# John McCain’s Health Care Architect says “There are no uninsured Americans.”

John Goodman is the supposed “Health Care Architect” for John McCain’s campaign and he recently gave an interview to the Dallas News in which he claimed, with a straight face, that with ER rooms unable to lawfully turn away people in immediate need there are no uninsured Americans:

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.”

Mr. Goodman seems to be blissfully unaware that having the government pick up the tab for emergencies is not the same thing as having health insurance or that resorting to such means is way more expensive for everyone involved than true health insurance would be. That’s the sort of advisors a John McCain presidency will include.

The folks at Think Progress sum up the flaws with this argument:

Not only is ER care the most expensive way to get health care, but it also does not provide dental care, eye exams, therapy, and routine check-ups. Moreover, the availability of good emergency room care is in decline. In 2006, 119 million visits were made to ERs, up from 90 million in 1996. At the same time, the number of hospital ERs dropped to fewer than 4,600, from nearly 4,900, causing wait times to also increase.

They also point out that President Bush pretty much made the same argument in 2007 saying: “I mean, people have access to health care in America. After all, you just go to an emergency room.” Thus showing that a McCain administration will be no different than a Bush administration.

## 28 thoughts on “John McCain’s Health Care Architect says “There are no uninsured Americans.””

1. That’s scary. Can you get a hip replacement or cancer therapy in ER’s nowadays?

2. Yep. The expense is a big problem in So. Cal. because all the illegal aliens have to use the ER. Maybe that’s why so many government policy makers are infatuated with the illegals – it brings more money through their hands to process same. Follow the buck.

3. We got a problem here with people that just don’t understand and/or care what it’s like to not have Health Insurance. I don’t understand how people don’t look at our society and say pathetic.

4. Leguru: interesting.

I occasionally hear conservatives complaining about the medical costs of illegal immigrants, yet even when they are in power, they do nothing to solve the problem.  I wonder how much the bill comes to?  Here in California I would think it could be up to a billion or so a year…I don’t know the details of the state system, but in my area I believe that the county picks up a lot of the slack before the state gets involved…seems to me like a good way to hide and spread one of the biggest costs of having an immigrant workforce!  Counties and the state, all strapped for money, get to share the financial burden that business owners, through official state channels, should already be paying.  Nice.
I’m torn on the immigration issue.  Philosophically, I really don’t care.  The world is a small place after all, and we’re going to have to learn to share.  I would rather learn spanish than support most conservative policies right now.
The economics are the other side of this coin.
I am a poorly paid clerk.  Every illegal in this state is helping to lower my already low wages.  Upping my rent.  Benefiting from my taxes.  Making health care even more expensive.  By using a large immigrant workforce, legal or otherwise, we are corrupting the market in favor of owners while screwing laborers.
What are the solutions offered by politicians?  Dems don’t care, because they might offend their immigrant voters, and the repuglicans want to build some stupid, shitty fence and hire a few thousand more cops who won’t even make a dent in the problem!  How about employing a few poorly paid clerks to go around and check records, and then deporting illegals and fining their employers?  It’s already the law, and even with today’s gas prices not too expensive…yet somehow even conservative anti-immigration hawks refuse to fund it sufficiently.  I wonder why.

5. It’s already the law, and even with today’s gas prices not too expensive…yet somehow even conservative anti-immigration hawks refuse to fund it sufficiently.  I wonder why.

Because actually deporting large numbers of illegal aliens will create a personal and media backlash even Republicans fear – and will hurt a lot of businesses, at least in th short term.

The solution in my opinion lies less (or at least not only) in enforcing immigration controls but rather in making sure that people can’t be employed at seriously below-average wages.

6. I don’t get it.  How can anyone, outside of the too-rich-to-care-about-the-world, possibly think that McCain represents them?

7. How can anyone, outside of the too-rich-to-care-about-the-world, possibly think that McCain represents them?

I don’t get that either, but I think it has a lot to do with being unable to admit that your political choice (or whatever you were brought up in), have been wrong.

I have a good American friend who voted for Bush. Twice. He was religious, yet at the same time, willing to discuss religion openly and without preaching with an atheist like me. Yet he was not open enough with his own convictions to see that he and his country were being screwed over. He’d rather continue to repeat or invent new reasons why the Democrats would be worse.

8. Oh! I am so relieved to hear this! I’m a diabetic and require a steady, regular supply of medication along with regular doctor visits and blood work, among other things.  I am so overjoyed to know that I no longer have to consider the health care options when looking for a job! Why, I can just go to the emergency room the next time I go into a coma due to low blood sugar, or when I inevitably lose my eyesight, kidneys or feet due to unregulated blood sugar!  Sweet! The fact that my pancreas doesn’t work right should have no bearing on my state of health so long as I don’t mind constant headaches, thirst, excessive urination, blurred vision, nausea, dizziness, neuropathy, chronic fatigue, loss of appetite, possible amputation, kidney failure and of course the ever popular death!  Screw health insurance! I can just go to the emergency room and let the government pay for it! America Fuck Yeah! I love this country!

9. You are sick! No, really, you are sick. Sick of the BS we are being fed.

Oh noes! What are the symptoms!?! Can I get it treated at the emergency room too!?

10. The state of health care in the US is declining from what I’ve been reading – and seeing.  And some of us – myself included are among the underinsured – it’s better than no insurance, but still, when you get hit with a car accident or something, it’s hard with high deductibles.

It’s amazing how most other ‘advanced’ countries have some form of universal health care provision.  This also gives companies in these countries an advantage in that their employees are covered without their need to pay large amounts into health benefits.  And there are a lot of people in the US who get locked into their jobs for benefits when they would rather go elsewhere.

There is much more to be said on this – but from the rising costs of healthcare, the increase in those uninsured, and the increased use of the ED as a primary care physician, things are not going to get better soon.

The other side of this that I have seen (I volunteer as an EMT) is that people will sometimes refuse a trip to the hospital in the ambulance due to their lack of insurance even when the should go.  That is sad.

And the idea of reclassifying people as to their likely source of payment for healthcare sounds like an idea from Dilbert’s pointy-haired boss.  What they’ll find, \begin_sarcasm to their infinite delight \end_sarcasm, is that many people will have the payment source of ‘no one’ (implies the non-profit hospitals should absorb this – that’s another issue) or ‘the state’ – that’s where it ends up if people can’t pay.  It’s all going to fall back on those who are paying and on the public taxes – only in a more expensive way than getting some decent insurance going for everyone.

11. BB- one contributor to this board has asked why should an elderly couple in Dakota have to pay for your health care? I wonder if you make the same response as me.

If I was Hillary I’d be deeply insulted by her supporters who are now supporting McCain.  “So you see me more like someone who is committed to Bush’s policies than a reformer?”

12. Well in reality, I have a nice, full coverage medical plan paid by my employer, but my response to the question would be as follows (I guess):

Health care should be one of the basic rights that is guaranteed to all people.  Now before anyone jumps on me about paying your fair share and any other libertarian ideals, let me elaborate.

(I believe that) basic health care, along with food, water, shelter and primary education are some of the things that as a working society we should be providing for all in order to give everyone a chance to better themselves, and by extension further bolster society.  Much like the taxes we pay go to pay for roads, fire and police services, national defense, etc.  Libertarians that I have spoken to often say that they would be willing to pay for these things on their own, and do not appreciate the fact that the government has to be involved.

Frankly, I think they are a tad delusional.  Reality paints a different picture on most of them, and their ideas in many ways are either completely unrealistic, or would require such an overhaul of the current system as to make it completely unfeasible. Pay for the roads? What, the road in front of your house? What kind of job do YOU have? Road ain’t cheap.  Privatized police? Take a look at what is going on in Iraq with firms like Blackwater. What exactly is going to prevent private companies from hiring unqualified, or worse, criminal contractors to police your streets? Government regulations? The kindness of their corporate hearts?

The basics I mention are hardly unrealistic though.  Many nations already have a working and reliable system in place.  Our current system is broken in many different ways (not just the way that this post points out), but I don’t believe that they cannot be fixed.

As to the “Why should an elderly couple in Dakota have to pay for your health care”? Well, surely they collect Social Security? Medicare? Use the roads and bridges and municipal services that would not be in place or working if not for the collective tax dollars and federal, state and local governments implementing them, don’t they? None of these programs are pay as you go.  Social Security relies on the workers of today to pay in so that dear old Tom and Martha in North Dakota can collect their monthly stipend. That’s the way it was designed and that’s the way it works. It’s not a savings or investment account, it’s a communal fund. The problems we are seeing in such programs are due to mismanagement, not poor design. When they are properly administered, they do work as planned. Scrapping the system because the morons running it are futzing it up is not a logical means of solving the problems their futzing caused.

I am not ashamed to say that I hold some socialist ideas, and I think that correctly administered social programs can and do work.  As a society and a species, we will move into the future working together, not as separate individuals who only look out for themselves.

That said, there is something to be also said about being independent and self sufficient.  I look at that in this way.  If you are able to be self sufficient, then great, good for you.  You should realize that you did not get there in a vacuum though.  People helped you get to where you are, no matter how much you want to think you are a self-made person.  Nobody is a self-made person.  Everyone has had some help in getting successful; maybe you just need to be honest with yourself on that. You also need to realize that not everyone “gets it” or is as lucky as you.

Society, when it works (and it only works if people that care actually work to make it work) is about sharing the burden when you get right down to it. It’s about helping out your fellow man so that the group can succeed. We are social creatures, and social creatures work together for the betterment of the group, and as a result, the individual benefits when the group benefits. Hardcore libertarianism has always struck me as a bit contrary to human nature in that the myth of the “rugged individualist” doesn’t seem so much a shining example of what everyone should strive to be as it is an elitist pinnacle that nobody really can achieve, but many claim to hold. Those who could live separate from the rest of the world hardly got there on their own.

I’m not advocating free luxury items and limitless, unwarranted welfare though. People should be accountable, and take responsibility.  I don’t see how allowing them to fall through the cracks actually encourages people to do that though. Education is a great place to start, but the current education system we have in the US (and probably in other countries) seems to be solely geared toward stamping children into good little workers, not really teaching them important things like critical thinking, or how to do things like handle your money or any number of things that most of us had to learn through trial and error once we got thrown out into the “real world”.

OK, wow, I hope that didn’t sound so rambling and crazy as it looks on the screen.  Somebody go and fine tooth comb it! Yes I am aware that many of my views are not fully aligned with each other, that’s partly why I do not claim to “be” anything (liberal/libertarian, democrat/republican, socialist/fascist, etc.), except an atheist.  I’ll stick to my guns on that one. (/Rant) Hope that helps.

As for Hillary, I think she said it best when she endorsed Obama at the convention, asking her supporters, “Were you in this campaign just for me?” Obviously, given the tone of the question and context of the speech, she was not looking for a “yes”. Her supporters need to realize that getting McCain elected will be like shooting your brother in the head after he eats all of your Oreos.  Its not just an overreaction, its an incredibly damaging and irreversible overreaction.

13. The premium for a private health care plan for a husband, aged 59 and wife age 61 in our area is $2,464.00 per month and does not include eyeglasses or dental care. If it was a$5,000 annual deductible for both husband and wife it would reduce the premium to $1600.00 per month. Since the average gross family income in my town is$48,000 BEFORE taxes, it doesn’t take too much figuring to see that nearly your entire income would be eaten up with private health insurance.  In addition, this is for a near-elderly couple with NO pre-existing conditions.  Can any of you name a couple of your aquaintance that has NO pre-existing conditions at the above age?  Remember, asthma, osteoporosis, coronary artery disease are afflictions for lots of young and old.

14. BB- You’re not me by any chance?

I would add that some so-called ‘libertarians’ (I can’t tell them apart from neo-cons) basically assume that if you can’t afford the essentials, then it is your fault.  Well they did give us the man (Quayle) who wanted everybody to be ‘above average’. And that is the weakness of the ‘libertarian’ system- if the poor were all to raise themselves above average, the result would be a new average, and inflation. Not only would the inflation lead to wage demands, Doctors would be saying “Hey, I earn the same as a street sweeper- give me a pay rise”, this pushing up the cost of healthcare.

In addition there are only so many top ‘slots’ available- somebody actually has to do the work.

15. Hussar, I’ve always suspected I wasn’t actually who everyone told me I was, but I’m fairly certain I’ve never been to Jolly old England, and I hope I would know if I was carrying on a conversation with either a voice in my head or an alternate personality, but I did stop taking those meds the doctor told me to never stop taking…

Anyway, as for your additional comments about the libertarian ideals, I have to say that there is an answer to the all problems of the all too real stratification that inevitably occurs due to all people not being of the same level of intelligence, skill, competency, etc. The answer of course is Objectivism, which I see as Libertarianism taken to it’s ultimate conclusion.

I admit my knowledge of that philosophy is second hand (never read Atlas Shrugged, and frankly don’t have any desire to), but I think the gist of it is that there are different levels of competency in the world, those who succeed do so because they believe the correct things and as a result take the correct actions (so far sorta good), and those who fail have nobody to blame but themselves (veering off the road a little bit now).  I’ve heard that Rand further determined that there are three classes of people, the “ruling class” who are of course the disciples of Objectivism (shit, where’d the road go!?!), the “hangers on” or “working class” who follow the “geniuses” of the “ruling class” (Oh, there it is, no wait, this is a railroad track), but are not capable enough to reach that level themselves (is that a light up ahead?), and the “leeches” who I guess are all the rest of us that actually believe that working together as a society is a good thing (Shit! the tires are locked onto the rails and I can’t stop the car! AND I think that’s a train coming at us…), but apparently our true motives are to just leech off the geniuses that follow objectivism (Fuck! That is a trai…). I’m not going to directly mention that other infamous group of people who felt specially entitled for completely unfounded reasons (you know, the one’s whose name sounded like “Nazis”?), but this objectivism stuff sounds a bit familiar.

Wow, that must be a new record or something, I invoked Godwin, probably isolated both Libertarians AND Objectvists (or at least pissed them off) AND maybe if I’m lucky got more attention for this thread! I am a credit to this community! And now I’m not sure who the f**k I am…

16. Do you want to be Last Brother or Bog Hussar?

The problem is that the Geniuses (Genuii?) believe that all are leeches.  This point of view is not helped by those on the Left who do not re-inforce “from each according to his ability”.  Do you remember how computers meant that we would all be doing less work- Instead the Genius class have just made the workers do more, automating every one else into the leech class.

I still can’t work out why some of these are voting GOP. The fundie I can see, but the former democrat “Obama has no experience”? I see, because McNugget doesn’t need experience- he’s got the Shrub’s policies/advisors.

17. I wish to apologise. The McNugget thing was wrong- connecting him to poor quality fast food.

I should have gone with McCains oven chips (fries to you)- A pale, tasteless substitute, that leaves you disappointed.

18. BB- Exactly.  I read Atlas Shrugged when I was about eighteen, and it was pretty exciting, what with all the superlatives that were thrown around.  I re-read it when I was in my twenties, and I could see how dangerous it was: just another kind of fascism- superficially attractive, but it doesn’t work.  Imho, the main problem with Rand’s objectivism is the same as with many other “ism’s”: the taken-for-granted and unexamined notion that there exists some objectively perfect system by which we should live. This applies to religion, and many other philosophies, as well.

A good (not the only) antidote for this the study of evolution and evolutionary psychology:  the historical and biological perspective shows that we are groping in the dark when we try to design societies: nothing like this has happened before (on Earth, at least), and there’s no reason to think there are any pat answers.  A system of democracy with checks and balances, and a well-educated electorate, is my candidate for what we should strive for, even though it has lots of warts: as Churchill (no dummy) said,  “Democracy is the worst form of government, except for all those other forms that have been tried from time to time.”

LH- alas, real fish and chips is not available in Vienna.  Another strike against it.  With any luck, though, I’ll be in Merrie Old England again next year, and be able to eat my fill of the real thing.  I am addicted, but luckily, I only need a fix every couple of years.

19. Hussar – I guess I’ll have to take “Bog Hussar”, “Last Brother” reminds me of a ‘70s Blaxploitation flick title for some reason. I’d never made the connection between those fries and old Johnny boy, but its a good fit.

Zilch – I agree with you and Churchill on the democracy, and it reminds me of another similar quote attributed to Churchill (paraphrased) “You can always rely on Americans to do the right thing, after they have tried everything else.” I just hope McCain isn’t going to be part of “everything else”.

20. Vimes had once discussed the Ephebian idea of democracy with Carrot and had been rather interested in the idea every one had a vote, until he found out that while he, Vimes, would have a vote, there was no way in the rules that anyone could prevent Nobby Nobbs from having one as well. Vimes could see the flaw there straight away.

A democracy is where people who don’t understand the problem choose someone with no training to do a job that experts disagree on.

Classic example- those who were going to vote Clinton, so will now vote McCain.  On the BBC website some left a comment, he was going to vote Obama, but now because of Palin, will vote Republican. Sorry, is a liberal easily confused with a woman who wants to have Creationism equally billed in school.

Non-Seperation is only an amendment away.

21. Zilch- where will you be?

22. LH- I’ll be in Leeds, performing at the Medieval Congress there.  It’s not yet certain that we will get the gig, but I’ll let you know if we do.  If so, I’d like to go via London, so I can spend some quality time in the British Museum.

Where are you?  You’ve told me before, but I’ve forgotten.  It would be great to chat over beer and chips.

23. Aylesbury, Buckinghamshire- about 30 miles North-west. Made the county town in 1529, by Henry VIII, co-incidentally at the time Aylesbury Manor was owned by one Thomas Boleyn.  Hell of a Engagement Ring.

I once got a behind the scenes at the BM. It’s not what you know…

24. And Zilch- remember this link?

25. Re-opening this thread just to annoy the Yanks

Following this.  How much would a US citizen be trying to find in his bank account, because it cost me nothing (well, my taxes)?