It became clear almost immediately that Idaho Rep. Raúl Labrador had struck a sour chord with many Idahoans at his town hall in Lewiston on May 5.
“You are mandating people on Medicaid accept dying,” a woman told him from one of the podiums set up for constituents. His response set off backlash that has echoed across social media on Saturday.
“That line is so indefensible,” Labrador said. “Nobody dies because they don’t have access to health care.”
The auditorium erupted in boos, jeers and gasps.
“It absolutely kills people. You don’t know what you’re talking about,” the woman, who later identified herself as an emergency room nurse, replied. “You should sit in ER waiting rooms and explain to people that their children are going to die because they can’t afford insurance.”
This time, the auditorium erupted in applause.
Video of the exchange quickly made its way to CNN and CBS. An Idaho Statesman article about the incident was posted to /r/NottheOnion, a Reddit forum dedicated to “true stories that are so mind-blowingly ridiculous that you could have sworn it was an Onion story.” By Saturday afternoon, the post had been upvoted nearly 28,000 times.
“Should we just deny healthcare for everyone and nobody would die anymore?” reads the top comment on /r/NottheOnion. Dozens of other commenters shared stories of people they knew who they said had, in fact, died because they lacked access to health care.
It was a larger echo of what the same criticisms being made in Idaho.
“People that can not afford healthcare do not take as many preventative care as those that can afford it,” wrote Boisean Bob Haycock on the Statesman’s Facebook page. “Think a low income family is as likely to get annual exams, schedule preventative screenings for cancer and other diseases, or seek care when early symptoms show up if it is money out of pocket that they need for food and rent?”
Idahoans on Twitter and Facebook referred to the congressman as ignorant and naive. Many cried hypocrisy and pointed out that lawmakers, like Labrador, had recently voted in favor of the American Health Care Act, which exempted those lawmakers from its provisions. However, the House also approved a subsequent piece of legislation that nullified that exemption.
Labrador posted on his Facebook page thanking constituents for coming to his town hall events in Lewiston and Coeur d’Alene. Those posts, too, were inundated with criticisms.
“You continue to be a constant source of disappointment,” wrote one woman. “I have breast cancer, a pre-existing condition under your Trumpcare bill that you and your Republican friends are so proud of. ... You are literally trying to kill me because it costs too much money to take care of me.”
Idaho health experts weigh in
Of course, the internet is often seen as ground zero for unnecessary outrage. But in this instance, even medical experts said they were ruffled by the representative’s comments.
“My experience as a practicing physician differs from what Rep. Labrador asserts,” David Pate, CEO of St. Luke’s Health System, told the Statesman in an email. “I remember well two patients off the top of my head.”
Pate said one woman delayed attention for a mass in her breast due to lack of health insurance. Her cancer progressed so much, Pate said, that it had metastasized widely. She died soon after coming into the emergency room.
“Had she come in when the mass first appeared, it is possible it would have been treatable and perhaps curable,” Pate said.
His second example was similar — a 19-year-old man with a heart murmur whose parents were uninsured and did not get him regular checkups.
“Finally, he got to the point where he was so short of breath that he could not lie down. He came into the emergency room and I saw him, and at that time, his heart had grown so enlarged that it filled most of his chest, leaving little room for his lungs,” Pate said.
That patient also died from what the CEO said was a treatable heart defect.
“In both of these cases, the patients died because they were uninsured and waited to get health care until their conditions were so far advanced that we could only provide comfort care until they passed away. A terrible shame,” Pate said.
J. Robert Polk, a former chief quality officer and chief medical officer at Saint Alphonsus, said Labrador’s comments “show a profound ignorance of health care and a severe lack of competency in understanding how health care works.”
“Does he believe that all anyone needs is an emergency room visit when they are in dire straights from a health issue? Emergency room visits when you are up against the wall with a health issue can save your life, but as we know, sometimes the illness is too far along and in the best of medical hands, death is at the door, or at least a hospitalization,” Polk said.
Polk added that access to health care lowers risk of mortality and hospitalization, as well as financial strain from unnecessary hospital visits.
“Leaders should be held to a higher accountability and responsibility in terms of competence and education on issues,” Polk said. “Mr. Labrador is woefully failing.”
Boise doctor Richard Radnovich said there’s a limit to what doctors can do when patients can’t pay for care out of pocket.
“In talking with other doctors, it is clear that many patients in Idaho have died due to preventable disease because they don’t have insurance,” he said. “And while it’s true that people can, for example, go to the emergency room and get care regardless of their ability to pay, that’s hardly a solution for treating patients with preventable disease over the long term.”
Meridian physician Mark Grajcar told the Statesman he has spoken with Labrador’s staff about health care reform and better access to primary care before.
“(Labrador) endorses the direct primary care model which many physicians believe would improve the quality of care for Americans,” Grajcar said.
“Health care is extremely complicated. Access to care and having insurance are not synonymous. While I disagree with the comment that the lack of access to health care won't hurt individuals, I have seen how unaffordable insurance does not improve access to the care people need,” he added.
Grajcar said he, like the American Medical Association, opposed the AHCA as the “answer to our broken health care system.”
In defense of Labrador
Amid the backlash, there were also those who tried to add context to a more nuanced point they believed Labrador may have been trying to make prior to his clarification late Saturday.
“I’ll be generous and interpret that what he meant was a hospital can’t turn you away if you show up at the ER or by ambulance if you don’t have insurance. But that is not what the problem is with this scenario,” wrote orion1anon on a YouTube video of Labrador’s town hall.
“The problem is that persistent cough and nagging chest pain that you have been ignoring for a few years because you don’t have the money to go see a doctor turns out to be stage IV lung cancer when you finally get ill enough to go to the ER. That is how lack of health insurance kills people — conditions that could have been caught/treated early with regular screenings/doctor visits go untreated until its too late,” the commenter said.
Idahoan Chris Litzsinger on Facebook pointed out that Labrador’s statement could have referred to the Emergency Medical Treatment and Labor Act, a 1986 federal law that requires emergency departments to stabilize and treat anyone who comes into their facility, regardless of insurance status or ability to pay.
“He’s right, uninsured people can always go to the emergency room and receive treatment for traumatic injury. No hospital is going to turn them away in a moment of crisis, but someone has to pick up the cost of those visits,” Litzsinger wrote. “That someone is the hospital who passes higher costs on to the insurance companies who promptly pass higher costs on to those of us who pay for insurance. It’s a terribly inefficient way to provide health care for a country.”
Yet another commenter on the Statesman’s Facebook page echoed a statement Labrador made at a town hall in Meridian last month.
“Healthcare is a service not a right,” wrote Sheila Clark. “Humanity has survived thousands of years without such a ‘right.’ We take care of each other because it is the right thing to do, not because they are entitled to it.”