Dear Mitt,

If I hear you say this one more time...

"We don’t have a setting across this country where if you don’t have insurance, we just say to you, ‘Tough luck, you’re going to die when you have your heart attack,’ ” he said as he offered more hints as to what he would put in place of “Obamacare,” which he has pledged to repeal. “No, you go to the hospital, you get treated, you get care, and it’s paid for, either by charity, the government or by the hospital. We don’t have people that become ill, who die in their apartment because they don’t have insurance.”

...I swear I will walk to the next campaign stop you have, no matter where it is, and start screaming until you hear me. So just take a minute, shut your stupid campaign advisers up, sit down, and listen.

Let's start with Ann, your very own wife. Your campaign loves to talk about how she fought back against MS and cancer to be here today. Do you truly believe that would have been possible if you didn't have the health insurance and means to make sure her medical bills were covered?

How did Ann discover she had breast cancer? Did she find a lump and go to the doctor? Or did she have a mammogram? Was it covered by your health insurance? If so, then imagine yourself penniless (I know, it's a stretch of your imagination, but try). Do you think it would have been caught early enough to be handled with a lumpectomy? Because it wouldn't have.

What if you were poor instead of rich in 1998 when Ann started having MS symptoms? Do you think she would have been able to go to a doctor? No, here's how that would have gone. Perhaps she felt dizzy from time to time, or had pain she couldn't explain. Maybe her vision got weird or she was having memory lapses. Whatever the symptoms, if you were not insured and did not have any money, the emergency room would not have helped you one bit.

Here's what would have happened. You might have taken her to the emergency room, where they would take your information including employer, Social Security number, driver's license number, and other information. They would immediately have seen that her condition was not life-threatening and sent her on her way. Whatever costs were incurred would follow her to wherever she worked and lived.

No diagnosis for Ann, but if she actually was lucky enough to get a job and be eligible for her employer's health insurance, that visit to the emergency room meant a pre-existing conditions exclusion would be slapped on her for six months or so, while the MS went untreated. And because the MS went untreated, she might not be able to actually hold onto that job due to cognitive or physical disability.

So now she can't get insurance and she still has no diagnosis, and there's no available treatment for her because she can't afford it, and no neurologist will take her as a patient without some way to pay. While all of this is going on, you and your pals are busy cutting back Medicaid benefits, making eligibility so impossible to meet that it covers children, but not their parents unless they're living in dumpsters and maybe not even then. Because all of your children are adults by the time these symptoms appear, Medicaid might not even cover her at all ever, since she has no dependent children to meet those eligibility requirements.

And still, the emergency room will not treat or medicate the symptoms of MS. Nor will there be any dressage horse for Ann, nor will there be any alternative treatments, nor will there be any traditional treatment, nor will there even be a diagnosis! Because there is no money for those things. Food, shelter, transportation, and clothing take the money. No money for medicine or doctors. None.

Yet you have the audacity to say that emergency rooms are adequate, that they're not going to let you have your heart attack in an apartment.

What a cynical and ugly thing to say, because here's the part you're missing, Mitt. Prevention is key.

People with health insurance actually get some preventive care. But people who don't have health insurance wait until they drop on the street. People with chronic conditions and no health insurance are out of luck.

There is no greater inhibitor to the entrepreneurial spirit than a pre-existing condition, and nothing guaranteed to stop prosperity from knocking on one's door faster than a chronic health condition. That's a fact.

That uninsured guy down the street who is struggling to make ends meet has no idea he has a cholesterol problem if he doesn't ever have a physical.

That uninsured mom on the next block struggling with fatigue and weird symptoms has no idea she might have type II diabetes because she doesn't even go in for routine pap smears, much less a physical exam.

That writer for your favorite blog might think she's having a heart attack only to find it's something else, something that she needs to have treated but something which isn't immediately life-threatening, only completely debilitating.

The college kid who suddenly loses 40 pounds in one summer and can hardly get out of bed won't know he has ulcerative colitis because he has no money for doctors when tuition and books take all he earns, when he can actually feel well enough to earn something. If he does end up in the emergency room, they'd probably spend around $20,000 for the diagnosis and prescribe a pill that costs about $5 per month to keep the inflammation under control. He'd be stable and they'd send him home until a few days later when he's brought back into the emergency room in a diabetic coma because well, the cure for the ulcerative colitis brings on a diabetic reaction.

And then you know what? That same kid would be uninsurable for life. He would be on the hook financially for all of his medication to keep the colitis away, the insulin and the testing kits. That's around $600/month, Mitt.

College education? Bye. The best he could hope for would be the mercy of a corporate lackey job somewhere that might cover him and his pre-existing condition after he worked there for awhile.

Assuming he didn't get sick again.

Assuming the creditors for the emergency didn't hound him until his employer fired him.

Assuming he could even get a job without a degree.

Anyone who thinks emergency rooms and charities are a substitute for access to ongoing health care is either deluded, cynical, or lying.

In your case, Mitt, it's all three. Just admit that you're comfortable with 82 million people not having insurance and accept that you're down with seeing a percentage of that 82 million people die. No charity and no emergency room will handle the medical needs of 82 million people.

And for the portion of that 82 million that might own a home, or have money in the bank? That, my friend, would be the largest wealth transfer in the history of this country.

The college student is my son. My 401k account was spent to get a diagnosis because for the first and only time in my life I was laid off in 2008 and couldn't afford the COBRA premiums. Doctors, labs, and hospital bills ate my retirement plan.

That is just fine with you, isn't it, Mitt? Now we're insured and so is he but we breathe a sigh of relief with each day that passes that we still have that insurance because my almost-60 year old spouse and I have a long way to go until Medicare, and at least another year until Obamacare is reality.

That is, unless you repeal it. And replace it with a whole lot of nothing.

Oh, yes. Medicare. That thing which you think my husband should be able to get, but not me. That profit center you see before you is built on my early death.

Voting for you would be like signing a death warrant. No thanks, Mitt. Take your hard-hearted ideas about my health and well...shove them.

Here's Susie's story. I dare you to look her in the eye and tell her to go to the emergency room. Tell her why she's not worthy of health care. Go ahead. Do it.