In Cleveland this week, Republican presidential nominee Mitt Romney addressed concerns about his proposal to repeal the Affordable Care Act (more commonly known as Obamacare), a law that would insure an estimated 30 million Americans. Critics contend that depriving so many people of coverage would lead to unnecessary deaths. Romney contested that claim:
"We don't have people who become ill, who die in their apartment because they don't have insurance," Romney told reporters. He pointed to the example of an uninsured heart attack victim who can go to any emergency room and still receive care.
Romney's statements would seem to defy logic. With roughly 50 million Americans uninsured, there must be some people who die because they cannot get treatment. And indeed one study estimates that 26,000 deaths occur every year as a direct result of not having insurance, a rate of one person every 20 minutes.
But Gov. Romney was not talking about the people in that study, the Americans who develop life-threatening conditions over time because they can't afford to see a physician. Romney was simply noting a fact, that anyone can go to the hospital if he or she has a heart attack. Which is true. A law passed by Congress in 1986 requires all hospitals to provide emergency health care, regardless of the patient's citizenship or ability to pay.
Now, I'm an Obama supporter. And I don't think very much of Romney's health care proposals. But I would like to comment on his assertion that uninsured people don't die in their homes. Because I happen to know a person who did. And this occurred despite the fact that he went to the emergency room and sought help.
His name was Todd. I met him when we worked together at a Biggby Coffee (formerly known as Beaner's) in downtown Lansing, MI. He was in his mid-30s and I had just graduated high school. Todd was a funny guy -- the kind of person who threw around his big personality. The coffee shop where we worked was located among several state government offices and we served a lot of state senators and their staffs. Todd was well known for refusing to allow anyone to order with a grumpy attitude, no matter how important they were.
After I left Lansing to attend college, I came back and visited the coffee shop a couple times to catch up with Todd. But one day my dad (a regular customer) called to let me know that he had very suddenly and tragically died. It happened on one of the hottest days of the year. Todd was laying down in his apartment, which didn't have air conditioning, and he was suffering from chest pains. Eventually he went to the emergency room. The doctors checked him out and determined that he had heat stroke. They told Todd to sit in the emergency room's air conditioning and drink water.
So he did. After a few hours, Todd returned home and went to sleep. He died sometime before the next morning. It was later discovered that Todd had a very rare heart disease. He didn't tell the doctors about the condition because he didn't know that he had it.
When I heard about Todd's death, I was not exactly sad. I was more surprised. It seemed strange that a middle-class (i.e. privileged) person like me would know someone that died of preventable causes. I suspect that Gov. Romney would be surprised as well. This didn't happen in a Third World country or an area of extreme poverty. It happened in the middle of Lansing, just blocks from the Capitol building where Mr. Romney's father once presided as governor.
It's impossible to know if the emergency room could have prevented Todd's death if he'd had insurance. But it's hard to blame the doctors for failing to diagnose him. Todd was displaying signs of heat stroke, and it was a hot day. Why bother to run tests on the off chance he had an extremely rare disease? And who would pay for those tests? The numbers just didn't add up.
Whether or not you think that the federal government should help more people get insurance, most Americans believe that hospitals should provide care to someone in a medical emergency. But our bodies are complicated. The emergencies are not always obvious.
It's extremely difficult for researchers to gather statistics on how many people die as a result of not having health insurance. This is because, by definition, they are the people who rarely have contact with our health care system. But if Obamacare is allowed to move forward and the uninsured receive coverage, then perhaps emergency rooms will run a few extra life-saving tests on those suffering from chest pains on a hot day. The numbers will start to add up in favor of people like Todd.
(I be remiss if I didn't conclude by noting that Todd was a Navy veteran. At first I was confused when I heard he didn't have insurance because I thought all veterans were covered by the Department of Veterans Affairs (VA). But it turns out that there are very strict guidelines on emergency care that veterans can receive at non-VA hospitals. I think this makes the case against repealing Obamacare even stronger, but I suppose you could consider it a completely separate policy matter.)