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Emergency rooms aren’t free

Posted: September 27, 2012 7:46 p.m.
Updated: September 28, 2012 5:00 a.m.

Amidst a necessary, but life-threatening, debate on the future of health care for millions of Americans, presidential candidate Mitt Romney revealed why it’s OK that almost 50 million Americans are uninsured. Romney said in an interview with a TV broadcast news program that people who are uninsured are “care(d) for” with the help of America’s emergency room services:

We do provide care for people who don’t have insurance. If someone has a heart attack, they don’t sit in their apartment and die. We pick them up in an ambulance and take them to the hospital and give them care,” he said. “Different states have different ways of doing that. Some provide that care through clinics. Some provide the care through emergency rooms,” he said.

It’s unclear to me whether Romney believes that because people can’t afford the insurance they don’t deserve necessary long-term health care or if he is just generally uninformed about how ER and clinics operate.

I can’t argue with him; it’s a logical move to go to the ER when you are having a heart attack. The uninsured, like the insured, need long-term, preventative health screenings and care that the ER was not created to provide, however. Emergency rooms can’t provide long-term or non-emergency care that can help lessen the chance of an emergency, whether you are or aren’t insured. Under the Emergency Medical Treatment and Labor Act (EMTALA), people cannot be turned away from emergency service. EMTALA, enacted in 1986, gives the “public access to emergency services regardless of ability to pay.” If people seek emergency rooms for things that a primary care doctor is for, it creates a longer waiting time that could be fatal and less hospital personnel to deal with the growing number of people who seek ER and health clinic services.

Why can’t we get that kind of law for primary doctors and specialists, too?

Health care reform is critical for everyone. Even the insured have to wait several weeks before they can get an appointment with their primary care physician, pushing them to find emergency services such as the ER or places such as Doctor’s Care. America’s health care system is failing both the uninsured and insured with rising premiums and prescription medication prices. Daily, people have to choose between health insurance and their mortgage or rent, or between medicine and food.

The ER does not currently -- and to my knowledge, never has -- provided pro bono services; they have bills, too. Clinics serve millions of people with small amounts of federal funding. Last summer, my mom and I volunteered for Mission 2011. We watched thousands of people line up at the Carolina Coliseum for 1) free health, dental and vision care and 2) assistance with finding a “medical home,” a place they can go for routine care. Some worked, some didn’t; some had insurance, others couldn’t afford it. Of course, it wasn’t primary physician quality, but it was some assistance.

There are news reports that hospitals are suing patients who fail to respond to bills sent by hospitals. That’s sick, especially if people can’t afford it; but it is what it is: hospitals need money to provide services. Uninsured people who can’t afford to pay their hospital bills and those who can afford it and choose not to pay, affect taxpayers and insurance premiums for insured persons.

In a press release from the American College of Emergency Physicians (ACEP), in response to Romney’s comments, President Dr. David Seaberg, said “Emergency care is not health insurance.”

In 2008, John Goodman, an adviser to then presidential nominee John McCain, also said the ER was sufficient for the uninsured.

Former president of the ACEP, Dr. Linda Lawrence said his comments were “reckless:”

“Emergency physicians can and do perform miracles every day, but taking on the full-time, medical care for 46 million uninsured Americans is one miracle even we cannot perform” she said. “Access to care in the emergency department is no substitute for the comprehensive health care policy that should be at the heart of the platform of any presidential campaign.”

I’m not well versed in governmental policies, but if there is one thing that I believe the government should provide it’s health care, at a reasonable price for everyone or through taxation. To me, it’s morally and socially irresponsible to not provide health care, and food, to those in need, and health care and food are two things everyone needs. I’m not saying it’s the government’s job to provide everything, but if they don’t assist, who will? A church or local non-profit can provide a lot, but comprehensive health care isn’t one of those things. I don’t like that we are trillions of dollars in debt, but I rather we be a trillion dollars in debt with something like quality health insurance for every American, in every state, no matter what their condition, to show for it.

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