There are always emergency rooms

THERE ARE ALWAYS EMERGENCY ROOMS…. Mississippi is arguably the nation’s poorest state. With crushing poverty and a massive number of families without health care coverage, Mississippi stands to benefit more than most from the Affordable Care Act.

The Boston Globe had a fascinating piece this week, explaining that Gov. Haley Barbour (R), a 2012 presidential candidate, is determined to “throw out the overhaul” of the health care system and reject the improvements that would benefit literally hundreds of thousands of his struggling constituents.

“There’s nobody in Mississippi who does not have access to health care,” Barbour said. “One of the great problems in the conversation is the misimpression that if you don’t have insurance, you don’t get health care.” […]

“Most of the health disparities in Mississippi are not because of the inability to get access or afford health care,” said Barbour. “They are because of diet, alcohol, because of drugs, the very high incidence of illegitimacy that leads to high incidence of low-birth weight children.”

Now, the article is filled with overwhelming evidence that countless families in Mississippi are “falling through the cracks,” ineligible for Medicaid but unable to afford private coverage. And because these people can’t afford preventive care and/or medication, they routinely fall victim to more serious (and expensive) ailments.

“There is a lot of needless suffering,” Roy Mitchell, director of the Mississippi Health Advocacy Program, said. “But this is Mississippi. People suffer.”

Of course, they shouldn’t, and they don’t have to. The Obama administration, through the ACA, is poised to expand Medicaid eligibility in the state, and “will pick up 100 percent of the cost of the Medicaid expansion from 2014 to 2016 and 90 percent of the cost after 2020.” Barbour, meanwhile, wants no part of it, no matter how many people will benefit.

Pressed on Barbour’s belief that “nobody in Mississippi” lacks “access to health care,” the governor’s office said was talking about “emergency room procedures.”

Of course, having access to an emergency room isn’t the exactly same thing as having access to health care.

This comes up from time to time, and Republicans really ought to know better. It’s true that under the previous system — before the Affordable Care Act passed — if you’re uninsured and get sick, there are public hospitals that will treat you. But it’s extremely expensive to treat patients this way, and it would be far cheaper, and more medically effective, to pay for preventative care so that people don’t have to wait for a medical emergency to seek treatment.

For that matter, when sick people with no insurance go to the E.R. for care, they often can’t pay their bills. Since hospitals can’t treat sick patients for free, the costs are passed on to everyone else.

In other words, it’s the most inefficient system of socialized medicine ever devised.

And yet, Republicans keep praising it. Virginia Gov. Bob McDonnell (R) told Fox News last year, “The fact is a lot of people that don’t have insurance are getting [care] right now. They’re not denied in the emergency rooms.” Rep. Steve King (R-Iowa) made a nearly identical case in 2009, and Sen. Jim DeMint (R-S.C.) was thinking along the same lines a month prior. In July ’09, Senate Minority Leader Mitch McConnell (R-Ky.) was asked about the 47 million Americans who go without health insurance, McConnell replied, “Well, they don’t go without health care,” because they can just go to the emergency room.

In 2008, the conservative who shaped John McCain’s health care policy said anyone with access to an emergency room effectively has insurance. The year before, Tom DeLay argued, “[N]o American is denied health care in America,” because everyone can go to the emergency room. Around the same time, George W. Bush said the same thing: “[P]eople have access to health care in America. After all, you just go to an emergency room.” In 2004, then-HHS Secretary Tommy Thompson said our healthcare system “could be defined as universal coverage,” because of emergency rooms.

It’s a dumb argument. That it remains a staple of Republican rhetoric only adds insult to injury.