Barbara Shelly, Kansas City Star

Poor Mitt Romney. In trying to be all things to all people on health care, he’s found himself stuck in a time warp.

The Republican presidential nominee, supposedly a new man after his sparkling debate performance last week, has not completely abandoned his clueless ways, as he revealed in an interview this week with the editorial board of the Columbus Dispatch.

While discussing the U.S. health-care system, Romney amazingly and wrongly said that Americans don’t die for lack of health insurance. “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.

“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.”

Oh yes we do, Mr. Romney. This nation has millions of people who become ill because they can’t afford preventive medicine. We have sick people who can’t get well because they can’t afford medications. We have people who live in pain because they can’t pay for treatments.

And yes, Mr. Romney, we have people who die sooner than they should because they don’t have insurance. Different studies have placed the number from 18,000 to nearly 45,000 people a year.

“He is ignorant of the facts,” said Dr. Sharon Lee, chief executive of Family Health Care, a clinic in Kansas City, Kan. “I see patients all the time who die or have very high morbidity because of a lack of insurance.”

We may pack a patient into an ambulance and rush to the hospital once the heart attack occurs, as Romney happily noted. But if that person is one of the 48 million Americans who are uninsured, we probably won’t pay for the blood pressure medication or the stent or the pacemaker that could have prevented the heart attack from occurring.

Lee spoke of just such a person.

The man lost a good job with health insurance because of a heart condition. He suffered terrible chest pains but avoided a visit to the emergency room, not wanting to burden his family with the bills that would result. When a relative finally coaxed him into Lee’s clinic, she took him immediately to a hospital.

“He had a cardiac bypass that afternoon and he died,” Lee said.

What kind of a health policy encourages people to wait until they are in crisis, and then, as Romney explained, “you go to the hospital, you get treated … and it’s paid for, either by charity, the government or by the hospital?”

Oh, wait. That’s the U.S. policy. Health care by default. The broken system that costs more and produces poorer results than most other industrialized nations.

The one that Romney signed landmark legislation to fix when he was governor of Massachusetts, and he worked with his legislature to design a system whereby nearly everyone would have insurance policies, some with the help of government subsidies, others prompted by employer and individual mandates.

The federal Affordable Care Act, modeled after the Massachusetts law, is designed to fix the same problems that Romney took on as governor.

But now Romney says he’ll repeal “Obamacare,” and he lends a clumsy endorsement to a status quo that isn’t acceptable to anyone.

Romney surely knows better. His work in Massachusetts shows he understands the benefits of getting people insured. In the interview with the Ohio newspaper he proposed open enrollment periods in which people could purchase insurance without being denied for a pre-existing condition. As a fallback to the individual mandate, that’s not a bad idea.

But for every step forward on health care, Romney follows with two steps backward. And now he’s gotten himself stuck in the cruel and costly system that he once set out to fix.