In an interview with the Dallas Morning News yesterday, John Goodman, the “Father of Health Savings Accounts” and architect of Sen. John McCain’s (R-AZ) health care plan, said the term “uninsured” is a misnomer because Americans have ER access. According to Goodman, “only people who are denied care are truly uninsured — everyone who gets care is effectively insured by some mechanism,” the paper states:
Mr. Goodman, who helped craft Sen. John McCain’s health care policy, said anyone with access to an emergency room effectively has insurance, albeit the government acts as the payer of last resort. (Hospital emergency rooms by law cannot turn away a patient in need of immediate care.)
“So I have a solution. And it will cost not one thin dime,” Mr. Goodman said. “The next president of the United States should sign an executive order requiring the Census Bureau to cease and desist from describing any American — even illegal aliens — as uninsured. Instead, the bureau should categorize people according to the likely source of payment should they need care. “So, there you have it. Voila! Problem solved.”
Goodman’s analysis reflects a radical view of the state of health care in this country. Uninsured Americans are less likely to seek health care and more likely to die because of a lack of insurance. A 2002 Institute of Medicine Report estimated 18,000 unnecessary adult deaths because of a lack of insurance. The Urban Institute estimated that 22,000 died in 2006 for the same reason. Goodman apparently thinks they were “effectively insured.”
In July 2007, President Bush offered similar commentary as Goodman:
I mean, people have access to health care in America. After all, you just go to an emergency room.
Not only is ER care the most expensive way to get health care, but it also does not provide dental care, eye exams, therapy, and routine check-ups. Moreover, the availability of good emergency room care is in decline. In 2006, 119 million visits were made to ERs, up from 90 million in 1996. At the same time, the number of hospital ERs dropped to fewer than 4,600, from nearly 4,900, causing wait times to also increase.