"I mean, people have access to health care in America. After all, YOU JUST GO TO AN EMERGENCY ROOM."
--G.W. Bush, Cleveland, 7/10/07

(in a prepared speech, as posted on the Bush White House Internet Site. I kept a copy, anticipating the Obama administration taking down the Bush post (which is right here), and for those wishing to verify from an official source, I discovered that the official Bush White House U.S. Government Archive site also has a copy here). The quote is in paragraph 16, the one that starts with "The immediate goal...".



Incidentally, Bush's idea may work out OK for you, at least financially, if you are pretty dirt poor, but may not work out so well for you if you have any assets to lose. If you go to the emergency room, and/or the the hospital, they can track you down and make you pay. Until and unless you have nothing left to lose. That's one problem, with the Medicaid- or Emergency-Room-Only safety-net system he is touting in the speech. (And let's not forget that those emergency room costs get cost-shifted to everyone with insurance, making their insurance unaffordable. It also gets cost-shifted, in an even worse form, to those without insurance but with assets to lose, who are able to afford treatment when their illness is short of full-financial-wipeout. That is, the insurance companies all negotioate a nice discount of around 30% off full retail, which you won't generally get from the hospital or doctor if you have no insurance.)

Another problem, of course, with the emergency room system is that it's really not that good for your health to wait until you are sick, rather than getting preventive checkups.

By the way, the reason that the "just go to the emergency room" idea works at all is that there is a Federal law (since the Reagan Administration in 1986) which requires emergency rooms to treat you in an emergency, whether or not the hospital will be able to recover charges. (For information and more references on that 1986 law, called ENTALA, you can start with this Wikipedia Article on ENTALA .) Thus, you see that the current law, rather than deal with the problem, has an irresponsible cost-shifting to the rest of us just built right in.

(People aware of court Tenth Amendment challenges to the new Obama law, based on that its mandate on individuals to maintain insurance or pay a tax/penalty, and therefore "compels", rather than just "regulates" commerce, as permitted of the Federal Government in the Constitution, might wonder how this challenge can hold water if the ENTALA mandate that emergency rooms and ambulance services treat and transport people who can not possibly pay is constitutional. However what I've been told on this is that in the legal technical interpretation of ENTALA, the act of commerce in considered the hospitals' and ambulances services' single economic transaction of taking Federal funds for the services of all patients it uses those funds for--thus all the free emergency-room treatments and ambulance rides count as part of that one big transaction with the Federal Governemt, which the hospitals and ambulance services could avoid if they chose not to take any federal funds for Medicare or anything else.)

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