Republican nominee Mitt Romney was criticized by several media outlets for his remarks about health care in a recent interview with the CBS newsmagazine "60 Minutes." When pressed by journalist Scott Pelley about how many poor people would have no access to health care if a future President Romney succeeds in repealing the Affordable Care Act, Romney noted that poor people in this country already have access to health care at any emergency room in the country, regardless of their ability to pay.
Some opponents have characterized his remarks as an endorsement of emergency room use to treat indigent patients, rightly observing that emergency room medicine is the most expensive form of health care. Consequently, Romney's statement has become something of a partisan football, with both sides ignoring the larger point.
Americans have made a collective decision that they won't tolerate people dying in the streets just because they can't afford health care. They believe that to be a wise and morally necessary decision for a civilized society to make. That's why, by law, every patient who needs treatment can get it, but if they can't afford it, they generally end up in emergency rooms. This constitutes an ad hoc universal care system that already is in place, one that too often delivers health care in the most expensive, inefficient and ineffective way possible.
Some libertarians argue that the current system ought to be entirely market-driven, so those who can't pay are left to their own devices, even if it costs them their lives. Such thinking constitutes a distinct minority, and neither the Democratic nor Republican party is willing to go to such extremes. But there are too many, particularly on the right, who simply demand "Obamacare" be repeal with no alternative plan, implicitly suggesting that the wildly inept and unsustainably costly status quo is an acceptable alternative. It is not.
Given how much rapidly rising health care costs are contributing to the nation's staggering debt, it is inexcusable for a politician of either party to ignore the need to continue to control those costs along with expanding coverage. Romney's observation, therefore, should be seen as a warning. The nation has much to do to fix its health care problems, and just repealing Obamacare alone won't do it.
But that leads us to the question of workable alternatives. We're still waiting to hear one. Without it, the nation's health care challenges will end up, both figuratively and literally, in the emergency room.