Out of Sight, Out of Mind

It has become clear how Senator John McCain’s ‘health care reform’ plan was developed while managing to totally exclude any program that would provide health care insurance for America’s uninsured. It turns out, dear people, that John McCain doesn’t believe uninsured Americans exist, and he’s willing to go to some great lengths to see to it that the uninsured become invisible to all.

From the McCain adviser who helped craft the Republican nominee’s health care plan, quoted in the Dallas Morning News on the reported statistics of the nation’s uninsured:

“But the numbers 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’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.”

Aside from trying to hide the plight of the uninsured from public view, Mr. Goodman’s stroke of genius is based on — apparently — not fully understanding federal emergency room regulations. The federal law passed in 1986 to prohibit ‘patient dumping’ gives everyone the right to emergency care, regardless of ability to pay. However, if you are not having an ‘emergency,’ they do not have to treat you. They may well refer you to a family doctor (something the uninsured often don’t have) or a community health care clinic or ‘urgent’ care center.

After passage of the federal patient dumping law, hospitals developed their own methods for keeping uninsured people out of ER’s:

“A new initiative at two hospitals in the Houston area will try to ease the burden on ERs starting today. By pre-screening adult patients, the Ben Taub and LBJ hospitals will require those who don’t need emergency care to seek treatment at community health clinics, or else pay a relatively hefty fee: a $150 deposit. A deposit at an urgent care setting will run $80. Actual cost for treatment will be on a sliding scale based on a patient’s ability to pay.”

If you’re uninsured, out of money — and not having a life-threatening emergency — you not only don’t exist in John McCain’s world, you’re completely out of luck.