Thursday, August 28, 2008

What a McMoron

I've disagreed with Representative Scott Garrett and his stand on a number of health insurance issues (SCHIP primarily); however, I don't recall seeing him give as idiotic a suggestion as one of Sen. John McCain's closest advisers did yesterday. In response to the Census Bureau's latest figures on the uninsured, one of the architects of McCain's health plan put in his two cents (h/t Blue Jersey).
But the numbers are misleading, said John Goodman, president of the National Center for Policy Analysis, a right-leaning Dallas-based think tank. Mr. Goodman, who helped craft Sen. John McCain's health care policy, said anyone with access to an emergency room effectively has insurance, albeit the government acts as the payer of last resort. (Hospital emergency rooms by law cannot turn away a patient in need of immediate care.)

"So I have a solution. And it will cost not one thin dime," Mr. Goodman said. "The next president of the United States should sign an executive order requiring the Census Bureau to cease and desist from describing any American - even illegal aliens - as uninsured. Instead, the bureau should categorize people according to the likely source of payment should they need care.
"So, there you have it. Voila! Problem solved."

Obviously, that's not a solution nor does it do anything to deal with rising health care costs. Glossing over the differences between functional coverage and coverage of last resort would make costs worse. Those of us with health insurance take the first hit, as our costs are artificially higher for insurance and care because hospitals hedge their fees to deal with unneeded uninsured emergency room visits. Then, as taxpayers, we're smacked again when the hospitals guess wrong.

Access to a doctor's office saves money compared to emergency room visits. This has been shown in study after study. For example, this is part of a policy study conducted at Duke University back in 2001 of the then 1.2 million uninsured in North Carolina:
The average charge for a non-urgent emergency room visit is roughly 2.3 times more than an office-based visit, meaning that an emergency room visit costs $58.36 more than an office-based visit ($103.25 versus $44.89) (ACP-ASIM, 2000). If the additional 26,000 persons who would be able to access primary care in an office-based setting under the first policy reduced non-urgent emergency room visits by 100 percent as earlier estimated, a cost savings of $1.75 million [$58.36 x 30,000] would be realized. In addition, if the number of preventable hospitalizations were reduced by 6.0 percent as previous estimated, a cost savings of $3.3 million would be realized, assuming that the average cost of one preventable hospitalization was $7,565

As with any issue, you need good numbers to see how big of a problem you have and how best to deal with it. Lumping functioning government insurance (Medicare, Medicaid, SCHIP) with rescue payments for charity care would make determining the best course of action difficult to say the least.

If the Republicans want to reclaim the mantle of fiscal responsibility and point toward lower health care costs, shutting this guy up should be priority number one.

I have to believe that Garrett is smarter than to agree with McCain's McMoron, but Garrett and his colleagues have to come out against this idiocy or they are giving tacit endorsement with their silence.

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