I've been hearing this "no one in America goes without health care because of the emergency room" line from Republicans since at least the 90s. At least Mitch McConnell accepts that this isn't, to use his word, "efficient", though of course he neglects to mention that 20,000 Americans die every year because of lack of coverage. The dramatic and childish imaginations of conservatives are such that they can't imagine health care the prevents death as being anything but something that involves being rushed to the hospital, as if people don't perish quietly from long term diseases.

But obviously, the biggest gap with reality that this talking point exposes is the Republican willingness to subject 1/5th of the country to a choice between bankruptcy or death/mutilation. That's why I find the emergency room talking point so baffling---surely, they have to know that most people, when they think of emergency rooms, think first of being billed (to pull from recent personal experience) $1,500 to have a small piece of glass removed from their foot. I'm sure that the retort would be that it wasn't an emergency and I should have been a savvy consumer who fished it out myself, but of course, that would have meant going after my foot with a melon baller, since we'd already extinguished all other options because I didn't really feel I could afford emergency room bills. In other words, for all the talk about the market and free choice, there is no such thing if you're facing a medical emergency. Non-emergency care needs do get put off and ignored, until they become emergency care needs and avoiding massive debt is impossible.

As a talking point with the intent to persuade, the "just go to the emergency room" one is stupid, so I'm forced instead to assume that Republicans actually think it's a great idea to create a huge class of people that are stuck in bankruptcy. We are talking the "hunger is a great motivator" mentality, so of course it's reasonable to think that washing the country in unnecessary debt is a great way to turn people into compliant, fearful workers. There's a lot of talk in the air about how having guaranteed health care gives people the freedom to change jobs (and therefore bargain with employers from a stronger position for better wages), and I'll add to it that being debt-free is also incredibly freeing for people, making them able to take risks and stand up for themselves in ways that people swimming in debt just can't do.

Honestly, I'm surprised there wasn't more of a move during the Bush years to recreate debtors prisons, to add extra "motivation" for people that got stuck in a health care crisis to live their lives as obedient wage slaves. Or, in some cases, as obedient because they have no other choice.

The other funny thing to me about the emergency room talking point is how it directly conflicts with Republican attempts to scare the public about lines and waiting for health care. Clearly, your average Republican politician or pundit has not been to an emergency room in recent memory, because the lack of health insurance obviously creates these horrific waits. As someone blessed with great health but not so great coordination, I've only been in E.R. in my adult life for accident-related purposes (and one prescription drug reaction), and barring the stroke of luck of being the only person at E.R. when I stepped on glass, the wait has dragged on forever. And it was easy enough to look around and see why---emergency rooms are packed with people who are just plain sick. One time after cutting my finger, I seemed to be the only person in the waiting room that was there for a reason other than pneumonia. If people were able to get health care when they first got sick, instead of living in denial and hoping it would go away, I wouldn't have had the time to finish so many thick novels while trying to distract myself from concerns like, "Will I need stitches?" Seriously, if waiting in line bothers you so much, you should be the first to support health care reform.