This Ad Writes Itself

It got lost amid the convention and the VP picks, but a top advisor for John McCain calling the emergency room a form of insurance is a very memorable moment. It's also not at all new. I remember a Republican winger making this argument to me in 2003. They have such a disconnect with how those who struggle in the health care system that they actually believe destroying the nation's ERs makes sense on any fiscal or medical level.

But the numbers are misleading, said John Goodman, president of the National Center for Policy Analysis, a right-leaning Dallas-based think tank. Mr. Goodman, who helped craft Sen. John McCain’s health care policy, said anyone with access to an emergency room effectively has insurance, albeit the government acts as the payer of last resort. (Hospital emergency rooms by law cannot turn away a patient in need of immediate care.)

“So I have a solution. And it will cost not one thin dime,” Mr. Goodman said. “The next president of the United States should sign an executive order requiring the Census Bureau to cease and desist from describing any American – even illegal aliens – as uninsured. Instead, the bureau should categorize people according to the likely source of payment should they need care.

“So, there you have it. Voila! Problem solved.”

The reason we have skyrocketing health care costs is because we funnel tens of millions of people into expensive ER care, resulting in a "hidden tax" on everyone with insurance. Goodman wants to perpetuate that. And McCain's campaign wants to tax health insurance as income for those who get it from their employers.

This is how Republicans think. They consider poor people "lucky duckies" for getting to sit in an ER for two hours, dying on the floor while clogging the facility where real emergencies are supposed to be dealt with.