Conservatives dismiss the importance of extending health insurance coverage to the 46 million uninsured by arguing that every American already has access to health care in the nation’s emergency rooms. “We hear a lot of people talk about the 46 million plus who don’t have access, well that’s hogwash,” Rep. Paul Broun (R-GA) told a caller on CSPAN’s Washington Journal in April, “Everybody has access, the problem is everybody doesn’t have insurance”:
- Sen. Jim DeMint (R-SC): “Well, no one is going to go without health care, because everyone can just show up at the hospital, but that’s just not the most efficient way to do it.” [Huffington Post, 11/04/2009]
- Rep. Steve King (R-IA): “All Americans have health care. Every single one. And 85 percent of us are insured….you would throw out the liberty of America. Throw out the baby with the bath water of the best health insurance industry in the world, the best health care delivery system in the world. Destroyed by a desire to create a dependency society to steal our freedom.” [CSPAN, 10/07/2008]
- Rep. Virginia Foxx (R-NC): “There are no Americans who don’t have healthcare. Everybody in this country has access to healthcare.” [Talk Radio News Service, 7/24/2009]
But a new study published in Archives of Surgery has found that not all Americans are treated equally. Uninsured Americans “with traumatic injuries, such as car crashes, falls and gunshot wounds, were almost twice as likely to die in the hospital as similarly injured patients with health insurance,” the study concluded.
Researchers have long argued that uninsured adults face a higher risk of mortality than insured adults, are less likely to seek needed medical care, and are more likely to develop serious chronic conditions. This Harvard team of researchers hypothesized that “given the pervasive evidence of disparities in screening, hospital admission, treatment, and outcomes due to insurance status, a disparity in outcomes in trauma patients (in-hospital death) among the uninsured may exist, despite preventive regulations (such as the Emergency Medical Treatment and Active Labor Act).” They were right:
The report does not definitively explain why the variations “in mortality would exist in a system where equivalent care is not only expected but mandated by law,” but concluded that access to care not the same as having health care insurance.
The uninsured patients may experience treatment delay, different care than insured patients (“uninsured trauma patients were less likely to be admitted to the hospital and received fewer services during their admission compared with insured trauma patients”), and possess “a lower rate of health literacy and may have less aptitude in communication with physicians and other treating team members.”