Despite 50 million uninsured, another 25 million underinsured, a steep drop-off in employer-provided coverage, costs forecast to rise by 9% in 2010, 1 in 5 Americans delaying needed treatment and medical bills involved in over 60% of personal bankruptcies, Mitch McConnell pretends to fear reform which "denies, delays, or rations health care." As it turns out, the Senate Minority Leader like fellow Republican George W. Bush and Tom Delay believes no one goes without health care in America; they just need to go to an emergency room.
Like Republican National Committee chairman Michael Steele, McConnell used his appearance on Meet the Press Sunday to evade the moral dimension of a nation with millions left uninsured. Regardless, he told NBC's David Gregory, "they don't go without health care":

GREGORY: Do you think it's a moral issue that 47 million Americans go without health insurance?
McCONNELL: Well, they don't go without health care. It's not the most efficient way to provide it. As we know, the doctors in the hospitals are sworn to provide health care. We all agree it is not the most efficient way to provide health care to find somebody only in the emergency room and then pass those costs on to those who are paying for insurance. So it is important, I think, to reduce the number of uninsured. The question is, what is the best way to do that?

If the "don't go without health care" mantra sounds familiar, it should. After all, the last Republican President and the last Republican House Majority Leader said the same thing.
During a July 2007 visit to Cleveland, President Bush unveiled his emergency room cure for the ills of the U.S. health care system. Rejecting the expansion of the successful - and even more popular - State Children's Health Insurance Program (S-CHIP), Bush assured Americans that there was no crisis in medical coverage:

"I mean, people have access to health care in America. After all, you just go to an emergency room."

In November that year, indicted former House majority leader Tom Delay took Bush's health care clown show overseas. Speaking in the UK, Delay announced:

"By the way, there's no one denied health care in America. There are 47 million people who don't have health insurance, but no American is denied health care in America."

But while his comments were greeted in England (as the AP reported) with "derisive laughter," no one was chuckling back home.
The GOP's Emergency Room Health Care Plan also reemerged during the 2008 election. It was repackaged by the architect of John McCain's health care proposals, John Goodman. No one in the United States is uninsured, Goodman, pronounced, because Americans have access to emergency room care. As the Dallas Morning News reported:

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. (Hospital emergency rooms by law cannot turn away a patient in need of immediate care.)
"So I have a solution. And it will cost not one thin dime," Mr. Goodman said. "The next president of the United States should sign an executive order requiring the Census Bureau to cease and desist from describing any American - even illegal aliens - as uninsured. Instead, the bureau should categorize people according to the likely source of payment should they need care. So, there you have it. Voila! Problem solved."

As it turns out, not so much. While Goodman's comments were tragically comic on their face, the data show that even America's emergency rooms are in a state of crisis.
While high-profile cases of the deaths of untreated ER patients in Los Angeles and New York put a face on the crisis, a 2006 report by the Institute of Medicine revealed that U.S. emergency rooms can barely cope with the volume of patients in the best of circumstances:

The study cited three contributing problems to the rise in emergency room visits: the aging of the baby boomers, the growing number of uninsured and underinsured patients, and the lack of access to primary care physicians.
The report found that 114 million people, including 30 million children, visited emergency rooms in 2003, compared with 90 million visits a decade ago. In that same period, the number of U.S. hospitals decreased by 703, the number of emergency rooms decreased by 425, and the total number of hospital beds dropped by 198,000, mainly because of the trend toward cheaper outpatient care, according to the report.

"Americans want to see changes in the health care system," Mitch McConnell declared on June 11, "But they don't want changes that deny, delay, or ration care." Of course, that's exactly what millions of Americans already face today.
Just not in the imaginary America of Republicans like McConnell, Bush and Delay. There, "they don't go without health care."
UPDATE: On Friday, July 24, Rep. Virginia Foxx (R-NC) became just the latest Republican to claim, "There are no Americans who don't have healthcare," adding, "Everybody in this country has access to healthcare."