After hearing Mitt Romney’s views of emergency medical care during a recent interview, I’ve concluded that he is a dope.
He was recently interviewed on MSNBC’s “Morning Joe” about some book he’s peddling and his response to one of the questions just shows that he has no clue about the economics of health care.
Question: Do you believe in “universal coverage”?
Answer: “Oh, sure. Look, 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, particularly if they are people who have sufficient means to pay their own way.”
Can’t embed the video here, so you’ll have to go to MSNBC and start the video at about 5:35 to cut to the chase.
Hospital emergency departments provide medical care to patients just for the heck of it with no expectation of payment? Businesses just give you services and you don’t have to pay them for it? Great business model! Why didn’t I think of that?
In fact, I like that business model so much that I’ve decided to go to Massachusetts to take out a loan at a bank. Then I can get some “entirely free money for which I have no responsibility.”
On the way, I’ll stop at a car dealership where I can get an “entirely free car for which I have no responsibility.”
And I’m going to enroll my kids in some Massachusetts colleges where they can get an “entirely free education for which they have no responsibility.”
Oops. Better watch what I say before I get thrown in the Gulag.
Don’t laugh, using Mitt Romney’s logic, the “emergency room” docs in Massachusetts are already there.
I don’t think you understand Romney at all. He is not saying he likes the way it works, in fact, if you look at the Massachusetts model, the source of their funding was doing away with the essentially free ER trips that he is referring to. What he was saying is that it doesn’t make sense to do business the way that it is right now, as people go to the ER, get care and then hide from the responsibility to pay it back.
So as I understand it, you and he actually agree. He is making the same point you are: you can’t go get a car and drive away for free (though that is a model that Kia should look into to restore the value/car ratio), so why should we continue with a system that lets people get free care from the ER while hiding behind an “I have no insurance” mask. In Massachusetts, they used the money saved from paying for “free” ER visits and applied it toward insurance subsidies.
Now whether or not you agree with his mandate to obtain health insurance or not is fine, but don’t twist his words to be the opposite of what they mean.
I never stated Romney likes the way it works and it’s hard to “twist” a verbatim transcript of his statements.
First, he’s starting with a faulty assumption – that emergency medical care is “entirely free” and that patients who receive that care have “no responsibility” for paying for it.
It’s like me saying “I want Pluto to be a planet again so it can be just like the sun, the moon, and the other stars.” Noble cause, wrong basis for the cause.
Maybe he’s advocating for a system change, but perpetuating the notion that emergency medical care ever was “entirely free”, is unacceptable. Who exactly is supposed to provide that “entirely free” care, comrade?
Second, I absolutely agree that we need to find a way to provide for the 40+ million Americans without insurance. Increasing insurance subsidies isn’t the way to do it and only increases the costs in the system. Instead of paying providers directly, the state has introduced a “middle man” – the insurance companies – who will take a cut of the health care dollars before passing it along to the medical providers.
Third, if you want to argue whether “health insurance = access to care”, we’ve already seen that experiment fail. Stick a fork in Medicaid. Medicare and the Massachusetts systems are at their tipping points. Many Massachusetts residents can’t find primary care physicians to care for them and subsequently emergency department volumes increased. Now we’re going to duplicate that model nationwide?
And what about those people who can’t get/can’t afford insurance? Guess they’ll have to keep going to the “ER” for their entirely free care for which they have no responsibility.
While I’m not entirely familiar with American politics, the point he seems to be making is:
- People are taking ‘primary care’ problems to the ED, because they want to take the cheapest (for them) way out
- The ED is not the cheapest place for this care to be provided
- Universal coverage would, ideally, allow these people to go to primary care instead, taking burden off EDs
- Taxpayer money therefore would subsidise cheaper primary care rather than expensive and unnecessary ED care
He doesn’t seem to be condoning the notion that patients have ‘no responsibility’, he is just commenting that the current system encourages that.
Here in backwards Australia, everyone is covered by Medicare and gets cheap and good quality (but not always fast) care. People can also take out private health insurance (all health insurance companies here are not-for-profit) and get fast and good quality (for a bit more money) care. I cannot understand how Americans are opposed to this.
I agree with WC.
The problem is not that we have to get the uninsured, insured. In fact, I think this is part of the problem. We are seeing so many patients with out of state Medicaid because there is no where the patients can be seen in their own state for the simple reason that no one can afford to take care of them. You can give everyone insurance, but if it doesnt pay for their care, all you have done is made the situation worse.
Our problem is the cost of healthcare. We have to fix what is raising the costs. The seperation of the patients from their insurance dollars, the inability to compete, the government CMS, spendand HIPPA regs that make the nurses spend 85% of their productivity doing paperwork instead of taking care of patients; procedures and tests being ordered becuase of legal precident and not evidence based medicine, and the need for the healthcare industry to support the trial lawyer industry.
Medicaid (Government access) is like 25 guages IV access. Sure, you can pat yourself on the back that you got it for someone but it is pretty much useless.
So do it. Revolt from CMS, if you dare.
“procedures and tests being ordered becuase of legal precident and not evidence based medicine, and the need for the healthcare industry to support the trial lawyer industry.”
Stop with this nonsense. You guys could end these “fears” if you wanted, and you don’t. And med mal is a tiny subset of plaintiff’s practice. If you’re supporting the “industry” then the industry’s reach is pretty minimal.
Perhaps if physicians took more responsibility for where they are right now and own up that their own actions are in large part responsible for this situation, they’d have a better idea how to proceed. Stop pretending you’re such victims.
Also, some of you seem genuinely shocked that you might make less money or even lose money once in awhile. Are you SURE you want the free market if this surprises you? Because that’s how the free market works. Your income doesn’t always climb, or even maintain.
Working at the university hospital….anyone who showed up got care and sooooo many didn’t/don’t pay it back. Those uninsured folks who were admitted to the trauma unit were given a notice that the daily rate for care was $24,000 (yes, 24 thousand dollars a day). They had to sign that of course they promised to pay this rate. How many uninsured folks actually coughed up any money, let alone $24,000 per 24 hours (I kid you not, I saw many of these letters, duly signed by the patient).
Yeah whitecoat I think he’s just making the point that insured people are already paying for the uninsured when the uninsured show up to the er and get treated because they are required to, then subsequently don’t pay the costs of their visit because they can’t
http://www.theatlantic.com/magazine/archive/2009/09/how-american-health-care-killed-my-father/7617/
despite the combative title this is one of the best articles I’ve read on healthcare reform. I really think implementing a consumer driven system based on hsa’s and government mandated catastrophic insurance would markedly reduce costs and improve care in this country.
If Tom and Braden are correct about what Mr. Romney meant, then he should have said that. The transcript doesn’t convey that point. As a frequent public speaker he should be able to convey his point more clearly.
If he DID convey his point clearly, then shame on him! I am one of the uninsured 40 million, I pay my own way even though at times I have qualified for government help. I don’t believe that people should accept that help so easily. I have, in the past, accepted help from charities, but I don’t believe taxpayers should have to support my choices, even if I believed them to be the best option at the time.
Ughh! I just read a cool letter addressing the issue that we are in a “cultural crisis,” not a “health crisis.” People are buying luxuries and leaving it up to us to buy their necessities! I still get frustrated when I, the owner of a six year old cellphone, see everybody and their mothers with a blackberry or droid. Great post, bud.
Mark Cuban on the subject of health insurance for free!
http://blogmaverick.com/2010/02/27/if-free-works-on-the-internet-can-it-work-for-health-insurance/
I think this would be a good idea … if it were a free and less regulated market.
Unfortunately, it isn’t.
We have HIPAA, EMTALA, Stark laws, CLIA, medical malpractice lottery judgments, patients who defraud the system, RAC audits and a gajillion JCAHO regulations – just off the top of my head.
VISA doesn’t give kickbacks to those who make fraudulent credit card charges. How would the system deal with health care fraudsters?
Although I give him credit. He’s exhibiting thinking outside of the box and that is the kind of thinking we need to solve these problems.
“We have HIPAA, EMTALA, Stark laws, CLIA, medical malpractice lottery judgments, patients who defraud the system, RAC audits and a gajillion JCAHO regulations – just off the top of my head”
Ugh, stop making excuses for inaction, and DO SOMETHING different. All you do is bitch.
BTW, did you ever find someone who won the “lottery” of malpractice who you’d like to trade places with?
” patients who defraud the system”
And physicians don’t?
C’mon man, its his blog. If he wants to bitch, he can bitch. Do you never just feel the need to vent?
Its very hard to try something different when there are so many rules in place telling you exactly how to do things. I don’t think that’s an unfair assessment. How difficult it would be to change things, I can’t even begin to claim to know.
Of course no one is suggesting that doctors don’t defraud this system. The problem is, at least in my state, auditors check up on doctors. They don’t check up on patients.
I think Matt’s point on this is in large part concerning how for the last several decades doctors have just been taking whatever they get handed legislatively without mounting credible resistance. A lot of Jim Plagakis’s arguments about the worthlessness of pharmacy associations readily carries over to the AMA.
Yeah, matt. I’d love to change positions with this lady.
http://www.lawyersandsettlements.com/settlements/14304/medical-malpractice-lawsuits-lawsuit.html
60 mill for a damaged labia. I’d give my left nut for 3 mill…guess that makes me a whore.
Oh Shah..would you REALLY?
No amount of money would cause me to want to go through that and be deformed.
No one will see your nut and the other still works I guess. ?
But deformed in that way…especially if pain is involved.
I rather have my health and normalcy any day over money.
60 million does seem excessive though. On the one hand ..NO amount of money would make me happy ..on the other it seems like too much was paid out.
Well, you can’t argue with a lady on that one. I doubt that was what was collected, though.
I’ll double down for half her award I’d give up both nuts and get neuticals with the winnings.
Matt, why is it that you demand evidence and as soon as it is provided you immediately discount it?
Please provide evidence that she did not collect.
I said I “doubt” she collected. It is entirely possible she did, if the physician had that kind of cash which was reachable by a creditor. I’m unaware (but it’s possible) that an individual physician can get an insurance policy that large. It’s also likely (but not certain) that it was appealed. Often (but not always) cases are settled on appeal.
So far there’s only evidence of the jury finding. No idea if it was knocked down by remittur, or was overturned on appeal, or collected at all. So to date, we don’t know if she’s collected anything.
Even frequent public speakers can mess up.
“I simply misspoke.” I think I’ve heard that a couple times from practiced public speakers with pretty good speech writers…
I agree with Tom and Braden. It was just a poor choice of words. It’s “entirely free” to the patients who dodge the bill (many of them if my understanding is correct)… VERY expensive for the hospital and responsible patients.
He’s reflecting on the Massachusetts experiment, which has driven many of the newly covered patients to the Emergency departments (there has been a documented surge in ED visits), because Primary Care physicians aren’t accepting new patients.
Well, the good thing about MA universal coverage is that it isn’t forced. It just means there are some hefty-ish tax fees if you don’t bother to get health insurance.
The bad thing is that it misses people who make plenty but don’t want to pay in and don’t have lump sum to pay fees.
Happily, we do have plenty of insurance options for those without money to get connected to doctors (in Boston, home of the medical schools) for better preventative care.
Health insurance appears to be a lot more helpful here than in a lot of places.
People will go to the ER, with or without insurance, usually.