WASHINGTON -- Downplaying the need for the government to ensure that every person has health insurance, Mitt Romney on Sunday suggested that emergency room care suffices as a substitute for the uninsured.

"Well, we do provide care for people who don't have insurance," he said in an interview with Scott Pelley of CBS's "60 Minutes" that aired Sunday night. "If someone has a heart attack, they don't sit in their apartment and die. We pick them up in an ambulance, and take them to the hospital, and give them care. And different states have different ways of providing for that care."

This constitutes a dramatic reversal in position for Romney, who passed a universal health care law in Massachusetts, in part, to eliminate the costs incurred when the uninsured show up in emergency rooms for care. Indeed, in both his book and in high-profile interviews during the campaign, Romney has touted his achievement in stamping out these inefficiencies while arguing that the same thing should be done at the national level.

And while Romney refused to agree on Sunday that the government's role is to ensure that every American has health care, he has endorsed such an idea in the past.

When asked in a March 2010 interview on MSNBC's "Morning Joe" whether he believes in universal coverage, Romney said, "Oh, sure."

"Look, it doesn't make a lot of sense for us to have millions and millions of people who have no health insurance and yet who can go to the emergency room and get entirely free care for which they have no responsibility, particularly if they are people who have sufficient means to pay their own way," he said.

Watch Romney on "Morning Joe" in 2010:



And in a 2007 interview with Glenn Beck, Romney called the fact that people without insurance were able to get "free care" in emergency rooms "a form of socialism."

"When they show up at the hospital, they get care. They get free care paid for by you and me. If that's not a form of socialism, I don't know what is," he said at the time. "So my plan did something quite different. It said, you know what? If people can afford to buy insurance ... or if they can pay their own way, then they either buy that insurance or pay their own way, but they no longer look to government to hand out free care. And that, in my opinion, is ultimate conservativism."

Getting rid of high numbers of inefficient emergency room visits was actually a key goal of Romney's health care reform in Massachusetts, as he noted in his book "No Apology":

After about a year of looking at data -- and not making much progress -- we had a collective epiphany of sorts, an obvious one, as important observations often are: the people in Massachusetts who didn't have health insurance were, in fact, already receiving health care. Under federal law, hospitals had to stabilize and treat people who arrived at their emergency rooms with acute conditions. And our state's hospitals were offering even more assistance than the federal government required. That meant that someone was already paying for the cost of treating people who didn't have health insurance. If we could get our hands on that money, and therefore redirect it to help the uninsured buy insurance instead and obtain treatment in the way that the vast majority of individuals did -- before acute conditions developed -- the cost of insuring everyone in the state might not be as expensive as I had feared.

In the "60 Minutes" interview, Romney stressed that each state should address the problem of the uninsured through different means. But he didn't speak with the same alarm about the cost of emergency room care.

"Again, different states have different ways of doing that," Romney responded. "Some provide that care through clinics. Some provide the care through emergency rooms. In my state, we found a solution that worked for my state. But I wouldn't take what we did in Massachusetts and say to Texas, 'You've got to take the Massachusetts model.'"

Romney's efforts to limit emergency room care in Massachusetts were largely successful.
Six years after he signed health reform into law, visits to emergency rooms in Massachusetts are decreasing and the state has the highest rate of residents with health insurance.

Dr. Somava Stout, who helps oversee primary care for the Cambridge Health Alliance, told CBS in June, "You have people who before would get their diabetic care in the emergency room who instead are coming into primary care, taking care of their diabetes, not ending up hospitalized every three or every four months. I mean it's a huge difference."

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