Poverty Misconception #10 - "Let Them Use The Emergency Room"

(This is the first in a series on "The Top 10 Misconceptions About Poverty," based on Marie Antoinnette's alleged statement, "Let them eat cake.")

The conversation usually goes something like this:

"Did you know that there are nearly 50 million Americans who don't have health insurance?"

"Yes, I did. But those numbers are inflated. The actual amount is more like 16 million."

"Well, either way, it's too many. Whether it's 5% or 15% of the population, isn't it shameful that so many people in a society as wealthy as ours don't have basic access to health care?"

"What do you mean 'don't have basic access'? Even a homeless person can get health care when they really need it. Emergency rooms are required by law to treat anyone who comes through their doors. It's not like people are dying in the street."

At this point, the conversation invariably devolves into an argument about emergency room statistics, the benefits and savings that come with good primary care, and how much the current system increases everyone else's costs. And anyone who takes a serious look at the situation will know that emergency rooms are not the solution to our health care woes. At best, they're an expensive band-aid - but I won't bore you with the statistical argument here. That's been well-documented in other places.

Instead, I would like to point out the fallacy that is inherent in even attempting to make the emergency room argument. Even if it were a viable solution to the problem of the uninsured, why would someone on the right even suggest it? It goes against the entire conservative philosophy.

The one consistent belief that I have heard expressed by conservatives is "the power of the individual" - the notion that first and foreost, people are responsible for themselves. Self-interest, both at a personal and a corporate level, is the fuel for our economy. They object to a national health care system, and to anything that resembles socialism, because they believe at a fundamental level that it is not the government's role to ensure the people's welfare. The free market, powered by self-interest, is the way to achieve the greatest good for the greatest number of people.

So isn't the argument that the uninsured can use the emergency room for health care antithetical to this conservative philosophy? Because the insured patients that go to a hospital pick up the tab for the uninsured. What could be more socialistic than that? The "haves" are carrying the load for the "have nots."

Wouldn't a more consistent argument from the conservative side be to just tell the uninsured, "Tough. That's what you get for being lazy?" I've heard a few jerks say that, but most conservatives I know are compassionate people and want to do something to help those without access to health care. And most understand how complicated the actual solutions are going to be.

The real problem, then, with saying "let them go to the emergency room" is that it's a lazy answer. It's a way for a conservative to shut down a conversation, instead of digging into the more nuanced layers and issues which might expose some contradiction in their conservative beliefs.

So instead of launchging into a barrage of facts of figures on the impracticality of the ER solution, which will only lead to defensiveness, perhaps the best response is to agree and then take the discussion deeper - to say something like this: "Yes, letting them go to the ER might be something we can do for now. But why don't we talk about some solutions that are feasible for the long term, that don't involve just letting the insured patients pay for the uninsured."

You're not likely to get a ringing endorsement for a national health system out of such a conversation, but you might get past that reflexive and and completely impractical suggestion that the emergency is the solution to our problems.

Left vs. Right Does Not Define Us

Back in June, I went to the graduation ceremony at the local public elementary school. One of the teachers, who happens to be a member of my church and a card-carrying Republican, spoke briefly of a new after-school program that she has helped initiate. It is designed for children who are in danger of not having the basic skills necessary to begin first grade - a type of program that is quite common around the nation, but that had been sorely lacking in this rural Virginia county.
I was choking back tears as this teacher called about two dozen children to the stage – most of them from desperately poor African American families – and presented them with hugs and certificates. Knowing that she also invests a considerable amount of her personal time making home visits and tutoring these students, it dawned on me what a significant difference she makes in the lives of young children who have an incredible number of obstacles thrown between themselves and academic success.

This remarkably dedicated kindergarten teacher reminds us of how incomplete and misleading the typical left vs. right dichotomy can be. It would be easy to consider her Republican voting record and her conservative views on issues such as abortion, gay rights, and gun control, and to conclude she has little in common with folks on the left. From this, it would be easy to assume that, like some Republicans, she takes a “blame the poor” attitude toward poverty issues and has little compassion for those who are suffering in this economic crisis. Because of such stereotyping, it would be easy to ignore the fact that she is dedicating her life to helping poor children in a woefully underfunded public school system.

Those of us who get pigeonholed into easy categories of left/right and Democrat/Republican often fail to see the common bonds we share with our so-called political enemies. We cannot allow differences on a handful of “hot-button” issues to be exploited by those with political agendas and ambitions. If people of good will and legitimate concern for the common welfare continue to beat up one another based on these outdated categories, more sinister forces that have no concern for the people or no particular stake in partisan politics will further consolidate their power.

A prime example of this sinister tactic is the recent attack on teachers’ unions in many states. In this budget crisis, in what should be a time for the people to rally around its education system and proclaim that it is always a top priority, we have allowed partisan politicians trying to increase their own power to bitterly divide us. People who care deeply about the same thing have been duped into throwing stones at one another, to the great detriment of our nation’s children. Shame on them, and shame on us for taking the bait.

So before you place yourself in staunch opposition to someone because of who they voted for or how they feel about one of those wedge issues, please consider the deeper, non-partisan values that might be shared. Both sides might be surprised if we can steer the conversation away from the oppositionalism that is consistently fed to us. “Seek common ground” is not a naïve, pie-in-the sky slogan. It might be our only hope.