I don't think enough can be said about the sheer boneheadedness, arrogance, and, yes, elitism of this statement from McCain advisor, John Goodman.
But the numbers are misleading, said John Goodman, president of the National Center for Policy Analysis, a right-leaning Dallas-based think tank. 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.
What Mr. Goodman (and every other person who decries universal health care as socialized or government-sponsored medicine that the U.S. cannot afford) fails to recognize is that we already have government sponsored "health care" in the form of Emergency Rooms across the country. The problem is that this government sponsored health care happening in the most expensive, least effective way possible.
Anyone, whether or not they have health insurance, can walk into an emergency room and receive medical care. Unfortunately there are a number of problems with this scenario: It creates a strain on an already overburdened hospital system exacerbating problems of overcrowding and understaffing and endangering the lives of people who have true emergencies. Too often the uninsured who end up in emergency rooms would never have ended up their if they'd had access to any type of affordable preventive care. Of course, this means that by the time they reach the ER, their health is often much worse (sometimes fatally so) than if they'd seen a doctor at the onset of symptoms. It also means that the cost of their service will be several times greater than what they would have paid at a doctor's office. To add insult to (often literal) injury, because of the "usual and customary rate" deals worked out in advance between insurance companies and hospitals, the rates charged the uninsured can be double or triple what is charged to patients who have insurance.
What this means is that the very people who can afford it the least are the ones who are being charged the most, which of course begins the cycle where the lack of routine, preventive care leads to more Emergency room care. An uninsured patient can't go for a mammogram say to the lab, "I'm only paying $30 because that's what those with insurance pay." They have to pay the $150. They're charged $800 for an ultrasound instead of the $200 your insurance company pays. And those are the ones who can actually get the tests they need. The ones who really can't afford it aren't going to the doctor's office at all because they simply don't have the cash in hand -- and it's a rare doctor who will take a patient without insurance unless they pay up front. No, those people end up going to the Emergency Room and being charged $2000 or so for what could have been handled by a $100 doctor's visit. Of course, if they can't afford a doctor's visit, they can't afford an ER bill, so that cost often falls back on public hospitals and the taxpayers. ERs have become very expensive doctor's offices where a growing percentage of the patients can't pay. It's a self-perpetuating system that benefits only those at the top of the chain and is simultaneously bankrupting public hospitals and those without access to insurance.
What does this mean for the rest of us, whether we are insured or uninsured? It means financially strapped hospitals. And that means fewer doctors, fewer nurses, aging equipment, longer waits, fewer essential tests performed, and trauma centers closing all around the country. In short it means poorer health care for all.
http://www.stjameshospital.org/...
According to a 2003 study by the Healthcare Financial Management Association and GE Capital, 41% of hospitals nationwide do not spend enough to replace and refurbish buildings and equipment as they wear out, let alone keep up with community needs for new technologies and services. Most of these hospitals have operating margins of less than 2%. Even a non-profithospital must run a 2% to 3% operating margin to simply keep up with ongoing maintenance costs. Continually absorbing costs for uninsured and underinsured patients also puts pressure on hospitals to raise rates even more to insured patients. This in turn makes health insurance evenless affordable, leading to even more uninsured patients.
http://www.wilsoncountynews.com/...
According to Texas Hospital Association statistics, more than 25 percent — or 5 million people — are uninsured or underinsured in the state. Each year, premiums climb and neither businesses nor employees can afford to meet the rising costs. These individuals then join that steadily growing number.
The impact of this is felt at the front doors of the medical center’s emergency room (ER), and is evident in its bottom line. Without health insurance, the only option left to many uninsured Wilson County residents is to seek non-critical care at the local ER. Connally Memorial must then accommodate these individuals, in place of others who may be in need of more urgent care, and to the detriment of its overall financial health.
Following a $15 million bond that was passed in 2004, taxpayers were promised that the new facility — which opened March 2005 — would not cause a rise in taxes. If the tax rate does increase this year, it would be due to the rising costs of treating uninsured and underinsured patients, and not as a result of the new building, Chilek said.
http://www.bcm.edu/...
The effect of uninsurance on individuals, families and communities, demonstrates that everyone suffers when large portions of a city or state are without health insurance. Emergency rooms become overcrowded as people who can find care nowhere else are forced into that doctors’ office of last resort. They are the only place mandated by law to evaluate and treat those who are ill and in an emergent condition.
Hospitals, hit by increasing bills that are not paid, begin to close services that they once provided because the community needs them – not because they make money. Doctors who find themselves increasingly called out to provide care to people without funds begin to take themselves off call lists, making their specialties less available.
http://www.cbsnews.com/...
this year [Grady Memorial Hospital in Atlanta] could lose $55 million - and close. There are too many patients with no way to pay.
If Grady closed, Atlanta would have a true trauma 9-1-1. In a metro area of more than 4 million people, this is the only Level 1 trauma center.
From Los Angeles to Chicago to Birmingham, 20 trauma centers have closed since 2000. And America's trauma centers will lose another $1 billion this year.
This should come as no surprise. We've been warned for years.
In 1991, a Congressional study found that
Money troubles have put at least 60 hospital trauma centers out of business, particularly in violent inner cities where speedy treatment is often a matter of life or death.
The study was requested by Senator Donald W. Riegle Jr., a Michigan Democrat who is chairman of the Senate subcommittee on health for families and the uninsured. He said the study showed a need for "comprehensive reform" of the health care system.
The Congressional agency reviewed 35 trauma centers in Chicago, Detroit, Los Angeles, Miami, San Diego and Washington. Of those, 15 have closed in the last five years, 12 of them because of financial hardship. Most of the centers still operating are losing money.
The high cost of treating trauma patients, many of whom have no health insurance, and limited assistance from Medicaid and other Government programs are the major reasons for the crisis, the agency said. Inner-city hospitals have a disproportionately high share of uninsured trauma patients.
The question isn't whether or not taxpayers should bear the financial burden of healthcare for the uninsured in this country, they're already bearing it.
It's time for an administration with a real plan to solve the health care crisis in this country. McCain not only wants to slap a bandaid on the problem, he apparently expects us to go to the Emergency Room to get it.