One argument for making sure that everyone is covered by
health insurance in the United States has been that without such protection hospital
emergency rooms end up treating the poor, effectively for free, thereby driving
up prices for everyone else. This is because hospitals that take Medicare are
required to screen and provide appropriate treatment for individuals who show
up in their emergency departments, regardless of whether those individuals are
covered by health insurance or have the ability to pay. [1] Hospitals
covered by the law are permitted to transfer such individuals to other
facilities only under restricted circumstances.
This is an unfunded mandate. [2]
Hospitals get no money from the federal government to assist with compliance. “Hospitals
and physicians shoulder the financial burden for the uninsured by incurring
billions of dollars in bad debt or ‘uncompensated care’ each year.” [3]
But medical providers might not be able to make up the difference with their insured
patients as much as they would like due to controls on prices brought to bear
by insurers. In any event, the cost is borne either by the medical providers,
or by the insured population, or by both.
Now the argument that we need to have a more sensible plan
to get healthcare to people who can’t afford it assumes that providing
healthcare to everybody is a required goal for a decent and civilized society.
But it seems that we are being treated to more and more misanthropic creativity
from the Republican Party every day.
Last week Representative Diane Black, a Republican from
Tennessee, was being interviewed by Chuck Todd on MSNBC regarding congressional
progress on healthcare. [4]
At one point during the interview she expressed the wish that that President
Trump would eliminate both individual and employer mandates by executive order,
as if that could lawfully be done, in order to obtain the presumed salutary
effects of market forces. Chuck Todd responded by asking whether one can
legitimately talk about a market with the situation being what it is in
hospital emergency rooms providing uncompensated care. To that problem Ms.
Black replied that she would like to get rid of the law requiring hospital
emergency rooms to treat whoever shows up.
Yes, you read that correctly. Ms. Black would like to relieve
hospitals of the burden of providing emergency treatment to all regardless of
ability to pay. It’s as if making sure that everyone receives the emergency
treatment that they need isn’t a priority for her at all. Presented with the
problem that our current method of providing low-income people with medical
care will keep her market idea from working, she literally proposed that we
should, therefore, put a stop those with low income from obtaining medical
services. A more sardonic display would be hard to find.
Politics, with its clothes off, really is about control of
resources within a society. We should expect nothing else. That’s a good thing
to remember so we don’t inadvertently vote for someone who would harm us.
