Shots - Health Blog
4:02 pm
Thu October 11, 2012

Romney: People Don't Die For Lack Of Insurance

Originally published on Tue October 16, 2012 1:48 pm

Another day, another editorial board, another controversial remark for Republican presidential nominee Mitt Romney. On Wednesday, it was abortion. On Thursday, health care.

The former Massachusetts governor has said repeatedly that one of his top priorities is to repeal the federal Affordable Care Act, known increasingly as "Obamacare." He's said less about what exactly he would replace it with.

In a discussion of that plan with editors of The Columbus Dispatch, Romney said this:

"We don't have people that become ill, who die in their apartment because they don't have insurance. We don't have a setting across this country where if you don't have insurance, we just say to you, 'Tough luck, you're going to die when you have your heart attack.' No, you go to the hospital, you get treated, you get care, and it's paid for, either by charity, the government or by the hospital."

Now that sounds similar to comments Romney made last month in an interview with CBS's 60 minutes — but not the same.

What he said last month was that if people need emergency care, they can always go to a hospital and get it. And that's true. The Emergency Medical Treatment and Active Labor Act requires hospitals to treat people who show up with bona fide emergencies, or women in, as the name suggests, active labor. But it doesn't require them to provide that care for free. They can, and usually do, try to collect from even uninsured patients, often at fees well above those negotiated by insurance companies.

But Romney was talking about something slightly different in Ohio: the idea that the U.S. doesn't have people who become ill or die because they don't have insurance. That, however, is belied by a large and growing body of academic studies, starting with a landmark study from the nonpartisan Institute of Medicine in 2002 that found 18,000 people died in the year 2000 because they lacked health insurance. Various updates of that study have come up with even larger numbers, mostly because of a growing number of uninsured people, combined with the increasing cost of medical care. In other words, there's a growing gap between what you can get with insurance and without.

And it's not just deaths. Studies also show people who get sick have worse outcomes if they don't have insurance than if they do, across a wide array of ailments, from cancer to heart disease to asthma.

Meanwhile, Democrats were already poised to pounce. Even before Romney made his comment, access to insurance was something President Obama's campaign has been hammering on. In events in Colorado, a swing state, the president has been introduced by a college student named Ryan Case, who recently lost both his parents after they lost their health insurance.

After Romney's comment in Columbus became public, the Obama campaign tweeted a link to a video featuring Case blaming that lack of insurance for contributing to both of his parents' deaths.

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Transcript

ROBERT SIEGEL, HOST:

Another day, another editorial board - another controversial remark from Mitt Romney. Yesterday, it was abortion; today, health care. As part of our occasional series "In Context," NPR's Julie Rovner joins us now, to talk about what has fact-checkers abuzz today. And, Julie, this comment came in a discussion with editors of the Columbus Dispatch. What did Romney say?

JULIE ROVNER, BYLINE: Well, as we've heard repeatedly, over the course of this campaign, the former governor says one of his top priorities would be to repeal the Affordable Care Act. That's the federal health law some - now, including the president - call Obamacare. What we've heard less about, is what Mr. Romney would replace it with. So it was in the context of trying to explain what he wants to do, that he said this - and I quote, "We don't have people that become ill, who die in their apartment because they don't have insurance. We don't have a setting across this country where if you don't have insurance, we just say to you, tough luck; you're going to die when you have your heart attack. No, you go to the hospital, you get treated, you get care. And it's paid for either by charity, the government, or by the hospital."

SIEGEL: That is a quotation of what Mr. Romney said...

ROVNER: Yes.

SIEGEL: ...Gov. Romney said to the Columbus Dispatch. It sounds a lot like remarks he made during his interview with "60 Minutes" last month. What's the difference?

ROVNER: Well, it's similar. What he said last month was that if people need emergency care, they can always go to a hospital and get it. And that's true. There's a federal law called the Emergency Medical Treatment and Active Labor Act, or EMTALA, that requires hospitals to treat people who show up with bona fide emergencies; or women in - as the name suggests - active labor. But it doesn't require the hospitals to provide that care for free; they can send those uninsured people a whopping bill. And usually, they do try to collect something.

SIEGEL: And back to yesterday's statement - the difference between what he said yesterday, and that earlier comment?

ROVNER: Well, there are a couple of things. First of all, he seemed to be suggesting that anyone without insurance can go to the hospital and get care. That's not the case. The EMTALA law only says that the hospital has to stabilize your emergency condition, not that it has to provide you full care. So it's only if there's some sort of emergency going on, not just if you don't feel well. But more importantly, the idea that we don't have people in this country who become ill or die because they don't have insurance, is belied by a large and growing body of academic studies - starting with a landmark study from the nonpartisan Institute of Medicine, in 2002. It found that 18,000 people died in the year 2000 because they lacked health insurance.

Various updates of that study have come up with even larger numbers - mostly because there are a growing number of uninsured people, combined with the increasing cost of medical care. In other words, there's a growing gap between what you can get with insurance, and without it. And it's not just deaths. Studies also show that people who get sick have worse outcomes if they don't have insurance, than if they do. And that goes across a wide array of ailments; everything from cancer to heart disease, to asthma.

SIEGEL: So is the Romney statement likely to have political implications?

ROVNER: Well, it's something the Obama campaign has already been trying to capitalize on. They've got this college student from Colorado, named Ryan Case - remember, Colorado is one of those key swing states. He's been introducing the president at some events there. Today, the campaign was tweeting a video that Ryan made, about how he blames lack of insurance for the death of both his parents. Here's a snippet of that video.

(SOUNDBITE OF VIDEO)

RYAN CASE: He didn't have health insurance because he was laid off. His kidneys failed. He had a heart attack. I feel like if he had health insurance, he would still be here.

SIEGEL: Julie, that's not a very subtle ad right there.

ROVNER: No. It's really not. It's a really very sad story, and it's an issue that I think the Obama campaign is going to be hitting very hard as we get into these last weeks of the campaign.

SIEGEL: OK. "In Context," with NPR's Julie Rovner. Thank you, Julie.

ROVNER: Thank you, Robert. Transcript provided by NPR, Copyright NPR.