One reason I won’t vote for McCain

Is his healthcare advisor’s attitude toward’s Emergency Departments:

 In the Los Angeles Times‘s (8/28) Booster Shots Blog, Shari Roan wrote that this week, “John McCain campaign advisor” John Goodman “said, in effect, that as long as there are emergency [departments], no one in America is really uninsured.”


Op-ed columnist Paul Krugman writes in the New York Times (8/29, A21) that according to Goodman, in America, “there’s no such thing as being uninsured. After all, you can always get treatment at an emergency [department].” Furthermore, Goodman “the president of the National Center for Policy Analysis, an important conservative think tank…wants the next president to issue an executive order prohibiting the Census Bureau from classifying anyone as uninsured.”

Understand that there are a few issues here:

1)  An unfunded government mandate that requires that anyone presenting to an ER requesting medical evaluation, or someone requests a medical evaluation on their behalf, must receive screening for an emergency medical condition regardless of ability to pay.

I have no issues with screening people for medical problems…but the government provides no compensation or liability coverage for hospitals or physicians following this mandate.

Why should this concern you?  When the ER is full of uninsured people demanding an evaluation for their chronic pain or made up medical conditions, or just because they are bored and it’s your hospital’s turn for their daily/weekly/monthly ER visit (yes, it happens…over and over and over again)…YOU or your LOVED ones, who are responsible users of the system will be a) waiting for an ambulance to return to service after transporting the “sprained ankle” who didn’t have money to call a cab or b) waiting in the waiting room because all rooms are full…

Problem #2

Going to the ER to be screened for an emergency medical condition is no substitute for primary preventative care.  People come to the ER only AFTER they are ill, or well advanced into a serious medical condition for which the might have sought treatment had they had insurance.  In addition, the ER is only required to screen for an emergency medical condition and provide stabilizing treatment.  In other words, if the patient does have a medical condition, but it is not an emergency (long term treatment of hypertension, for example), the ER is a horribly inadequate place to be seen and evaluated.

A patient like that will fall through the cracks, not follow up, not be treated for his ongoing medical problem until he shows up in an ER years later (if he can get in) with a heart attack, stroke or flash pulmonary edema.

The stance of the McCain advisors is flat out abuse of the existing Emergency Medical System, which will ultimately hinder your ability to receive appropriate and timely emergency medical care when you or your family needs it most.

  4 comments for “One reason I won’t vote for McCain

  1. fryguy
    September 3, 2008 at 12:00 pm

    Doc – What percentage of cases do you see in the ER that are should not be ER cases?

    (As you referred to sprained ankle, and chronic problems, etc.)

    Do ER departments really make a critical injured patient wait for a sprained ankle patient to be treated?

    Thanks for a great blog!!

  2. Doc Shazam
    September 7, 2008 at 7:09 am

    No, we don’t make them wait, but if the ER is physically full then there is nowhere for a critical patient to go. Even if patients are moved to the hallways, the care of the critical patients suffers because the MDs & RNs have even MORE patients to care for. Even if 100% of our attention is focused on the critical patient, there are about a hundred eyes watching every move you make.

    In fact, one night, we spent about 2 hours delivering a critical premature baby in the ER (no L&D in our hospital), and asshats in the next room wanted to know why no one would get them a glass of water.

  3. April 30, 2010 at 3:51 pm

    John McCain is also a very good politician. he did not win because the people are not satisfied on the Republicans.:`,

Leave a Reply

Your email address will not be published. Required fields are marked *