‘After all, you just go to an emergency room’

July 11, 2007

The president’s speech in Cleveland yesterday wasn’t just a bizarre defense for the status quo in Iraq; it managed to also include some bizarre ideas about healthcare. This gem, for example, won the coveted Clueless Quote of the Day from Dan Froomkin.

“The immediate goal is to make sure there are more people on private insurance plans. I mean, people have access to health care in America. After all, you just go to an emergency room.”

Kevin asks, “Did somebody actually write that line for him? Was it adlibbed?” In fact, it was the latter; Bush’s event was kind of a town-hall style speech. He didn’t have a podium or a teleprompter, so this was the president without a net. His comments on healthcare reflected whatever thought popped into his head.

Kevin added, “Does Bush really believe that emergency rooms are a great way of providing medical care for poor people?”

Actually, I think he might.

It didn’t get too much attention at the time, but three years ago, then-HHS Secretary Tommy Thompson (you know, the supposed presidential candidate?) visited Iraq to drop off $1 billion to help establish a universal healthcare system for Iraqis. Pesky congressional Dems asked why the administration opposes universal care in the U.S., while supporting a system in Iraq.

Health and Human Services Secretary Tommy Thompson said yesterday there are major differences between the two countries that defy simple comparisons.

“Even if you don’t have health insurance,” said Thompson, who toured medical facilities in the Iraqi cities of Baghdad and Tikrit on Saturday and Sunday, “you are still taken care of in America. That certainly could be defined as universal coverage.”

He didn’t specifically mention emergency rooms, but the implication was pretty obvious, just as the president’s comments were yesterday: in the United States, sick people receive care whether they have insurance or not, which necessarily makes our system “universal.”

In a sense, that’s true. If you’re sick, there are public hospitals that will treat you in an emergency room. Of course, it’s extremely expensive to treat ill patients in this way and it would be far cheaper to pay for preventative care so that people don’t have to wait for a medical emergency to go to the hospital.

Under the Bush administration model, a sick person with no insurance goes to the emergency room for treatment. Does he get a bill once he’s taken care of? Probably, but it doesn’t matter because he can’t afford to pay it.

If the patient can’t pay the bill and hospital can’t treat sick patients for free, who pays the medical bill? Everyone else.

Yes, everyone pays, everyone gets treatment. Bush and his team support the most inefficient system of socialized medicine ever devised.

Well, it’s not only that — some poor people may go to an emergency room but some may not. They may not go — even when they are in great medical need — because they don’t want to not be able to pay. They don’t want to incur medical bills that they know they can’t pay. So they die instead.

Others may go, incur the bills, and feel terrible about it when they can’t pay. They may try to partially pay at the expense of other needs they and their family may have. The bills hang over their heads whether they ever get paid or not.

  • Average cost of visit to an emergency room in North Carolina — $1029. Some health care system.

  • “Bush and his team support the most inefficient system of socialized medicine ever devised.”

    and, because people use the emergency room instead of regular physicians or physician assistants or nurse practitioners, they support the most expensive system of socialized medicine ever devised.

  • Yeah, Mr Bush, you go to the emergency room, and then you go to hell. If you’re lucky enough to survive whatever caused you go to the emergency room, you then get to be hounded by bill collectors for the rest of your life.

    But of course a rich prick like you wouldn’t understand that kind of thing.

    We will bury you.

  • Is it any wonder we’re all feeling like the end to this man’s term cannot come soon enough? That “emergency room” comment was right up there with his famous comment about the ob/gyn’s not being able to practice their love with women, and both are indicative of someone who has no earthly idea what the big problem with “health care” is all about.

    I live in an area where you cannot swing a dead cat without hitting someone in the medical profession. There are 19 hospitals within a 30 mile radius of my home, two medical schools, and a School of Dentistry. That there is so much health care available should mean that this is one of the healthiest populations you could find. Of course, it isn’t, but Bush would not understand that availability does not always equal access. That a lot of people cannot afford to see a doctor for routine care, and that hospitals are not required to treat those whose conditions are not life-threatening.

    Why doesn’t he know these things? He has an army of experts who have a wealth of information on this problem, so he has no excuse for not knowing, and yet he gets away with these inane comments because he routinely speaks to groups of people who do not question anything he says. And then, to add insult to injury – for which there is no cure – the media dutifully showcases him and allows his comments to stand without challenge – giving those comments the weight of truth to people who still think the media is a gatekeeper for the truth.

  • You only get emergency care in an emergency room. Its not like you can show up to an emrgency room and get chemotherapy.

  • “After all, you just go to an emergency room.”

    This may be the dumbest thing Bush ever said. He should henceforth recuse himself from any discussion of any topic containing the letters h-e-a-l-t-h-i-n-s-u-r-n or c. (Don’t you have some brush to clear, George?)

  • Wheee! It just never gets tiresome, listening to The Leader Of The Free World say things that suggest he didn’t even review the material prior to the event. You’d think that with his head being so dense, it’d be so heavy that he’d need some sort of a modified Segway to help his neck hold the weight. It defies explanation how a man who is in a position where he’s bombarded with new information on a daily basis could be getting stupider as he goes along.

  • George Bush on medical care: “After all, you just go to an emergency room.”

    Barabara Bush on the Katrina tragedy: “And so many of the people in the arena here, you know, were underprivileged anyway, so this–this [slight chuckle] is working very well for them.”

    It’s a family thing.

  • Kevin asks, “Did somebody actually write that line for him? Was it adlibbed?” In fact, it was the latter; Bush’s event was kind of a town-hall style speech. He didn’t have a podium or a teleprompter, so this was the president without a net. His comments on healthcare reflected whatever thought popped into his head.

    Well, I differ- I think that he doesn’t know shit about whatever he’s supposed to talk about at a particular event and they just prep him with a bunch of bullet points the night before or hopefully in two sessions, possibly jogging some memories of policy discussions they’ve annoyingly foisted on him before. To me that seems like the quality of speech we get from this guy and I can’t imagine he has any real interest in any kind of public issue except running a war (which he personally doesn’t want to give up, because running a war is exciting) since he admittedly doesn’t even read newspapers.

  • If we have socialized health care, it shouldn’t cover a lot of things, though. Plastic surgery if you get deformed in an accident or are born deformed, but not if you’re born ugly or want fake boobs. No lancing of boils, but lasering of moles and freckles that look like they could turn cancerous. And so on. Just for the record.

    We’ll have two health care systems side by side, a private one for everything you want, and a public one for everything you need. Get a good prosthesis or wheelchair from the government, get a grwat one from a private practitioner. And the right-wingers will still be (their version of) happy, because they’ll be able to turn themselves silly with rage over the particulars of what the socialized medicine should/should not cover in policy debates.

  • If the patient can’t pay the bill and hospital can’t treat sick patients for free, who pays the medical bill? Everyone else. — CB

    That’s why, “The immediate goal is to make sure there are more people on private insurance plans” (first part of the quote). So that more of the costs of that wonderful, universal “healthcare” can be spread among the paying individuals, rather than his buddies in the insurance business.

    As for the second part of the quote (about the emergency rooms)… I’d be willing to bet that that’s what George W(itless) Bush thinks, because that’s all he knows. “All those uninsured parasites, running to the emergency rooms on any silly and frivolous pretext, making healthcare more expensve for the rest of us.”

    I’ve heard that argument time and again even from people with moderate insurance plans. Given that the Shrub had been cradled in a golden safety net throughout his life…

    We have a free clinic in our little town, which, I suppose, takes some of the burden off the hospital — it offers *preventive* care, so that fewer people have to resort to the emergency room “care”. One of the first thing they tell us there, at the volunteer orientation meeting, is that we have to make sure we’re never judgmental or patronising towards those who are forced to use the clinic. Yet, even those who run it (the few paid staff) do, at least when the patients aren’t in the hearing distance. Describing the drug dispensation program (partially subsidised by the big pharmaceutical firms), one of the women made a comment “and this is the real stuff; costs hundreds of dollars at the pharmacy. Now me, I’m insured, so I get the generic version”. Reagan’s “welfare queens” live and prosper, obviously.

    Needless to say, I saw the “lady” at the Repub primaries (I’ve signed up to be an elections officer) a couple of weeks later (Virginia’s state elections are off-cycle and coming up this November)

  • Those roars of demented fury you hear in the distance? Yeah, that’s every person who works for a hospital with an ER, howling for bits of the pResident.

    But I think N. Wells nailed it. That was the “real” Bush speaking. Isn’t he such a dear sweet mama’s boy?

  • Sounds like our preznit needs to get himself to a theater to see “Sicko” and PAY ATTENTION!!!

  • Hospitals are only obligated to provide treatment under actual emergency conditions. Otherwise, they can just send you home, telling you to see a doctor.

    On the other had, if they *do* treat you and you lack insurance, you will receive a bill that will likely be several times the amount that would have been billed to your insurance carrier, if you had had one. That is because hospitals need to maintain a “retail price” for care, which they discount heavily to insurers. Those without insurers are billed this phony, inflated “retail” price.

    For those who can’t pay, many hospitals, especially the ever-more-common for-profit variety, are now hounding patients via debt collectors, and law-suits that may involved seizures of cars, etc.

    Because of this, many don’t seek care, and suffer with chronic and even life-threatening conditions.

    Many people die because they did not seek care in a timely fashion. Bush is living in a dreamworld if he thinks otherwise.

  • swan @ 14

    It’ll have to be worse than that.

    Private will need to handle legit therapies too, like bone marrow transplants for breast cancer. It’s proven effective, but only 10% of the time. Wasted money 9 times out of 10. THIS is the equivalent of the new color TVs Rudy spoke of. Very expensive therapies that will become affordable someday like MRIs and bypass surgery. Not sure if Rudy sees the analogy the same way. I just realize not every citizen can get every cutting edge therapy without utterly bankrupting the system. Check out Oregon for a plausible model.

    Private should also cover BS like acupuncture and chiropractry.

  • “Hospitals are only obligated to provide treatment under actual emergency conditions. Otherwise, they can just send you home, telling you to see a doctor.” (From Nancy)

    I think not, Nancy. If you come in with a cough, the ER doc doesn’t know if you’ve got a cold or pneumonia. And to know that, you have to be triaged (vital signs taken, symptoms taken, etc). That ALONE costs money since you’ve taken time and used the hospital ERs resources. Then, if the doc doesn’t want to take the chance of being sued later, a chest xray and blood count needs to be done. By then, you’re REALLY eating into the resources and the dollars. And, if the blood count or xray looks suspicious, you get treated… even if it turns out to be just a cold.

    In MY hospital, EVERYONE who can crawl through the door gets triaged and treated. It may be just some cough syrup and a Claritin with a recommendation to follow up with a private physician, but that’s treatment. And it MAY prevent someone from progressing into pneumonia.

  • You don’t have to be poor to not be able to afford a medical bill. Even minor brain surgery and the associated hospital stay can easily run into six figures if you don’t have insurance. When I had a 30-hour hospital stay a couple of years ago, I received a bill for $11,000. Since I belong to an HMO, I paid $100, the insurance company paid about $1,000, and NO ONE paid the rest. In other words, the hospital only expected to be paid about $1,100, which is borderline reasonable. But some poor clown without insurance would have to pay $11,000! In any other business, that would be called insurance fraud. In health care, it’s business as usual.

  • My mom fell and broke 3 ribs about a month ago, the emergency room charged her over $4,000.00 for x-rays & painkillers, she was only there for about 4 hours, thankfully she has insurance.

  • Try this one.

    I take my son to the doctor. The doctor runs blood tests, suspects pneumonia and wants to do an intraveneous antibiotic, but because they don’t do x-rays or IVs, he sends us to the ER, where they do the x-ray and the drip and run the exact same battery of blood tests that the doctor ran two hours before.

    Total cost – almost $800 just for the ER visit. We haven’t got the bills yet for the ER doctor or the radiologist.

    We have insurance, but we have to pay a $1,000 per person deductible before 80/20 kicks in.

    I don’t understand why the pediatrician’s office can’t do x-rays and IVs. When I get an x-ray at my doctor, it costs about $100. An x-ray at the ER (total price of the visit) runs you over a thousand.

    This was our second ER visit in less than 12 months. The other was for the other kid, who needed a head CT after a serious fall at school. The hospital waited exactly one month after sending their bill (which wasn’t itemized) before sending the account to collections.

    And we have insurance.

  • That’s right…that is what we do, we treat “all comers” in the ER. As an Emergency Physician I know a thing or two about the healthcare system. Many uninsured have ample opportunity (at free, uninsured clinics where primary care doctors are provided) to follow up routinely for health care after visiting the ER, but many do not. Many people have no problem spending $300 on an NFL sports jacket, or $400 a month for a new “Escalade,” but would never think about putting that money away into a Health Savings Account in order to prepare for healthcare events. It is all about personal responsibility, and rationing YOUR OWN MONEY for YOUR OWN HEALTH CARE. For a true analysis of the health care system-visit my blog at : http://www.healthline.com, click on the “health experts icon”, and find interesting health related reading under “Straighttalk from the Stanford ER.”

  • I foolishly went to the ER once without insurance recently. I was there for about 8hrs, the doctor popped in and out and probably saw me for a total of 30 minutes. They went ahead with tests and procedures I told them I didn’t want to do, they did anyway, and it all added up to nothing. Only one procedure they did was necessary for diagnosis, the same one I told them needed to be done when I first arrived.

    I’m a 23yr old girl and I had a very naive idea of the system. Sure, I knew it would be expensive, but I was thinking more like $500 expensive not $2500 expensive! And for what? Thirty minutes of a doctors time? A bunch of useless tests I told them I didn’t need? Oh, and the $300 admission charge as well, because several hours after being there I was told I was in a private hospital (the closest one to my house.) I feel really stupid. I was completely duped and ripped off. How do they justify these prices? Did someone just invent them? Pull them out of thin air? Where is the logic that says it’s ok to force certain procedures and then grossly over-charge an individual for them?

    You go to an ER because you’re afraid for your life, vulnerable and scared. You’re not thinking about how you’ll be billed for every unnecessary torture they put you through. This is a scam that takes advantage of people who not thinking clearly. Well, I learned my lesson. First, never go to an ER without insurance.
    Second, suck it up and get some insurance.

  • I couldn’t understand some parts of this article – The Carpetbagger Report, but I guess I just need to check some more resources regarding this, because it sounds interesting.

  • Fuck this administration to hell! I’m suffering and can’t get insurance or treatment. I’m not poor, not an immigrant, not usually unemployed. It can happen to anyone. Serious fall, can’t walk. I walked into the ER and they told me I’d have to pay 100%. MRIs and emergency surgery = $100k+. The solution? Suffer and hope for the best.

  • Does GW really understand the real world and the true cost of health care? I doubt it but then neither do most of the other politicians in DC. People ask why
    does healthcare cost so much. The answers are many, complex and interrelated.
    The primary reason why an ER visit that should cost $500 is billed out at $2500 is because it is not uncommon for 80+% of the patients in many ER’s to not pay a dime. And because of Federal law if you show up at an ER that ER must take care of you. Yes they will bill you, and yes they will try and collect from you but large portions of the populace have no assets to go after and no wages to garnish. Thus costs are shifted to those who can be squeezed for money. Is this right….not really but if healthcare was not allowed to shift costs most facilities would go out of business in a matter of days.

    Want to decrease the true cost of healthcare? It will require changes that will leave many screaming facism at the top of their lungs. The reason for that is simple. Demand will always exceed supply when costs can be avoided or shifted to third parties such as the government and insurers. Stop treating people for self inflicted diseases like obesity (90% of obese people are that way because they have a self control problem not a metabolic one). Stop treating people for tobacco and alchol related disease….again these are personal choices issues. Stop treating people for HIV diseases acquired from lifestyle choices…..again person choice leading to expensive disease. And finally we as a society need to accept the fact that we all get old and die and stop spending billions of dollars annually in the futile attempt to avoid the inevitable. Typically most healthcare dollars are spend on people who virtually no chance at getting better…..they are dying of old age. Until we as a society accept these facts we are doomed to continue this spiral of insanity and finger pointing.

  • I accidentally came to this discussion site, and found out some very interesting discussions. I am in the same situation – My dad had a chest pain and I took him to ER – and they had him stayed in the hospital for 28-30 hours, and discharged him – his scan results were quite normal. My dad is not from United states, and so, just for security I took Travelers insurance – this is a very basic insurance – which pays a flat rate. Now I got the bill from the Hospital, and I came up to $11,084, his lifetime savings are not equal to $11,000 – the place where he came from. And its a lot of money for me too – as there is a baby on the way, I don’t know what to do – I am confused and this stress is kinda bothering me. Any suggestions are appreciated. The hospital ran it through the insurance firm and haven’t yet got any response. I am pretty sure, the insurance company will cover a lot.

  • Was the $11,000 after the Traveler’s insurance paid their portion? I wouldn’t worry. Your father was the patient. Your father is responsible for the bill. Your father lives in another country. I don’t think repo men can cross international lines.

  • Thanks Dave,
    I got a Benefit summary letter from Traveler’s insurance – and nothing was covered.
    $11,000 was the amount charged to the insurance company – and Traveler’s insurance is not even covering a penny, they have mentioned in the letter that, they were checking with the provider to know the break up of services. They are asking us to submit the visa i-94 details for their records.
    Taking his condition into consideration (as he just came out of ER)- i told him not to worry – and i will take care of every thing – he will be leaving with in a week, and i will be living here – hope this should’nt create any problems to me.

    • Comments are closed.