During his interview with 60 minutes last night, Mitt Romney implied that it's not the responsibility of government to insure the tens of millions of Americans who do not have health insurance because those people can just go to the ER.
ROMNEY: Well, we do provide care for people who don’t have insurance, people — we– if someone has a heart attack, they don’t sit in their apartment and die. We pick them up in an ambulance, and take them to the hospital, and give them care. And different states have different ways of providing for that care.
PELLEY: That’s the most expensive way to do it…In an emergency room.
ROMNEY: Different, again, different states have different ways of doing that. Some provide that care through clinics. Some provide the care through emergency rooms. In my state, we found a solution that worked for my state. But I wouldn’t take what we did in Massachusetts and say to Texas, “You’ve got to take the Massachusetts model.”
As Pelley pointed out, visits to the ER are the most expensive form of healthcare. Additionally, visits to the ER, particularly visits by the uninsured, are a major driver of healthcare costs. It's also one of the primary rationales for creating a mandate.
Mitt Romney acknowledged and made the case for this himself in 2007. At the 1:12 minute mark:
We say that citizens making three times federal poverty or more, that's $54,000 a year in our state for a family of four, you have to buy a policy that you can afford. And no more showing up at the hospital expecting someone else to pay your way.
For people earning less than three times federal poverty we the state will subsidize their purchase of a policy. They choose the policy they want. We subsidize its purchase. And that way we get everybody insured.
[Question] And that doesn't cost any additional dollars?
The answer is no because we've been spending in our state about $1.3 billion a year giving money to hospitals that give out free care. So we were spending about $1.3 billion. That money came from taxes, it came from assessments on hospitals and insurance companies, it came from the federal government, it came from all of the above. And we said, okay, look, instead of paying money to the hospitals to give out free care, why don't we subsidize the purchase of insurance?
And thus you have the definitive case for an individual mandate and Obamacare/Romneycare.
As always Mitt Romney will claim that what was right for Massachusetts isn't right for the nation, but I'm unconvinced that anyone buys that explanation.