Romney’s Emergency Room Flip

Last night on 60 Minutes, Scott Pelley asked Mitt Romney whether the federal government has a responsibility to cover the uninsured:

Pelley: Does the government have a responsibility to provide health care to the 50 million Americans who don’t have it today?

Romney: 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.

The emergency room aside for a second, Romney is saying he does not think 50 million Americans have the right to non-emergency health coverage. Full stop. At least, that’s the line he has to go with to fully distinguish himself from Obamacare.

But he isn’t exactly acting like a fiscal conservative either. Ambulatory care is absurdly expensive for all parties involved. For the uninsured patient, a trip to the hospital could mean financial ruin. Moreover, the overall health care market eats that cost, which drives everyone’s cost of care up. “Different states have different ways of providing that care.” Sure, but at great cost. Doesn’t it make more economic sense to provide coverage before people are so sick that they need to go to the ER?

Romney knows all about this problem. Here he is in his book, No Apology, talking about how Massachusetts avoided this ambulatory care free-rider problem in its 2006 reform, courtesy of TPM:

Under federal law, hospitals had to stabilize and treat people who arrived at their emergency rooms with acute conditions. And our state’s hospitals were offering even more assistance than the federal government required. That meant that someone was already paying for the cost of treating people who didn’t have health insurance. If we could get our hands on that money, and therefore redirect it to help the uninsured buy insurance instead and obtain treatment in the way that the vast majority of individuals did — before acute conditions developed — the cost of insuring everyone in the state might not be as expensive as I had feared.

Oh the mendacity.