Tea Party Debate Audience Cheered Idea of Letting Uninsured Patients Die

If it was up to Ron Paul, or many of the Tea Party audience members at  Monday night’s GOP presidential debate, churches, not the federal government, would help foot the bill for the medical costs of America’s 50 million residents living without health insurance.

CNN moderator Wolf Blitzer’s hypothetical question about whether an uninsured 30-year-old working man in coma should be treated prompted one of the most boisterous moments of audience participation in the CNN/Tea Party Express.

“What he should do is whatever he wants to do and assume responsibility for himself,” Paul responded, adding, “That’s what freedom is all about, taking your own risk. This whole idea that you have to compare and take care of everybody…”

The audience erupted into cheers, cutting off the Congressman’s sentence.

After a pause, Blitzer followed up by asking “Congressman, are you saying that society should just let him die?” to which a small number of audience members shouted “Yeah!”

Paul, a doctor trained in obstetrics and gynecology, said when he got out of medical school in the 1960s “the churches took care of them.”

“We never turned anybody away from the hospital,” he said. “We’ve given up on this whole concept that we might take care of ourselves or assume responsibility for ourselves. Our neighbors, our friends, our churches would do it. That’s the reason the cost is so high.”

According to census data released Tuesday, the number of uninsured people rose by about 900,000 from 2009 to 2010, bringing the total number of people living in the United States without health coverage to 50.9 million, or 16.3 percent of the population.

Texas, where GOP candidate Rick Perry has served as governor for more than a decade and Paul has served as a U.S. Congressman for more than 20 years, has more uninsured people, as a percent of population, than any other state. In the Lone Star State 26 percent of the population does not have health insurance, according to census data compiled by the Kaiser Commission on Medicaid and the Uninsured.

In 2009, the most recent year for which data is available, more than 22 million emergency room visits nationwide- or over 17 percent– were by people who did not have insurance, according to the Agency for Healthcare Research and Quality, a division of the Health and Human Services Department.

While uninsured people by law have to be treated in emergency rooms, studies show that they receive poorer-quality care than people with insurance. In fact, a quality of care study conducted by HHS found that there is a greater disparity in care quality between uninsured patients and those with insurance than any other demographic indicator.

“Of the many disparities we track, insurance-related disparities are typically the largest — bigger than race, ethnicity, and income,” Ernest Moy, who oversees the agency’s National Healthcare Quality Report and National Healthcare Disparities Report, said in a statement.

At Florida Hospital based in Orlando, regional vice president Richard Morrison said uninsured patients are an “everyday occurrence.”  If a man in a coma came into a Florida Hospital emergency room, as in the hypothetical used in the GOP debate, Morrison said he would “absolutely not” be turned away and would be treated the same way an insured patient would be treated.

“The hospital will take care of the individual,” he said. “And we would continue to care for him until he was discharged.”

But without insurance, the bill for an extended hospital stay would be hundreds of thousands of dollars. Because the hospital cannot serve patients with a bill that is more than 25 percent of their income, “he probably will have his bill written off,” Morrison said.

“The church could step up and help pay this person’s expense,” he said.

But as for churches footing the bill for all uninsured hospital visits Morrison said it would be “a big bite.”

“That’s a lot of money every year,” he said. “The church does step up when you have tragic situations. But it’s only a source, it’s not the source.”

In Memphis, Tennessee, there is one church that has become the source for health care for working people who do not have health insurance. The Church Health Center has been providing free health care, from routine check-ups to major surgery, to low-wage workers for more than 20 years.

“The basic idea is you’re doing a job nobody else will do,” said the center’s executive director Scott Morris. “If you get sick we think you ought to go to the front of the line.”

But Morris said the Church Health Center’s strategy could not work at a national level, because it is a community-wide effort based on relationships and trust where doctors, nurses and surgeons donate their time.

“We are a total house of cards,” Morris said. “We are built on handshakes.”

The center has a budget of about $14 million per year that is collected from charitable donations, but the yearly value of what it does is about $100 million because of all the donated services.

“We make a pretty significant dent in addressing the issues of the uninsured in Memphis, Tennessee,” Morris said. “Do we fully solve the problems of the uninsured? No. The church and the faith community cannot solve this monumental problem we have.”