October 3, 2013



Here is the essence of opposition to the Affordable Care Act, health reform widely known as Obamacare: It's an Orwellian overreach by the federal government to make purchase of a product, health insurance, compulsory.

U.S. Rep. Steve King goes so far as to refer to federal health reform as the "nationalization of our body and everything inside of it."

Agree or not, that's a straightforward ideology. No wiggling. No dodging.

But there is another side of the coin.

If, as the Tea Party suggests, it is downright Soviet - or even a "felony" "criminal act," according to Texas Gov. Rick Perry - to mandate that adult Americans purchase health-insurance plans, then why is it OK that existing law forces hospitals to provide emergency-room care for people who don't have insurance or the money to pay for services rendered?

It's wrong for government to make you buy something but fine for Washington to mandate a professional to serve you, and prescribe fines and allow for civil actions if he or she doesn't?

The latter is exactly what the Emergency Medical Treatment and Labor Act does.

What's the difference, on principle, between that 1986 law and Obamacare from the conservative perspective?

The Emergency Medical Treatment and Labor Act, according to the Centers for Medicare and Medicaid Service, requires critical access and Medicare-participating hospitals to screen and stabilize people regardless of whether or not they are beneficiaries of any program under the act - or in spite of a lack of insurance.

To be consistent shouldn't King be equally as upset about the emergency-treatment mandate - also known as the anti-patient-dumping statute?

Most reasonable members of Congress agree that the United States should be compassionate at the emergency-room door, that nurses should look to stop bleeding, that doctors should quickly examine patients with trauma, before some hospital clerk goes shuffling through a wallet or an orderly purse-dives for proof of insurance.

The difference: Obamacare asks people to pay up front for the services by having insurance - just as the State of Iowa mandates all drivers have a minimum level of auto insurance.

For that he's Khrushchev?

King and his brand of conservatives, on the other hand, want a federal government safety net, without the Obama pre-pay plan, for Americans who are irresponsible with their affairs, who don't buy health insurance because they know when the going gets really bad, alleged True Believing Capitalists like Congressman King don't have the stomachs for a real-deal system of winners and losers.

"I think that you can't turn people away when they're brought into the emergency room and need help," King said in an interview. "I don't think anybody would say, 'Send them out and put them on a stretcher on the street.'"

So mandate the service, but let people off the hook on paying? That's conservative? That's capitalism?