The Same Hymnal on Emergency Room Care
A sure sign of political silly season: seeing a whole lot of Obama supporters reflexively pushing the same attacks on Romney with the same overheated rhetoric at the same time on points that don't stand up to even the most modest logical scrutiny. You'd think, given the clear and obvious points of disagreement between these two tickets on some issues, that would be the focus, but no...
[W]e do provide care for people who don't have insurance ... 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 in 2010:
It doesn't make a lot of sense for us to have millions and millions of people who have no health insurance and yet who can go to the emergency room and get entirely free care for which they have no responsibility
NPR characterizes this as "Romney said almost exactly the opposite," but it's exactly the same point: Romney's been arguing for years that his health care mandate plan in Massachusetts was designed in large part to deal with the issue of hospitals getting stuck with the bill for emergency room care that federal law (EMTALA) requires them to provide, but for which they are often unable to collect payment from the uninsured. Romney in 2007, defending his plan on Glenn Beck's show:
When they show up at the hospital, they get care; they get free care paid for by you and me...If that's not a form of socialism, I don't know what is.
"Socialism" here is typical of Romney trying too hard to pander to his audience; he's never been a good political communicator, and if anything he was even worse in 2007, one reason why he lost in the primaries that year. (I'll set aside the issue, which will be the subject of a much longer post in the works, over how we distinguish socialism from other forms of collectivism). Plainly, though, what he's describing is a form of redistribution, i.e., some people receiving services and others getting the bill.
NPR argues that Romney is wrong because uninsured people do get stuck with large bills for emergency room services, but this completely misses his point, which is that (1) uninsured people do go to emergency rooms for care because they know it has to be given regardless of insurance or ability to pay and (2) hospitals are frequently unable to collect these bills, and end up passing on the costs to other customers and/or taxpayers.
You may agree or disagree with Romney's preferred solutions to this - which, in Massachusetts, were essentially identical to Obamacare. You may even think he's unduly concerned about the wrong problems. But what you can't do is attack him for saying this stuff without mentioning that Obama has been saying the exact same thing for years, and indeed has made it a central theme of his policy and legal arguments for his own health care policies. Here's Obama in June 2012:
First, when uninsured people who can afford coverage get sick, and show up at the emergency room for care, the rest of us end up paying for their care in the form of higher premiums.
And the only people who may have a problem with this law are folks who can afford health care but aren't buying it, wait until they get sick and then going to the emergency room and expecting everybody else to pick up the tab. That's not responsibility. That's not consistent with who we are.
Basically, Obama is calling people who go to the emergency room for care irresponsible and un-American. You have a problem with Romney saying this kind of thing, you also have a problem with Obama. Here's White House Press Secretary Jay Carney in June 2012:
You have a choice to buy -- if you can afford health insurance -- and you can, I assume, Jared. So if you don't buy it, and you can afford it, it is an irresponsible thing to do to ask the rest of America's taxpayers to pay for your care when you go to the emergency room.
Now, I wish we had a Republican candidate who was not burdened by the legacy of Romneycare, as its aftermath in Massachusetts illustrates the folly of the Obamacare solution to the EMTALA "free rider" problem; we have to settle for Romney pledging to repeal a law that does things he evidently still believes in. A more robust debate on the issue would benefit everyone. But it's a sign of the intellectual bankruptcy of Obama's defenders that they can find nothing better to do than beat up on Romney for making the exact same arguments as Obama in defense of the exact same policy solutions to the exact same problems. If it offends you to see this sort of thing said about people who go to emergency rooms to get EMTALA-mandated care they will not end up paying for, I have one simple answer for you: don't vote for President Obama.