During a 60 Minutes interview with Scott Pelley on Sunday evening, Mitt Romney suggested that there are already adequate measures in place to protect Americans who lack health insurance. According to Romney, Americans should just go to the hospital to seek care, regardless of the crippling expenses they may incur without adequate health coverage:
PELLEY: Does the government have a responsibility to provide health care to the 50 million Americans who don’t have it today?
ROMNEY: Well, 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. And different states have different ways of providing for that care.
PELLEY: That’s the most expensive way to do it…In an emergency room.
ROMNEY: Different, again, different states have different ways of doing that. Some provide that care through clinics. Some provide the care through emergency rooms. In my state, we found a solution that worked for my state. But I wouldn’t take what we did in Massachusetts and say to Texas, “You’ve got to take the Massachusetts model.”
However, as Pelley points out, ambulatory care is extraordinarily expensive and shifts costs from often-uninsured emergency room patients into the overall health care market, effectively driving up everyone’s cost of care.
All Americans are entitled to care though the Emergency Medical Treatment and Active Labor Act or (EMTALA), a law Ronald Reagan signed. It requires hospitals that accept Medicare or Medicaid funding to treat patients for emergency medical conditions regardless of legal status or ability to pay. But EMTALA only applies to medical emergencies. “So, yes, if you’re actively giving birth, you can expect to receive care at an emergency room,” Austin Frakt and Aaron Carroll explain. “If you’re actively having a heart attack, you can also get emergency room care. If you’ve been seriously harmed in a car accident, you can go to the emergency room.” Patients with chronic conditions that don’t require emergency interference — the millions of Americans with diabetes who need “regular access to medication to stay alive,” asthma patients, or women diagnosed with breast cancer — would not be able to access needed treatments.
Although Obamacare and Romney’s own health reform law in Massachusetts both overcome this hurdle by mandating and subsidizing health insurance for all residents, irrespective of pre-existing conditions, Romney no longer seems to believe that his own program — which has improved the lives of millions in Massachusetts while nearly eliminating the children’s uninsured rate in the state — is effective enough to be implemented in other states.
Romney has not always believed that emergency rooms are the best route for the uninsured. Back in 2008, Romney decried uninsured emergency room visits as “free riding,” declaring, “If somebody could afford insurance, they should either buy the insurance or pay their own way. They don’t have to buy insurance if they don’t want to, but pay their own way. But they shouldn’t be allowed to just show up at the hospital and say, somebody else should pay for me.” According to Jonathan Gruber, a close adviser and architect for Romney’s Massachusetts health care law, overcoming this “free-rider” dilemma was at the heart of Romneycare. “The guy has come completely full circle,” Gruber said.