Mitt Romney, On 60 Minutes, Cites Emergency Room As Health C

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Mitt Romney, On 60 Minutes, Cites Emergency Room As Health C

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Mitt Romney on 60 Minutes

WASHINGTON -- Downplaying the need for the government to ensure that every person has health insurance, Mitt Romney on Sunday suggested that emergency room care suffices as a substitute for the uninsured.

"Well, we do provide care for people who don't have insurance," he said in an interview with Scott Pelley of CBS's "60 Minutes" that aired Sunday night. "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."

This constitutes a dramatic reversal in position for Romney, who passed a universal health care law in Massachusetts, in part, to eliminate the costs incurred when the uninsured show up in emergency rooms for care. Indeed, in both his book and in high-profile interviews during the campaign, Romney has touted his achievement in stamping out these inefficiencies while arguing that the same thing should be done at the national level.

And while Romney refused to agree on Sunday that the government's role is to ensure that every American has health care, he has endorsed such an idea in the past.

When asked in a March 2010 interview on MSNBC's "Morning Joe" whether he believes in universal coverage, Romney said, "Oh, sure."

"Look, it doesn't make a lot of sense for us to have millions and millions of people who have no health insurance and yet who can go to the emergency room and get entirely free care for which they have no responsibility, particularly if they are people who have sufficient means to pay their own way," he said.

Watch Romney on "Morning Joe" in 2010:




And in a 2007 interview with Glenn Beck, Romney called the fact that people without insurance were able to get "free care" in emergency rooms "a form of socialism."

"When they show up at the hospital, they get care. They get free care paid for by you and me. If that's not a form of socialism, I don't know what is," he said at the time. "So my plan did something quite different. It said, you know what? If people can afford to buy insurance ... or if they can pay their own way, then they either buy that insurance or pay their own way, but they no longer look to government to hand out free care. And that, in my opinion, is ultimate conservativism."

Getting rid of high numbers of inefficient emergency room visits was actually a key goal of Romney's health care reform in Massachusetts, as he noted in his book "No Apology":

After about a year of looking at data -- and not making much progress -- we had a collective epiphany of sorts, an obvious one, as important observations often are: the people in Massachusetts who didn't have health insurance were, in fact, already receiving health care. 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.
In the "60 Minutes" interview, Romney stressed that each state should address the problem of the uninsured through different means. But he didn't speak with the same alarm about the cost of emergency room care.

"Again, different states have different ways of doing that," Romney responded. "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.'"

Romney's efforts to limit emergency room care in Massachusetts were largely successful.
Six years after he signed health reform into law, visits to emergency rooms in Massachusetts are decreasing and the state has the highest rate of residents with health insurance.

Dr. Somava Stout, who helps oversee primary care for the Cambridge Health Alliance, told CBS in June, "You have people who before would get their diabetic care in the emergency room who instead are coming into primary care, taking care of their diabetes, not ending up hospitalized every three or every four months. I mean it's a huge difference."
Source
It's not like relying on emergency rooms is incredibly expensive and inefficient.
Last edited by LadyTevar on 2012-09-24 12:08pm, edited 2 times in total.
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Re: Romney cites Emergency Room As Health Care Option

Post by mr friendly guy »

Its telling that Romney cites a medical condition ie heart attack which is an emergency and should be treated in the emergency department (oh sorry you Americans call it ER :D ). What about all those other conditions that can be seen as an outpatient, but still somewhat serious?

BTW there is a duplicate thread.
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Re: Mitt Romney, On 60 Minutes, Cites Emergency Room As Heal

Post by madd0ct0r »

It's not like Romney himself hasn't argued that in the past.
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Re: Mitt Romney, On 60 Minutes, Cites Emergency Room As Heal

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I seem to have made two of these threads. Could a mod remove one?

Merged into One --Lady Tevar
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Re: Mitt Romney, On 60 Minutes, Cites Emergency Room As Heal

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The problem with the "ER as health insurance" meme is that it provides care ONLY for acute and immediately life-threatening conditions. Cancer, for example, is NOT treated in the ER. If you show up there with cancer, assuming you're not going to die immediately, you'll be referred to an oncologist and sent home. Can't pay for the oncologist? Tough shit, then you won't get treatment. Until you're actually dying, in which case it's too late.

Well, OK, if you need a cut stitched up you can probably get that done in the ER, too, then sent on your way - with no follow up care. Get an infection? Sucks to be you. You might have to take your own stitches out, too.

This idea that the ER takes care of the uninsured is complete bullshit and really pisses me off.
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Re: Romney cites Emergency Room As Health Care Option

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mr friendly guy wrote:What about all those other conditions that can be seen as an outpatient, but still somewhat serious?
In the US the ER is not obligated to treat a minor or non-life-threatening condition, though most will put a few stitches in a cut or splint a broken bone for you. Thus, chronic conditions are not treated. Acute conditions that aren't life-threatening often aren't treated (though some hospitals will hand out charity treatment).
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Re: Mitt Romney, On 60 Minutes, Cites Emergency Room As Heal

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I'm not sure he realizes just how expensive the ER is for the insured(much less the uninsured) either. Is he trying to break people?
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Re: Mitt Romney, On 60 Minutes, Cites Emergency Room As Heal

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I don't think he understands that the average US income is around $41,600. He thinks $200,000-250,000 per year marks the middle class.

He doesn't get it.

He doesn't understand what it's like to NOT be wealthy. He has no comprehension of being middle class, much less working poor. He thinks that if you squeeze "those people" harder it will give them an "incentive" to "do better" - the reality is that there is already plenty of incentive to "do better", that's why Americans work more hours per year than just about anyone else, why they work themselves to death, there is already a fuck-ton of incentive to increase one's income.

After all, if life on "welfare" is so wonderful why don't all those rich people give up their money and go on the dole?
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Re: Mitt Romney, On 60 Minutes, Cites Emergency Room As Heal

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Gaidin wrote:I'm not sure he realizes just how expensive the ER is for the insured(much less the uninsured) either. Is he trying to break people?
I'm sure he knows exactly how expensive he is since he spent years fighting to prevent it in Massachusetts. This is not just Romney saying his heathcare plan is different from Obamas. This is the equivalent of a anti-smoking advocate suddenly touting the benefits of a pack a day in making you look cooler.

No seriously, they are already digging up speeches from his days as Governor talking to his state house and providing real facts and figures about how expensive it is for everyone involved to go to a emergency room without insurance. Expensive for the person, expensive for the hospital, expensive for the tax payer it's a lose-lose-lose.

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Re: Mitt Romney, On 60 Minutes, Cites Emergency Room As Heal

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Hell, some of the local ER departments have started setting up small clinics off to the side, less staff and overhead, where uninsured people coming in with the flu, scratches, non emergent shit, can get seen. It is still the ER,but not with the expensive trauma teams, equipment, etc... When they come into triage, they get referred over to the clinic. A healthy chunk, no pun, of the cost of ER are the highly trained trauma doctors, nurses, and insta-use of radiology/MRI and other services.
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Re: Mitt Romney, On 60 Minutes, Cites Emergency Room As Heal

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Whatever, it's basically the same shit that we saw with McCain in 2008. A former "moderate" (by Republican standards) gets nominated to be President, and suddenly makes a hard turn to the right.

Although I'm still really struggling hard to understand how "no free health care" has become a popular position with the voting public. I guess it has something to do with death panels.
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Re: Mitt Romney, On 60 Minutes, Cites Emergency Room As Heal

Post by Dalton »

Channel72 wrote:Although I'm still really struggling hard to understand how "no free health care" has become a popular position with the voting public. I guess it has something to do with death panels.
More like an appeal to selfishness. Why should THEY get something for free which YOU paid for and all that.
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Re: Mitt Romney, On 60 Minutes, Cites Emergency Room As Heal

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Gaidin wrote:I'm not sure he realizes just how expensive the ER is for the insured(much less the uninsured) either. Is he trying to break people?

I work at a hospital and my deductible for an ER visit is $250. Going to urgent care is $40. The ER visit used to be $50 but they are trying to discourage non-acute patients from clogging up the ER by making it cheaper to visit an urgent care facility. Believe me it is annoying as crap to have the ER packed full of people who should have been seeing their physician or going to an urgent care. It's especially fun having to make deliveries to the ER of medications that are available over the counter. In the past my hospital was known for being fairly easy to get controlled pain meds so some of our extra business is from drug seekers trying to convince physicians they need the "good stuff".

FYI: Our emergency department refers to itself as the ED and it's slowly catching on throughout the hospital staff. Our insurance still lists it as ER though.
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Re: Mitt Romney, On 60 Minutes, Cites Emergency Room As Heal

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Knife wrote:Hell, some of the local ER departments have started setting up small clinics off to the side, less staff and overhead, where uninsured people coming in with the flu, scratches, non emergent shit, can get seen. It is still the ER,but not with the expensive trauma teams, equipment, etc... When they come into triage, they get referred over to the clinic. A healthy chunk, no pun, of the cost of ER are the highly trained trauma doctors, nurses, and insta-use of radiology/MRI and other services.
This is actually something the NHS does in Britain. If you have a cut or minor broken bone (say a broken big toe), you don't go to A&E. You go to a Minor Injuries unit. The most complicated bit of kit a lot of those have is an X-ray machine, because for anything serious enough to require more, they stick you in an ambulance and send you to A&E, assuming you managed to get there under your own power. If you were actually picked up by an ambulance to begin with, you'd have gone straight to A&E in the first place.

This also has the advantage that those people, who are perfectly capable of waiting, aren't clogging up A&E and resulting in people who really need treatment having to wait while staff sort out who should be seen first.
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Re: Mitt Romney, On 60 Minutes, Cites Emergency Room As Heal

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I think the best part about this whole thing is that Romney was against it before he was for it.
The Washington Post wrote: Romney was against emergency room care before he was for it
Posted by Sarah Kliff on September 24, 2012 at 1:07 pm
During an interview that aired Sunday night on CBS’s “60 Minutes”, Republican presidential candidate Mitt Romney talked about emergency rooms as a solution for the uninsured.

“If someone has a heart attack, they don’t sit in their apartment and die,” he said. “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.”

That’s different from 2006, when Romney used to talk about emergency rooms as the problem. Massachusetts had just passed its universal coverage law that was meant, among other things, to move care out of emergency rooms, where costs are higher, and into primary care offices.

Romney wrote a Wall Street Journal op-ed in 2006, shortly after the law passed, arguing that emergency care for those without coverage drove up costs for everyone who did have insurance.

“By law, emergency care cannot be withheld,” he wrote. “Why pay for something you can get free? Of course, while it maybe free for them, everyone else ends up paying the bill, either in higher insurance premiums or taxes.”

The problem Romney refers to here is that of uncompensated care, the medical bills from doctors and hospitals that go unpaid. A Kaiser Family Foundation found that state and federal government spent $34.9 billion on uncompensated care in 2004.

Some costs likely get shifted to private consumers, too. A 2008 paper in the journal Health Affairs estimates that as much as 1.7 percent of private health insurance premiums are used to offset the cost of uncompensated care.

The fact that emergency room care tends to be more expensive than that delivered in other settings exacerbates this problem. Uncompensated care bills for the emergency room are higher than they would be for, say, an unpaid bill in a family physician’s office. Romney got at that problem in a separate Boston Globe op-ed, in 2004, when he was pitching his health reform plan.

“One way our insurers and our state health programs will be able to provide care at a lower cost is by directing patients towards the most effective and efficient care,” he wrote. “A sore throat can be diagnosed and treated by a physician at an emergency room, but the cost varies quiet dramatically.”

The data backs this up: Government data shows that the average emergency department visit cost $922 in 2008. The average office visit, meanwhile, came in at $199. Here’s another way to put it: Emergency room visits accounted for 4.4 percent of doctor visits but 14.4 percent of doctor visit costs.

Some of this is certainly due to the fact emergency rooms see more complex conditions. But separate research does suggest that there are higher charges for primary care delivered in an emergency room.

Romney is right when he says there’s a federal law that requires all emergency rooms to accept uninsured patients (how that gets applied on the ground, however, is another story). He was also right back in the 2000s, too, when he suggested that emergency rooms are expensive places to deliver health care.
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Re: Mitt Romney, On 60 Minutes, Cites Emergency Room As Heal

Post by Dalton »

That's the hallmark of his campaign. He used to be fairly moderate.
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Re: Mitt Romney, On 60 Minutes, Cites Emergency Room As Heal

Post by madd0ct0r »

was that speech televised?

does anyone feel like doing a mash up of romney debateing healthcare with himself?
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Re: Mitt Romney, On 60 Minutes, Cites Emergency Room As Heal

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Dalton wrote:That's the hallmark of his campaign. He used to be fairly moderate.
Yeah, it's McCain all over again. But, this is what happens when your political party takes a hard right and you have to 'adjust' in order to get the fucking nomination.
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Re: Mitt Romney, On 60 Minutes, Cites Emergency Room As Heal

Post by Dalton »

madd0ct0r wrote:was that speech televised?

does anyone feel like doing a mash up of romney debateing healthcare with himself?
Jon Stewart kinda did that already.
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Re: Mitt Romney, On 60 Minutes, Cites Emergency Room As Heal

Post by Lord MJ »

I believe Romney's position now is that Health Care reform should be a matter left up to the states. So if a State want's a Mass solution, or a tort reform solution, or using Emergency Rooms, it's up to them.
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Re: Mitt Romney, On 60 Minutes, Cites Emergency Room As Heal

Post by KrauserKrauser »

But the level of inefficiency that introduces is stupifying.

What is really funny is reviewing the basic arguments for uhc with people spouting limbaughannitybeck talking points and see them reach the conclusion that uhc makes logical sense and then just revert back no matter what.

Fact: people dying in the streets is bad

So some level of care should be available for all

Fact: er visits are the most expensive way to obtain treatment

So we should offer care to all but avoid requiring them to receive it in the er

Solution reached: some form of uhc

Even logical and simple cost saving measures like national standard.forms and.medical records or minimum required treatment plans just sails right past them as commie socialism government intrusion.etc.

I can almost always get them to agree that this is a good idea before the hannitization of america kicks in and the light bulb of realization blinks out.

There are.so.many logical cost saving measures that arent being talked about, mainly because it endangers the profits of the insurance.industry.
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Re: Mitt Romney, On 60 Minutes, Cites Emergency Room As Heal

Post by Edi »

And heaven help you if you actually make any argument that in any way, shape or form puts forth the position that health insurance industry profits are not and should not be sacrosanct. As soon as that comes out, they will ignore anything and everything else you say.

It's amazing how well they can ignore reality.
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Re: Mitt Romney, On 60 Minutes, Cites Emergency Room As Heal

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Personally I think this can't last much longer; it's equivalent to people jumping up and down and using "but would you want your daughter to marry one" as a counterargument to try and stop desegregation. At a certain point, you start seeing more and more people whose reply is "You know what? Fuck it. Yes."

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Re: Mitt Romney, On 60 Minutes, Cites Emergency Room As Heal

Post by KrauserKrauser »

I have no problem with profitable health insurance companies. My auto insurance company (USAA) is profitable and I enjoy the service they provide.

There are UHC plans out there that allow for profitable health insurance companies, provide coverage for all citizens, have the same or better outcomes and do it for half as much as the US.

The only reason I can guess for why we havent moved to copy the already existing models I simply attribute to the unlimited lobbying money that the current health insurance.cartels pour into Congress.

The amount inefficiency that is present in our healthcare system is.simply astounding.
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Re: Mitt Romney, On 60 Minutes, Cites Emergency Room As Heal

Post by Edi »

KrauserKrauser wrote:I have no problem with profitable health insurance companies.
Neither do I. The point here being that the mere prospect of health insurance profits being in any way lessened from what they now are so that the system could be improved shuts the freemarketards' reasoning faculties down.
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