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Romney Endorses Bush's ER Plan to Replace Obamacare

September 24, 2012

Appearing on Meet the Press two weeks ago, Republican presidential candidate Mitt Romney announced, "We're going to replace Obamacare. And I'm replacing it with my own plan." Now we know what the Romney health care plan is. As Mitt explained on CBS 60 Minutes Sunday, the federal government will meet its responsibility to the 50 million uninsured by letting states "provide the care through emergency rooms." Of course, if that prescription for disaster sounds familiar, it should. For years, the GOP's best and brightest--including President George W. Bush, Senate Minority Leader Mitch McConnell and disgraced House Majority Leader Tom Delay--has said exactly the same thing.

It was during a July 2007 visit to Cleveland that President Bush unveiled the GOP's 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 same 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 by law already have access to emergency room 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 the debate raged three years ago over what would be the Affordable Care Act, Senate Minority Leader Mitch McConnell (R-KY) previewed Romney's latest argument. Regarding those millions of uninsured Americans, McConnell insisted to NBC's David Gregory that "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?

In October, Senator McConnell would break new ground by warning that a public health insurance option "may cost you your life." But by then, he had plenty of support for the Republican ER plan. North Carolina Rep. Virginia Foxx proudly declared, "There are no Americans who don't have healthcare. Everybody in this country has access to healthcare." And in 2010, Paul Broun (R-GA) claimed that "people who have depression, who have chronic diseases in this country...can always get care in this country by going to the emergency room."
What makes Mitt Romney's endorsement of the GOP ER gambit so pathetic is that he knows better. After all, in his book No Apology, Governor Romney recounts how his administration had a "collective epiphany" that the $1 billion the state paid annually for emergency room care for the uninsured could become the basis for the 2006 Massachusetts health care reform law. That's why he praised his individual health insurance mandate to Glenn Beck in 2007 as an alternative to the current "socialism" by ensuring that residents "no longer look to government to hand out free care." But too cowardly to tout his successful Massachusetts law before the GOP's skeptical primary voters, Romney now not only wants to repeal the ACA, but gut the Medicaid funding key to his own 2006 reforms. Basically recycling the same 20 year-old health care plan George Bush and John McCain previously ran on, Mitt Romney now wants "state responsibility for those that are uninsured." As he put it Sunday:

Well, we do provide care for people who don't have insurance, people -- we- 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. And different states have different ways of providing for that care...Some provide that care through clinics. Some provide the care through emergency rooms. In my state, we found a solution that worked for my state. But I wouldn't take what we did in Massachusetts and say to Texas, "You've got to take the Massachusetts model."

Leave aside for the moment that U.S. emergency room capacity is shrinking or the percentage of uninsured in Massachusetts is 2 percent compared to almost 30 in Texas. To secure the Republican nomination, Mitt Romney adopted the Republicans' emergency room health care plan. So what if 50 million people would remain uninsured, another 25 million underinsured resulting in 45,000 unnecessary deaths a year even as a fifth of Americans defer needed care and over 60 percent of personal bankruptcies are related to medical costs? As Mitt Romney said of his intent to repeal Obamacare in March:

"If I'm the godfather of this thing, then it gives me the right to kill it."

Even if, it turns out, Americans are literally dying to get it.


Jon Perr
Jon Perr is a technology marketing consultant and product strategist who writes about American politics and public policy.

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