{"id":12973,"date":"2008-08-28T13:31:12","date_gmt":"2008-08-28T20:31:12","guid":{"rendered":"http:\/\/hill-kleerup.org\/blog\/wp\/2008\/08\/28\/an-emergency-room-is-not-health-insurance.html"},"modified":"2008-08-28T13:31:12","modified_gmt":"2008-08-28T20:31:12","slug":"an_emergency_room_is_not","status":"publish","type":"post","link":"https:\/\/hill-kleerup.org\/blog\/2008\/08\/28\/an_emergency_room_is_not.html","title":{"rendered":"An Emergency Room is not &#8220;health insurance&#8221;"},"content":{"rendered":"<div class=\"img-shadow-right\"><img loading=\"lazy\" decoding=\"async\" title=\"ER\" height=\"105\" src=\"https:\/\/www.hill-kleerup.org\/blog\/images\/hospital.jpg\" width=\"111\" \/> <\/div>\n<p>Except that <a href=\"http:\/\/www.dallasnews.com\/sharedcontent\/dws\/bus\/stories\/DN-Uninsured_27bus.ART.State.Edition2.4dce428.html\" target=\"_blank\">John McCain&#8217;s&nbsp;health care policy&nbsp;advisor&nbsp;thinks it is<\/a>. (emphasis mine)<\/p>\n<blockquote>\n<p>But the numbers [of uninsured Americans] 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&#8217;s health care policy, said <strong>anyone with access to an emergency room effectively has insurance<\/strong>, 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.)<\/p>\n<p>&#8220;So I have a solution. And it will cost not one thin dime,&#8221; Mr. Goodman said. &#8220;The next president of the United States should <strong>sign an executive order requiring the Census Bureau to cease and desist from describing any American \u2013 even illegal aliens \u2013 as uninsured<\/strong>. Instead, the bureau should categorize people according to the likely source of payment should they need care.<\/p>\n<p>&#8220;So, there you have it. Voila! Problem solved.&#8221;<\/p>\n<\/blockquote>\n<p>&nbsp;<\/p>\n<p>Yup! Let them eat cake! Or, instead, let them get eye care, dental care, preventive care, vaccinations, medications, and treatment for disease <em>before <\/em>it becomes life-threatening &#8230; at the ER! Yeah, that makes a <em>whole <\/em>lot of sense.<\/p>\n<blockquote><p>According to Mr. Goodman, only people who are denied care are truly uninsured \u2013 everyone who gets care is effectively insured by some mechanism. &#8220;So instead of producing worthless statistics that people fling around in vacuous editorials and pointless debates, the Census Bureau should produce meaningful numbers, identifying all of the sources of funds people will draw on if they need medical care,&#8221; he said. <\/p><\/blockquote>\n<p>&nbsp;<\/p>\n<p>Um &#8230; those who are denied care are <em>uncared for<\/em>. Not <em>uninsured <\/em>&#8212; which means not having health insurance.&nbsp;<\/p>\n<p>Now, granted, Goodman (and McCain) don&#8217;t actually seem to be saying that people should just get their health care at the ER. But understanding that people don&#8217;t have insurance to take care of stuff that is short of disastrous isn&#8217;t a &#8220;worthless statistic&#8221; &#8212; ER care is not just a &#8220;payer of last resort&#8221; (the emphasis on who&#8217;s ponying up for the money is telling), it&#8217;s simply not adequate or suitable to keep people <em>healthy<\/em>, just to (after sitting in the waiting room a dozen hours) deal with <em>emergencies<\/em>. It&#8217;s certainly of value to identify who&#8217;s picking up the tab &#8212; but that&#8217;s a secondary statistic (and, conveniently, a lot less embarrassing than identifying folk as &#8220;uninsured&#8221;).<\/p>\n<p>Goodwin, by the way, is the one touting the McCain plan (he helped draw up) to <a href=\"http:\/\/online.wsj.com\/article_print\/SB121737388416495023.html\" target=\"_blank\">remove the tax-exemption on employer contributions to health insurance<\/a>&nbsp;(but, remember, that&#8217;s not a tax increase).<\/p>\n<p>Of course, this is fully in line with <a href=\"https:\/\/hill-kleerup.org\/blog\/2007\/08\/08\/the_bush_health_care_plan.html\" target=\"_blank\">President Bush&#8217;s belief&nbsp;that the ER&nbsp;is a fine&nbsp;source of primary medical care<\/a>: <em>&#8220;I mean, people have access to health care in America. After all, you just go to an emergency room.&#8221;<\/em>&nbsp;<\/p>\n<p>Perhaps next time Sen. McCain needs to have some skin biopsied to look for cancer, he can just have the limo drop him off at the ER for the afternoon.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Except that John McCain&#8217;s&nbsp;health care policy&nbsp;advisor&nbsp;thinks it is. (emphasis mine) But the numbers [of uninsured Americans] are misleading, said John Goodman, president of the National Center for Policy Analysis,&#8230;<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_seopress_titles_title":"","_seopress_titles_desc":"","_seopress_robots_index":"","_seopress_robots_follow":"","_seopress_robots_imageindex":"","_seopress_robots_snippet":"","_seopress_robots_primary_cat":"","_seopress_robots_breadcrumbs":"","_seopress_robots_freeze_modified_date":"","_seopress_robots_custom_modified_date":"","_seopress_robots_canonical":"","_seopress_social_fb_title":"","_seopress_social_fb_desc":"","_seopress_social_fb_img":"","_seopress_social_fb_img_attachment_id":0,"_seopress_social_fb_img_width":0,"_seopress_social_fb_img_height":0,"_seopress_social_twitter_title":"","_seopress_social_twitter_desc":"","_seopress_social_twitter_img":"","_seopress_social_twitter_img_attachment_id":0,"_seopress_social_twitter_img_width":0,"_seopress_social_twitter_img_height":0,"_seopress_redirections_value":"","_seopress_redirections_enabled":"","_seopress_redirections_enabled_regex":"","_seopress_redirections_logged_status":"","_seopress_redirections_param":"","_seopress_redirections_type":0,"_seopress_analysis_target_kw":"","_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":false,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[54,7],"tags":[],"class_list":["post-12973","post","type-post","status-publish","format-standard","hentry","category-elections-2008","category-health"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack-related-posts":[{"id":133129,"url":"https:\/\/hill-kleerup.org\/blog\/2017\/03\/22\/tinkering-with-essential-health-benefits.html","url_meta":{"origin":12973,"position":0},"title":"Tinkering with &quot;Essential Health Benefits&quot;","author":"***Dave","date":"Wed 22-Mar-17 10:37pm","format":false,"excerpt":"So one provision of the ACA caught an incredible amount of flack through its effect, vs. what it actually did. The ACA required insurance policies in the insurance exchanges to ten essential health care benefits[1]:1. Outpatient care\u2014the kind you get without being admitted to a hospital2. Trips to the emergency\u2026","rel":"","context":"In &quot;~PlusPosts&quot;","block_context":{"text":"~PlusPosts","link":"https:\/\/hill-kleerup.org\/blog\/category\/blogging\/plusposts"},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":13633,"url":"https:\/\/hill-kleerup.org\/blog\/2008\/11\/03\/some_conservative_parents.html","url_meta":{"origin":12973,"position":1},"title":"Some conservative parents for Obama","author":"***Dave","date":"Mon 3-Nov-08 7:54am","format":false,"excerpt":"From a letter from a professed liberal about how and why her conservative parents are voting for Obama. I'm a dirty rotten liberal, so don't listen to me. Listen to...","rel":"","context":"In &quot;Elections 2008&quot;","block_context":{"text":"Elections 2008","link":"https:\/\/hill-kleerup.org\/blog\/category\/politics-law\/elections-2008"},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":12925,"url":"https:\/\/hill-kleerup.org\/blog\/2008\/09\/05\/the_mccain_speech_reviewe.html","url_meta":{"origin":12973,"position":2},"title":"The McCain speech reviewed","author":"***Dave","date":"Fri 5-Sep-08 8:09am","format":false,"excerpt":"The NY Times editorial nails it: Thursday night, Americans mainly saw the old John McCain. He spoke in a moving way about the horrors he endured in Vietnam. He talked...","rel":"","context":"In &quot;Elections 2008&quot;","block_context":{"text":"Elections 2008","link":"https:\/\/hill-kleerup.org\/blog\/category\/politics-law\/elections-2008"},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":133858,"url":"https:\/\/hill-kleerup.org\/blog\/2017\/07\/15\/the-bottom-line-and-junk-insurance.html","url_meta":{"origin":12973,"position":3},"title":"The Bottom Line and Junk Insurance","author":"***Dave","date":"Sat 15-Jul-17 8:38pm","format":false,"excerpt":"It seems like so short a time to have forgotten, but apparently that's the case: before the ACA came in, figuring out health insurance policies tended to be an exercise in sifting through fine print to figure out what was, or (more likely) was not covered, had what sort of\u2026","rel":"","context":"In &quot;~PlusPosts&quot;","block_context":{"text":"~PlusPosts","link":"https:\/\/hill-kleerup.org\/blog\/category\/blogging\/plusposts"},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":133674,"url":"https:\/\/hill-kleerup.org\/blog\/2017\/06\/14\/trump-now-thinks-the-house-aca-repeal-bill-was-too-harsh.html","url_meta":{"origin":12973,"position":4},"title":"Trump now thinks the House ACA repeal bill was too harsh","author":"***Dave","date":"Wed 14-Jun-17 10:02am","format":false,"excerpt":"Back when the House GOP passed the AHCA, Trump triumphantly tweeted:'It was a GREAT day for the United States of America! This is a great plan that is a repeal & replace of ObamaCare. Make no mistake about it.' [1]Now, as he tries to badger the Senate into getting something\u2026","rel":"","context":"In &quot;~PlusPosts&quot;","block_context":{"text":"~PlusPosts","link":"https:\/\/hill-kleerup.org\/blog\/category\/blogging\/plusposts"},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":30577,"url":"https:\/\/hill-kleerup.org\/blog\/2012\/10\/15\/yes-uninsured-people-do-die-because-ers-are-not-chronic-care-centers.html","url_meta":{"origin":12973,"position":5},"title":"Yes, uninsured people do die, because ERs are not chronic care centers","author":"***Dave","date":"Mon 15-Oct-12 6:50am","format":false,"excerpt":"It's worth quoting the key part of the phsycian's letter at length (emphasis mine):'It\u2019s true that EMTALA [the 1986 law requiring that emergency rooms treat you regardless of insurance status] requires a medical screening exam and stabilization of any emergency medical conditions. It does not, however, mandate admission to the\u2026","rel":"","context":"In &quot;~PlusPosts&quot;","block_context":{"text":"~PlusPosts","link":"https:\/\/hill-kleerup.org\/blog\/category\/blogging\/plusposts"},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]}],"_links":{"self":[{"href":"https:\/\/hill-kleerup.org\/blog\/wp-json\/wp\/v2\/posts\/12973","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/hill-kleerup.org\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/hill-kleerup.org\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/hill-kleerup.org\/blog\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/hill-kleerup.org\/blog\/wp-json\/wp\/v2\/comments?post=12973"}],"version-history":[{"count":0,"href":"https:\/\/hill-kleerup.org\/blog\/wp-json\/wp\/v2\/posts\/12973\/revisions"}],"wp:attachment":[{"href":"https:\/\/hill-kleerup.org\/blog\/wp-json\/wp\/v2\/media?parent=12973"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/hill-kleerup.org\/blog\/wp-json\/wp\/v2\/categories?post=12973"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/hill-kleerup.org\/blog\/wp-json\/wp\/v2\/tags?post=12973"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}