The only difference is they're saying it in public

Krugman's right:

Last week John Goodman, an influential figure in Republican health care circles, explained that we shouldn't worry about the growing number of Americans without health insurance, because there's no such thing as being uninsured. After all, you can always get treatment at an emergency room. […]

Mr. Goodman's assertion that lack of health insurance is no problem precisely echoed what President Bush said a year ago: "I mean, people have access to health care in America. After all, you just go to an emergency room." That's because both men - like Mr. Gramm - were just saying in public what modern Republicans say when they talk to each other. Despite attempts to feign sympathy, the leaders of today's G.O.P. fundamentally feel that Americans complaining about their economic and health care difficulties are, well, just a bunch of whiners.