Political Animal


September 24, 2012 2:59 PM Get Thee To An ER

By Ed Kilgore

It’s rare that Mitt Romney gets cornered into answering questions about what his agenda would mean for regular folks, and that’s particularly true with that la-la-la-I-can’t-hear-you category of domestic policy, health care. But it happened yesterday on 60 Minutes, when Scott Pelley pressed Romney on what will happen to people without health insurance if Obamacare is repealed. No problem!

We do provide care for people who don’t have insurance, people—we—if someone has a heart attack, they don’t sit in their apartment and die. We pick them up in an ambulance, and take them to the hospital, and give them care.

As TNR’s Jonathan Cohn promptly noted, this is pretty damn close to a “let ‘em eat cake” response:

That statement isn’t untrue. But it leaves out an awful lot. ERs are great if you need urgent help with a major medical problem: You’ve had a heart attack, you’ve been in an accident, whatever. And, yes, hospitals will generally treat you regardless of insurance status, if only because the law requires it. As a condition of accepting Medicare money, hospitals must provide stabilizing or life-saving treatment. But they will not provide basic, ongoing care. They will charge a lot of money for their services. In many cases they will do their best to collect on outstanding bills, even if that means using techniques that even the retail industry eschews as overly harsh. And sometimes, as Sarah Kliff notes today, hospitals find ways to avoid providing care in the first place.

And as Jon also notes, Mitt Romney is entirely aware of these facts, because the cost and inadequacy of ER care was a big part of the rationale for Romneycare.

But the health system Mitt Romney is committed to creating now is a lot worse than the situation he faced in Massachusetts, thanks to his promised deep cuts to Medicaid; an interstate insurance sales proposal that would gut state health insurance regulation; and another proposal to undermine employer-based coverage.

No wonder the slippery dude has found a thousand reasons not to get below the slogan level in promoting his policy agenda. The Mitt Romney of the very recent past would be a pretty strong witness for the prosecution.

Ed Kilgore is a contributing writer to the Washington Monthly. He is managing editor for The Democratic Strategist and a senior fellow at the Progressive Policy Institute. Find him on Twitter: @ed_kilgore.


  • Zorro on September 24, 2012 3:26 PM:

    In other words, Mittens' answer to socialist-fascist-muslim-communist-Saul Alinsky-ist health care is... the single most expensive form of socialized health care possible.


  • Mitch on September 24, 2012 3:28 PM:

    As I often said during the Bush Years (when the Emergency Room argument was frequently mentioned): ER care is the most expensive, least efficient form of socialized medical care in existence.

    It is pure socialism, because the bills that cannot be paid are passed to the tax payers. And this bills are always high, due to the ins-and-outs of ER care, and the fact that people who rely on it generally wait until the last minute to seek help.

    So I absolutely love it when my conservative friends say, "Everyone has health care - they can always go to the ER."

    It gives me the chance to go on the offense, "So you believe in socialized medicine after all! So why not do it more intelligently, in a way that benefits everyone?"

    Check and mate.

  • maggie on September 24, 2012 3:39 PM:

    Actually, that statement is NOT true. People without insurance DO sit in their living room and die. If you don't have insurance, you are much much more likely to convince yourself it's just indigestion.

  • lou on September 24, 2012 4:07 PM:

    Thems thats dies nots gonnas votes fors mitts anyhows. Yous peoples, sheeshes. Thes sickers yous ares the mores profits fors thes ERs. ERs ares fors economies growths, stupids. So yous sits on couches, eats cheetoes, watches TVs, yous responsibles, yous goods fors Mericans. Yous votes fors thes mans.

  • boatboy_srq on September 24, 2012 4:08 PM:



    Weren't we just talking here at WM about how life expectancy is dropping? And here we have The Entitled One harping that same old tune about how the ER is available to everyone. ER, it's probably worth saying, isn't health care: it's death prevention, pure and simple.

    OTOH, I do remember how the Reichwing was all up in arms about a guy in FL who wanted to honor his wife's advanced directives, and his inlaws and their attorneys/advocates/enablers wanted to stop him simply because she was still respiring and might (through some miracle) "come back to them." The idea that keeping the poor woman on breathing/feeding equipment would bankrupt the entire clan wasn't even mentioned - as if actually mentioning money where a life is concerned was some unnamed obscenity. Costs are irrelevant to these people when the patient isn't able to speak for him/herself at the moment of decision.

  • Bo on September 24, 2012 4:18 PM:

    To further elucidate on The MittWit's vapid claim that "no one is denied care", let's unpack the scenario he described.

    An uninsured poor person has a heart attack. He is taken most often to the nearest hospital emergency room. However, many metropolitan areas have communications systems with the ambulance/emergency vehicle network to (1) accept and take medical control of the patient before arrival at the hospital or (2) redirect the patient to another hospital ER because theirs is too full and no inpatient beds are available.

    Hospitals can easily game this system and "dump" patients on other hospitals in their service area. In addition, the sole requirement for any hospital ER is to stabilize -- not treat -- the patient. This means that the hospital can provide emergent treatment to a heart attack victim and then transfer him to another hospital for definitive treatment and follow-up.

    The MittWit's answer to Pelley's question was on a par with the kind of responses that deadheads like Mickey Bachmann, Jim Imhofe and Jeff Sessions are known for. Sorry, I really have a problem with an uninformed empty suit like Romney sitting in the Oval Office. He clearly doesn't know what he's talking about (other than his "textbook" answers about what it means to be a leader).

  • Kenneth Almquist on September 24, 2012 4:25 PM:

    A few years ago I read a news story about a young woman who had a medical condition--unfortunately I don't remember what--which was not debilitating if properly managed. Unfortunately, she didn't have insurance and couldn't afford treatment. One day she developed acute symptoms and was taken to the emergency room. At that point, she did receive medical treatment--in fact a lot of very expensive medical treatment--but it was too late. She died less then a year later.

    Unfortunately I don't remember sufficient details to find this story using Google. I wish I did, because there needs to be a way to get people to realise that real people will die if Republicans get their way and repeal Obamacare.

  • Hannah on September 24, 2012 4:36 PM:

    And here's the more important point missed by the Mittster: if this person with the heart attack had preventive care all along he/she may not have eventually had that heart attack. And people without health insurance are far less likely to get preventive care.

    Kenneth: very sad, and there are far too many people who fit that scenario. It's a national tragedy. There's a person who posts here who lost a brother in a similar manner.

  • st john on September 24, 2012 5:45 PM:

    Scott Pelley is not blameless. His ignorance and fear of the Mittster is blatant. I did not watch 60 Minutes, I admit, but based on what I am reading here and on other blogs, he sat there after one follow-up and let Mitt slide. Once again, the Lamestream MSM gets a ton of credit for the faux horse race being portrayed. Obama is far from the perfect answer, but compared to the Republican nominees, he is the second coming.

  • TCinLA on September 24, 2012 6:12 PM:

    if someone has a heart attack, they donít sit in their apartment and die. We pick them up in an ambulance, and take them to the hospital, and give them care.

    As noted, "they will not provide basic ongoing care."

    20 years ago, an artist friend of mine who did not have health insurance suffered a heart attack. She was stablized, and then sent home. No ongoing care or rehabilitation, which is crucial with a heart attack. As a result, for the next 15 years (she died 5 years ago in her early 50s) she suffered pain and growing inability to care for herself, not to mention she never was able to return to the work she had done before, and as a result slowly wasted away on the pittance that is Disability.

    For those who think I go too far in saying the only "good Republicans" are dead, it's events like this that led to that conclusion.

  • st john on September 24, 2012 6:23 PM:

    @TCinLA on September 24, 2012 6:12 PM: and, this is not an "anomaly" as some would like to portray similar anecdotes. Someone needs to do a historical record search of some of Romney's family who are not covered by health insurance and have used the ER as their first line of healthcare services. I bet that he and Ann have some distant family members who have been the "victims" of the Socialist State of America. Preferably non-Mormons, but I'll leave it open to discovery. I don't know the outcome, so I could be very embarrassed by the outcome. Maybe he has taken care of all his relatives, just to prove his point.

  • Nancy Cadet on September 24, 2012 7:25 PM:

    Someone needs to ask Mitt if Ann Romney got treatment for her MS and breast cancer in an ER.