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http://www.nytimes.com/2012/10/15/opinion/krugman-death-by-ideology.html?ref=paulkrugman
Mitt Romney doesn’t see dead people. But that’s only because he doesn’t want to see them; if he did, he’d have to acknowledge the ugly reality of what will happen if he and Paul Ryan get their way on health care.
Last week, speaking to The Columbus Dispatch,
Mr. Romney declared that nobody in America dies because he or she is
uninsured: “We don’t have people that become ill, who die in their
apartment because they don’t have insurance.” This followed on an earlier remark by Mr. Romney
— echoing an infamous statement by none other than George W. Bush — in
which he insisted that emergency rooms provide essential health care to
the uninsured.
These are remarkable statements. They clearly demonstrate that Mr.
Romney has no idea what life (and death) are like for those less
fortunate than himself.
Even the idea that everyone gets urgent care when needed from emergency
rooms is false. Yes, hospitals are required by law to treat people in
dire need, whether or not they can pay. But that care isn’t free — on
the contrary, if you go to an emergency room you will be billed, and the
size of that bill can be shockingly high. Some people can’t or won’t
pay, but fear of huge bills can deter the uninsured from visiting the
emergency room even when they should. And sometimes they die as a
result.
More important, going to the emergency room when you’re very sick is no
substitute for regular care, especially if you have chronic health
problems. When such problems are left untreated — as they often are
among uninsured Americans — a trip to the emergency room can all too
easily come too late to save a life.
So the reality, to which Mr. Romney is somehow blind, is that many
people in America really do die every year because they don’t have
health insurance.
How many deaths are we talking about? That’s not an easy question to
answer, and conservatives love to cite the handful of studies that fail
to find clear evidence that insurance saves lives. The overwhelming
evidence, however, is that insurance is indeed a lifesaver, and lack of
insurance a killer. For example, states that expand their Medicaid coverage,
and hence provide health insurance to more people, consistently show a
significant drop in mortality compared with neighboring states that
don’t expand coverage.
And surely the fact that the United States is the only major advanced
nation without some form of universal health care is at least part of
the reason life expectancy is much lower in America than in Canada or
Western Europe.
So there’s no real question that lack of insurance is responsible for
thousands, and probably tens of thousands, of excess deaths of Americans
each year. But that’s not a fact Mr. Romney wants to admit, because he
and his running mate want to repeal Obamacare and slash funding for
Medicaid — actions that would take insurance away from some 45 million
nonelderly Americans, causing thousands of people to suffer premature
death. And their longer-term plans to convert Medicare into Vouchercare
would deprive many seniors of adequate coverage, too, leading to still
more unnecessary mortality.
Oh, about the voucher thing: In his debate with Vice President Biden,
Mr. Ryan was actually the first one to mention vouchers, attempting to
rule the term out of bounds. Indeed, it’s apparently the party line on
the right that anyone using the word “voucher” to describe a health
policy in which you’re given a fixed sum to apply to health insurance is
a liar, not to mention a big meanie.
Among the lying liars, then, is the guy who, in 2009, described the Ryan
plan as a matter of “converting Medicare into a defined contribution
sort of voucher system.” Oh, wait — that was Paul Ryan himself.
And what if the vouchers — for that’s what they are — turned out not to
be large enough to pay for adequate insurance? Then those who couldn’t
afford to top up the vouchers sufficiently — a group that would include
many, and probably most, older Americans — would be left with inadequate
insurance, insurance that exposed them to severe financial hardship if
they got sick, sometimes left them unable to afford crucial care, and
yes, sometimes led to their early death.
So let’s be brutally honest here. The Romney-Ryan position on health
care is that many millions of Americans must be denied health insurance,
and millions more deprived of the security Medicare now provides, in
order to save money. At the same time, of course, Mr. Romney and Mr.
Ryan are proposing trillions of dollars in tax cuts for the wealthy. So a
literal description of their plan is that they want to expose many
Americans to financial insecurity, and let some of them die, so that a
handful of already wealthy people can have a higher after-tax income.
It’s not a pretty picture — and you can see why Mr. Romney chooses not to see it.
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