Someone enroll this guy in Intro to Public Heath

WUPR’s very own Steven Perlberg recently blogged about the inconsistency of Republican Presidential nominee Mitt Romney’s recent comment about emergency health care with his past stance, when he was Governor of Massachusetts. Just to refresh your mind, here’s the matter at hand:

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.

As a student of Public Health, this is infuriating to me on so many different levels.

The United States spends tens of  billions of dollars on emergency care–tens of billions which could improve many more lives if even a fraction of that went into preventative care.

By resigning some uninsured, mortally obese guy to poor health and a restricted, shitty life until he has a heart attack, we’re causing unnecessary, immense suffering both before and after he’s rushed to the emergency room. Instead of managing his obesity early on so that he could have a productive rest of his life, his life is even shittier because he’s not allowed to climb stairs after his heart attack.

This is not just a hypothetical: a myriad of studies show that uninsured, poor patients chose to hold out and suffer from their ailments as long as they can because they simply can’t afford the bills. Then they show up in the emergency room with freaky cases out of a medical texbook, or Mitt Romney picks them up in his delusional ambulance. Then he slaps them in the face either financial ruin, or he feels nice that day so the million-dollar open heart surgery goes on the Medicaid tab.

The most damaging result of Mitt Romney’s comment is that it propagates a common American misconception of how health care works. Contrary to popular belief and what you see on prime time television programming like House, only a fraction of the lives that are “saved” or total health care that is delivered are in emergency rooms.

The real work happens behind the scenes, when a primary care physician catches cancer on a yearly routine exam that insurance covers. Or even more behind the scenes (I just have to make the public health plug), when you don’t get food poisoning because that unhygienic E. Coli-loaded jalapeno pepper doesn’t reach your plate, or your sorry texting-while-driving ass doesn’t go flying out the windshield because evil-big-brother government requires all cars to be sold in the United States with seat belts.

Of course, I don’t mean to belittle the effort of America’s emergency room doctors. But they are already taxed beyond belief, working inhuman hours. The last thing they need is more uninsured patients coming in simply because they were ignored until then.

Mitt Romney’s comments come at an especially inopportune time for health in America. Obesity and its closely related disease, diabetes, are reaching epidemic proportions in the United States. 30% of the American population, and pushing on 35% nowadays, are obese. Such ailments, called chronic illnesses, are long-term–meaning they need to be managed over lifespans. In most cases, with a little applied health knowledge and a good supply of appropriate food and insulin, diabetes can be managed with minimal life impact. That’s if you have insurance to cover it. If not, well people, that’s why we have the emergency room so people can get all their diabetes-induced-sepsis-infected feet amputated. Wait, what?

Emergency care is called that, and not The Dumping Ground for All Your Problems Because you Didn’t Want to Deal With it, because it is not a safety net. It’s a last resort. As has been said before, and will surely be said again, Mitt Romney doesn’t get it.