The story broken by Dallas Morning News has gotten a lot of attention today. Here's what others have been saying.
A health care policy adviser for the McCain campaign told a newspaper reporter that nobody in the United States is technically uninsured, because everyone has access to hospital emergency rooms.
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.”
Voila indeed. And why stop with health care? Imagine how easily we could solve poverty if we simply stopped measuring income and wealth. And global warming? Pshaw. Just stop measuring atmospheric pollutants and temperature. Really, the possibilities are endless.
Remember, the McCain campaign would offer tax incentives that favor bare-bones coverage; it would also gut state regulations that mandate all insurers cover certain benefits. Most important, perhaps, it's likely that the McCain health plan would lead many people with employer-sponsored insurance to give up or lose that coverage. While many people would also get new coverage on their own, through the individual market, the benefits would be skimpier–and they would be available only to relatively healthy people, since insurers screen for pre-existing medical conditions when they sell policies individually.
This nonsense is surprisingly common in Republican circles. Last year, Tom DeLay argued, "[N]o American is denied health care in America," because everyone can go to the emergency room. Around the same time, George W. Bush said the same thing: "[P]eople have access to health care in America. After all, you just go to an emergency room." In 2004, then-HHS Secretary Tommy Thompson said our healthcare system "could be defined as universal coverage," because of emergency rooms.
This is, obviously, idiotic — though in an almost charming, movement conservative Tourette's sort of way — but one wonders who Goodman thinks is going to be the payer of last resort for non-emergency care? Santa Claus?
This is what we call a Kinsleyan gaffe: A mistake that reveals the truth. John McCain's health care plan is, by the admission of his own advisers, not particularly interested in the problem of the uninsured. It doesn't try and cover them or address their plight, and for a very simple reason: Conservatives in general are not interested in the problem of the uninsured. And why should they be? Health care is a market good, and not everyone can afford every market good, and if you distort the market thus to ensure universal access, you'll probably do more harm than good. There's even an "Anti-Universal Coverage Club" over at Cato for conservative brave enough to admit this truth. "To achieve 'universal coverage,'" they say, "would require either having the government provide health insurance to everyone or forcing everyone to buy it. Government provision is undesirable, because government does a poor job of improving quality or efficiency. Forcing people to get insurance would lead to a worse health-care system for everyone, because it would necessitate so much more government intervention. In a free country, people should have the right to refuse health insurance.
The problem with this analysis, according to an expert quoted in the article, is that people without insurance are less likely to seek non-emergency-room care, which ultimately drives up the cost to the health care system.
Even though tonight is Obama's big speech, it is time for progressives to ramp up another media narrative on John McCain. Check out his health care plan.
Aside from trying to hide the plight of the uninsured from public view, Mr. Goodman's stroke of genius is based on — apparently — not fully understanding federal emergency room regulations. The federal law passed in 1986 to prohibit 'patient dumping' gives everyone the right to emergency care, regardless of ability to pay. However, if you are not having an 'emergency,' they do not have to treat you. They may well refer you to a family doctor (something the uninsured often don't have) or a community health care clinic or 'urgent' care center.
Once again, why would anyone actually listen to John Goodman's advice on health care?
One of John McCain's health care advisers has proposed a novel solution to the nation's health insurance problems: stop counting those who don't have health insurance, since anyone can get health care if they go to an emergency room. Therefore…everybody's covered. To which one can only say: huh?