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Wednesday, September 26th 2012

Flip & Flop

You’d think political candidates, even conservative ones opposed to the expansion of the government roll in healthcare would avoid the oft repeated, and oft chastised, claim that America already provides a health safety net for all in the form of the emergency room. And yet here is Mitt Romney fumbling around with such an answer.

Why Romney persists so far to the right on an issue like this, with the nomination secured, is beyond me in terms of political strategy. It’s difficult to call his recent comments sincere. As recently as his last campaign for president he made contradictory statements,

During a GOP presidential primary debate in 2007, Romney said: “Look, the best kind of prevention you can have in healthcare is to have a doctor. And if someone doesn’t have a doctor, doesn’t have a clinic they can go to, doesn’t have health insurance to be able to provide the prescription drugs they need, you can’t be healthy. And you need to have health insurance for all of our citizens.”

And when arguing for his Massachusetts’ reform effort Romney was even more explicit. Sarah Kliff at Washington Post’s Wonkblog links to two op-eds during the period, one in the Wall Street Journal and one in the Boston Globe. Although behind a paywall, Kliff quotes Romney’s WSJ editorial as,

By law, emergency care cannot be withheld.

[...]

Why pay for something you can get free? Of course, while it maybe free for them, everyone else ends up paying the bill, either in higher insurance premiums or taxes.

Uncompensated emergency room care is expensive for society. It also provides a poor avenue for dealing with non-emergent issues which may in the future lead to more costly care. For instance, a patient presenting symptomatic with a headache from poorly controlled hypertension has his blood pressure acutely controlled and then is sent out the door without access to outpatient antihypertensives, other therapy or follow up and returns with a primary intracranial hemorrhage a month later. As Romney claims the emergency room treats true emergencies well, if at great expense. But outpatient emergency room care is a poor alternative to more substantial access. Even insinuating that the ER represents a legitimate safety net is irresponsible and has drawn ire when claimed by others than Mitt Romney. You think he would’ve learned. You think he would’ve remembered his experience in Massachusetts.

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