If a person without health insurance shows up at a hospital with a serious illness, should he get medical treatment he cannot pay for out of his own pocket?

This question was posed to Representative Ron Paul during the CNN/Tea Party debate on Monday. Representative Paul said the hospital and government should not pay for that person’s care, and when Wolf Blitzer asked if the person should be left to die,  the audience applauded and hooted their approval.

I’ve written about this issue and my mixed emotions when it comes to people who go without health insurance, get sick, and stick hospitals, and ultimately taxpayers, with their bills. (Arizona-ends-medical-expense-deduction-program)

What do you think?

The networking site, “Linked-In” has several groups for insurance agents, and there were recently some posts about the Obamacare mandate requiring everyone to buy health insurance starting in 2014.  I offered my thoughts on health insurance and the mandate as follows:

Until July of this year, Arizona Medicaid, known as AHCCCS (Arizona Health Care Cost Containment System)  and pronounced “access”, was very generous and would provide health insurance for people who ended up in the hospital without health insurance – even if they were not indigent. I have met accountants, property managers, and housewives who did not have insurance, got sick, and ended up in the hospital with huge bills. The hospital social worker signed them up for the for the AHCCCS Medical Expense Deduction  (MED) program and covered them for six months to more than a year.

Under the Medical Expense Deduction program, the state of Arizona provided people with health insurance and covered them 100% for their hospital bills and ongoing medical care.  As of July 1, 2011 the program was canceled, but those already in the system continue to get coverage.  I wrote about this program in a previous post: “Arizona Should Not Help People with Their Medical Bills”.

I am a generally a “bleeding heart liberal”, but I am glad to see the end of a program that rewarded people who went without health insurance and provided them with 100% coverage and no penalty for sticking the state and taxpayers with their bills.

I’m at the point where I think people who show up at the ER without health insurance should be turned away. How dare they think their state, or the hospital, and ultimately those of us with insurance, should pay their bills. So let ‘em croak on the hospital doorstep!

Is that a good idea? And what is the solution to the problem of 40+ million Americans without health insurance? I think it is the same idea Republicans proposed in the 1990′s and John McCain campaigned on in 2008: A mandate that everyone have health insurance (with tax breaks to help people of low and middle-income levels afford the coverage).

I guess I’m liberal on some things and conservative on others.  Or perhaps the idea that people should not get a free ride is neither conservative nor liberal. And perhaps the idea that everyone needs to take responsibility and get health insurance is just common sense.  So why do Republicans insist that “You can’t make me get health insurance!” – even though hospitals cannot turn people away from the emergency room? And I don’t understand why Republicans want to kill the bill that reforms the costly and crazy health insurance system we have now.

Where in the Constitution does it mention health care? This question has been asked by those who oppose the Affordable Care Act of 2010, which requires everyone to buy health insurance (with subsidies from the government) starting in 2014.  While the constitution might not specifically mention “the right to health insurance”, it appears that the Founding Fathers of our nation did believe in government-run, mandated health care coverage.

In 1798, Congress passed “An Act for the Relief of Sick and Disabled Seaman,” which was signed by President John Adams. The law authorized the creation of a government operated system of marine hospitals and mandated a 1% tax on the pay of merchant marine sailors to support it.

I found out about this law in a column by Rick Ungar, who writes for Forbes.com. Here is some of what he wrote:

During the early years of our union, the nation’s leaders realized that foreign trade would be essential to the young country’s ability to create a viable economy. To make it work, they relied on the nation’s private merchant ships – and the sailors that made them go – to be the instruments of this trade.

The problem was that a merchant mariner’s job was a difficult and dangerous undertaking in those days. Sailors were constantly hurting themselves, picking up weird tropical diseases, etc.

Adam Rothman, an associate professor of history at Georgetown University, commented on the 1798 law for an article in the Washington Post.

“[The 1798 law] is a good example that the post-revolutionary generation clearly thought that the national government had a role in subsidizing health care,” Rothman said.

“You could argue that it’s precedent for government run health care,” Rothman continues. “This defies a lot of stereotypes about limited government in the early republic.”

Rick Ungar at Forbes.com wrote:

Keep in mind that the 5th Congress did not really need to struggle over the intentions of the drafters of the Constitutions in creating this Act as many of its members were the drafters of the Constitution.

And when the Bill came to the desk of President John Adams for signature, I think it’s safe to assume that the man in that chair had a pretty good grasp on what the framers had in mind.

If you are interested in American history, you might want to read here about the importance of Sailors’ Health and National Wealth to the economic growth of the United States. The writer, Gautham Rao,  was a post-doctoral fellow in the Program for Early American Economy and Society at the Library Company of Philadelphia when he wrote the piece in 2008.