"ER as health insurance?"

The man from the free-market think tank sought to explain why the issue of uninsured Americans is overstated.

In the process, he inadvertently explained why one cannot overstate the problem.

He’s John Goodman. He’s with the National Center for Policy Analysis. He’s also a health-care policy adviser for John McCain. But we trust that on the campaign trail McCain isn’t going to frame the problem in Goodman’s terms.

Responding to a report that Texas again leads the nation in the number of people without health insurance — one in four uninsured — Goodman told the Dallas Morning News that the numbers are misleading.

He said anyone with access to an emergency room effectively has insurance, although the government will be the payer of last resort.

Well, if that’s his definition of health insurance, it’s not the kind Americans want or need.

That’s the kind that crowds emergency rooms, results in stratospheric costs for non-emergency care and drives up everyone’s medical bills.

That’s the kind that does not allow for preventive care and the checkups that avert catastrophic illnesses and the costs associated.

Yes, people who are ill are going to get treatment in the ER. And thank goodness for that. The problem is when hospitals or taxpayers have to foot the bill.

It is estimated Hillcrest Baptist Medical Center and Providence Health Network devote up to 8 percent of their budgets to cover expenses for patients who can’t pay.

The Texas Hospital Association estimates that annual health premiums for an average Texas family are $1,551 higher due to the added costs of covering the uninsured.

Texas hospitals spent $10 billion in 2005 on uncompensated care.

The irony is that the poorest Texans have health coverage through Medicaid. It is the working poor, and those whose employers don’t provide health benefits, who are without coverage.

Nationwide, these conditions drive up the cost of care while putting millions of people at risk for catastrophic illness because they don’t get regular checkups.

The McCain campaign, one particular adviser to the contrary, is treating the number of uninsured Americans as a problem. It proposes tax credits to allow individuals to buy health insurance.

The Obama campaign is proposing building on the success of the Children’s Health Insurance Program and Medicaid in filling in many of the nation’s gaps.

Cost? In either case, it will be significant. But finding a way to insure more Americans is a far better investment than courting disaster with lives that forgo preventive care, then paying the catastrophic costs that follow.