In a recent interview on CNN, Rep. Mark Meadows (R-NC), told Alisyn Camerota, “There’s a federal law right now that if you show up at [the emergency room], you get coverage, Alisyn. And so, it’s a false narrative to suggest we have people who can’t go in and get coverage. It’s a federal law.”
Yes, it’s true that if you’re in a car accident or fall off a ladder, you can go to the Emergency Room and get treatment, whether or not you have the ability to pay. It’s also true that, if you don’t eventually pay the bill, the hospital can sue you. And if they never do collect the money that’s owed to them, they pass on that cost in the form of higher prices for everyone.
In addition, the Emergency Room is the most expensive way to deliver healthcare. At a time when we should be seeking to drive down the cost of healthcare, Rep. Meadows is advocating that people who need coverage should just show up at the Emergency Room instead of having preventive care and far lower-cost office visits with a physician.
But I promised this argument would not focus solely on the fact that treatment in an E.R. costs, on average, $1,200 per visit. Let me tell you the real reason that relying on the Emergency Room for healthcare won’t work.
I have a very close relationship with a young man who, at the age of 19, was diagnosed with testicular cancer. Here’s how he came to receive the diagnosis and subsequent treatment.
The young man had noticed a lump. So, he decided to visit his primary care physician, who then ordered an MRI. He was then referred to a urologist, and he eventually underwent surgery. This progression of events was made possible because the young man had a job that provided him with insurance.
How would that scenario have turned out differently if he did not have insurance? He would have still noticed the lump. But with no insurance, he likely would have had no relationship with a primary care physician, and even if he did, at age 19, living paycheck to paycheck, it’s unlikely he would have the money for an office visit, let alone an MRI. So, there’s a good chance he would try to ignore the lump. With testicular cancer, that can be like signing your own death warrant. Some types of this cancer can grow and spread very fast, going from highly treatable to terminal in a matter of months.
Perhaps our young man would finally go to the Emergency Room.
It is absolutely true that, when presenting at the E.R., he would receive treatment. Maybe they would even do the MRI for him. At this point, he would have racked up a bill of nearly $5,000. How is he going to pay that?
But here’s what’s really important about this scenario. The next step in the process is the referral to a urologist. Now, it may be true that the E.R. is required by Federal law to treat this young man. But the urologist is not. And will not. No insurance, no treatment. Sorry, medical care is a business.
So, it’s likely that this is where the process for this young man would have ended. He knows he’s sick. In fact, he knows he has a deadly disease, one that can progress rapidly. But he has no access to treatment for it. He’s already got a bill for $5,000 from the E.R. The cost of one office visit with a urologist can be upwards of $800. And even if he can find a hospital where he can get the surgery he needs without insurance, it’s likely he will rack up another $10,000.
So, to fight his disease, he’s looking at somehow raising $16,000. (Although, if he followed the advice of Rep. Jason Chaffetz and passed on purchasing a new iPhone 7, he could probably scrape up 3% to 5% of what he needs.) That’s just for diagnosis and surgery. I wonder if Rep. Meadows knows of an E.R. where one can get chemotherapy and other cancer treatments on demand?
That’s hardly what any sane person would call “coverage,” and I promise you, this is not the type of “coverage” that Rep. Meadows would choose for himself or his family.
No, let’s call this what it is: a death sentence.
By the way, this young man? He’s my son. And this really happened. I’m happy to report that he is alive and well and will turn 29 later this year. But it’s only because he had insurance.