Should hospitals be allowed to turn away non payers/no insurace or liars at ER rooms?

As a follow up question from my Poll.

Should hospitals be allowed to turn away patients who cannot pay or have no insurance?


We all know that Emergency Rooms are being taken advantage of by illegal immigrants, and the working poor who use it as a form of health care.

Many people simply lie about who they are, their name, social security number, and the like. At the end of the day, the hospital gets stuck for the bill, which of course in turn gets passed on to other customers, and government support.


This is one of the huge factors that contributes ro the cost of rising health care.

So. Simple question. Should a hospital be allowed to turn away, or refuse emergency treatment to a patient whom either.

A.) is a known liar about identity.

B.) Admits they cannot pay for the needed care, and has no insurance.

C.) Patient is currently incapacitated, but their insurance information can not be verified to proceed with treatment.

D.) Or any other thing that would either prevent or mis lead a hospital from receiving payment for services rendered.


Is there any reason that an ER room should be allowed to deny EMERGENCY medical care to someone? Even if they do not have, nor will ever have, the ability to pay it back?

I would vote no on that myself, but I am curious what others think. I had a huge argument about this with someone who says this is THE largest factor that is contributing to medical costs. When asked how to combat it, this was his only solution. Personally. I cant think of a better solution to the problem either, other than to just tolerate it as is. The only other solution is to turn people away who need care.

 

If no one else is willing to pay for it.

Should the hospitals be forced to provide free treatment?

Perhaps we should force lawyers to provide free legal service to anyone who cannot afford it. Perhaps grocery stores should be forced to provide free food to those who cannot afford it. Perhaps mechanics should be forced to fix cars when certain families cannot afford it and need the car to get to their work. Where does it end? Why should hospitals be treated any differently than other businesses?

I do not agree with raising the costs for sick people to give treatment to other sick people who cannot afford it. That will just make it difficult for more families to afford to go to the hospital.

Besides, most hospitals are non-profits, and their objectives are to provide medical care to the community, so they usually are willing to provide free or low-cost medical care to a portion of the community who cannot afford it. When a non-profit hospital refuses to treat the poor, it is usually because it is already budget-strapped and simply cannot afford to do so. Forcing hospitals to treat the poor will cause many of them to go out of business, like what has happened in California. Often what happens is the quality of care goes down, as the hospital does not have the financial resources to treat so many people, and then the hospital gets shut down by the state for patient mistreatment. This is precisely what happened at the Martin Luther King Jr.-Harbor Hospital. It's closure left a whole community without adequate hospital care.

 

Hospitals should be free to turn away anyone they choose. No one should be forced to work against their will-that is slavery.

 

Doesn't Obama-care make this illegal now in the US? I don't know of any other industrialized country not taking care of it's people.

I will never understand why heath-care is not considered a right. After all, I don't call them if I don't need them. Same with the fire-department or the police... I consider them a government service they have to provide for everyone. Imagine if the fire-department first checked if you have enough money, before they stop a poor town burning... It just makes no sense. It's not like people love going to the doctor...

 

Would anyone be able to honestly look into the eyes of the family of the patient turned away and who has died for lack of treatment and tell them that their son/daughter because they were denied because they had no medical insurance? I don't think you'd ever see that done in any civilized society and I know the US considers ourselves to be civilized; at least up to this point.

 

How will you obtain that right if no one wants to treat you? Will you enslave doctors and nurses, forcing them to work? Will you take money from people and use it to bribe those doctors and nurses to do the work they don't want to do?

 

I don't care about a stupid poll. I care about intelligence.

This OP is seriously lacking in that.

The EMTALA, signed into law by George W. Bush, requires ER treatment for anyone requesting it.

Read and educate yourself. It might prevent more embarassing posts.

http://www.cga.ct.gov/2003/olrdata/ph/rpt/2003-r-0621.htm

 

I don't care about a stupid poll. I care about intelligence.

This OP is seriously lacking in that.

The EMTALA, signed into law by George W. Bush, requires ER treatment for anyone requesting it.

Read and educate yourself. It might prevent more embarassing posts.

http://www.cga.ct.gov/2003/olrdata/ph/rpt/2003-r-0621.htm

 

Um... you are aware. We DO provide free lawyers to people who cannot afford them..... Perhaps your not familier with your rights?

 

You mean like what happened here? Where fire fighting has been privatized? And someone didnt pay the bill? And so the firemen let the house burn down?


http://www.msnbc.msn.com/id/39516346/ns/us_news-life/t/no-pay-no-spray-firefighters-let-home-burn/

 

I guess thats the difference. I do not consider us to be civilized.

I think you could easily hire someone who would be willing to look another person in the eyes and tell them, to go die.

 

This law was passed in 1986 and has nothing to do with the recently passed health care act.

EMTALA

Main Points
The Emergency Medical Treatment and Labor Act (EMTALA) is a federal law that requires anyone coming to an emergency department to be stabilized and treated, regardless of their insurance status or ability to pay, but since its enactment in 1986 has remained an unfunded mandate.
The burden of uncompensated care is growing, closing many emergency departments, decreasing resources for everyone and threatening the ability of emergency departments to care for all patients.
Emergency physicians provide the most charity care of all physicians (AMA 2003).
ACEP advocates for recognition of uncompensated care as a legitimate practice expense for emergency physicians and for federal guidance in how fulfill the requirements of the EMTALA mandate in light of its significant burden on the nation's emergency care system.
Everyone is only one step away from a medical emergency.
What is EMTALA?

EMTALA was enacted by Congress in 1986 as part of the Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985 (42 U.S.C. §1395dd). Its original intent and goals are consistent with the mission of ACEP and the public trust held by emergency physicians.

Referred to as the "anti-dumping" law, it was designed to prevent hospitals from transferring uninsured or Medicaid patients to public hospitals without, at a minimum, providing a medical screening examination to ensure they were stable for transfer. As a result, local and state governments began to abdicate responsibility for charity care, shifting this public responsibility to all hospitals. EMTALA became the de facto national health care policy for the uninsured. Congress in 2000 made EMTALA enforcement a priority, with penalties more than $1.17 million, nearly as much as in the first 10 years (about $1.8 million) of the statute combined (U.S. Department of Health and Human Services' Office of Inspector General [OIG]). Between October 1, 2005, and March 31, 2006, $345,000 in fines were collected from 12 hospitals and one physician.
EMTALA requires Medicare-participating hospitals with emergency departments to screen and treat the emergency medical conditions of patients in a non-discriminatory manner to anyone, regardless of their ability to pay, insurance status, national origin, race, creed or color.
A technical advisory group was convened in 2005 by the Centers for Medicare & Medicaid Services (CMS) to study EMTALA. The advisory group focused on incremental modifications to EMTALA, but also envisioned a fundamental rethinking of EMTALA that would support development of regionalized emergency systems. A new EMTALA would continue to protect patients from discrimination in treatment, while enabling and encouraging communities to test innovations in emergency care system design, for example, direct transport of patients to non-acute care facilities, such as dialysis centers and ambulatory care clinics, when appropriate.
The Institute of Medicine in 2006 recommended that the Department of Health and Human Services adopt regulatory changes to EMTALA and the Health Insurance Portability and Accountability Act (HIPAA) so the original goals of the laws are preserved but integrated systems may further develop.
How does EMTALA define an emergency?

An emergency medical condition is defined as "a condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in placing the individual's health [or the health of an unborn child] in serious jeopardy, serious impairment to bodily functions, or serious dysfunction of bodily organs." For example, a pregnant woman with an emergency condition must be treated until delivery is complete, unless a transfer under the statute is appropriate.

What is EMTALA's scope?

According to the law, EMTALA applies when an individual "comes to the emergency department." CMS defines a dedicated emergency department as "a specially equipped and staffed area of the hospital used a significant portion of the time for initial evaluation and treatment of outpatients for emergency medical conditions." This means, for example, that hospital-based outpatient clinics not equipped to handle medical emergencies are not obligated under EMTALA and can simply refer patients to a nearby emergency department for care.

What are the provisions of EMTALA?

Hospitals have three main obligations under EMTALA:

Any individual who comes and requests must receive a medical screening examination to determine whether an emergency medical condition exists. Examination and treatment cannot be delayed to inquire about methods of payment or insurance coverage. Emergency departments also must post signs that notify patients and visitors of their rights to a medical screening examination and treatment.
If an emergency medical condition exists, treatment must be provided until the emergency medical condition is resolved or stabilized. If the hospital does not have the capability to treat the emergency medical condition, an "appropriate" transfer of the patient to another hospital must be done in accordance with the EMTALA provisions.
Hospitals with specialized capabilities are obligated to accept transfers from hospitals who lack the capability to treat unstable emergency medial conditions.
A hospital must report to CMS or the state survey agency any time it has reason to believe it may have received an individual who has been transferred in an unstable emergency medical condition from another hospital in violation of EMTALA.
What are the requirements for transferring patients under EMTALA?

EMTALA governs how patients are transferred from one hospital to another. Under the law, a patient is considered stable for transfer if the treating physician determines that no material deterioration will occur during the transfer between facilities.

EMTALA does not apply to the transfer of stable patients; however, if the patient is unstable, then the hospital may not transfer the patient unless:
A physician certifies the medical benefits expected from the transfer outweigh the risks OR
A patient makes a transfer request in writing after being informed of the hospital's obligations under EMTALA and the risks of transfer.
In addition, the transfer of unstable patients must be "appropriate" under the law, such that (1) the transferring hospital must provide ongoing care within it capability until transfer to minimize transfer risks, (2) provide copies of medical records, (3) must confirm that the receiving facility has space and qualified personnel to treat the condition and has agreed to accept the transfer, and (4) the transfer must be made with qualified personnel and appropriate medical equipment.
What are the penalties for violating EMTALA?

Both CMS and the OIG have administrative enforcement powers with regard to EMTALA violations. There is a 2-year statute of limitations for civil enforcement of any violation. Penalties may include:

Termination of the hospital or physician's Medicare provider agreement.
Hospital fines up to $50,000 per violation ($25,000 for a hospital with fewer than 100 beds).
Physician fines $50,000 per violation, including on-call physicians.
The hospital may be sued for personal injury in civil court under a "private cause of action"
A receiving facility, having suffered financial loss as a result of another hospital's violation of EMTALA, can bring suit to recover damages.
An adverse patient outcome, an inadequate screening examination, or malpractice action do not necessarily indicate an EMTALA violation; however, a violation can be cited even without an adverse outcome. There is no violation if a patient refuses examination &/or treatment unless there is evidence of coercion.

Who pays for EMTALA-related medical care?

Ultimately we all do, although EMTALA places the greatest responsibility on hospitals and emergency physicians to provide this health care safety net and shoulder the financial burden of providing EMTALA related medical care.
According to a May 2003 American Medical Association study, emergency physicians on average provide $138,300 of EMTALA-related charity care each year, and one-third of emergency physicians provide more than 30 hours of EMTALA-related care each week. Physicians in other specialties provide, on average, about six hours a week of care mandated by EMTALA, and on average incurred about $25,000 of EMTALA-related bad debt in 2001.
Some health insurance plans deny claims for legitimate emergency departments visits, based on a patient's final diagnosis, rather than the presenting symptoms (e.g., when chest pain turns out not to be a heart attack). Some also attempt to require preauthorization before a patient can seek emergency medical care, resulting in denied payment. These managed care practices endanger the health of patients and threaten to undermine the emergency care system by failing to financially support America's health care safety net.
ACEP advocates for a national prudent layperson emergency care standard that provides coverage based on a patient's presenting symptoms, rather than the final diagnosis. In addition, health insurers should cover EMTALA-related services up to the point an emergency medical condition can be ruled out or resolved.
For more information, visit www.acep.org.

 

Every ER visit is paid by taxes paid by you and I. Everyone must be treated in the ER.

Don't like it? Change the law and quit crying on an internet forum about it.

 

Actually, I do like it. I think that not only should the ER treat them, it should treat EVERYTHING. If a person walks into a hosp with cancer, he should be treated for cancer. Not for for whatever symptoms the cancer is causing. For example.

I dont think Obama care went far enough imo. I wanted a single payer universal health care system. Because being poor shouldnt be a death sentence.

And way to ignore every other point I made.

 

That would take away the benefit of the ER. Emergency treatment.

Blame the Republicans in Congress. That's what Obama wanted and what I want too. ObamaCare is a compromise. A bad one, but better than nothing.

I tend to ignore insults. If you want to discuss issues, I'll be glad to.

 

I will note though when this law was passed every county at least had one public hospital which often had medical staff as paid employees, reduced cost measures such as wards over semi-private rooms, an oversight committee that controlled costs over normal budget expenses (you had to prove a new expense was needed and the bar was usually pretty high) and they took a sliding fee scale for care. Milwaukee in fact still has one of these. They were not flashy but provided good care to those with less means. So having this law was rarely an issue they had to stabilize the patiant then could move then to the county public facility or to a charity care private hospital that would take them. They never intened this to be all on the private system like it is.

That is why hospitals agreed to lose some Medicare monies ,$500 billion, over a decade to get more people insured even on Medicaid they would get something over the ZERO they get now.

But should they turn people away ,no, but perhaps encouraging counties to have a public hospital would be good and some kind of clinic system for those of less means.

 

Not necessarily. The government doesn't always reimburse deadbeat ER patients. Often those are covered by increased costs for paying patients.

 

we already force lawyers to provide free legal services to people who cant afford it you idiot, everyone ever charged with a crime has exactly that said to them in as many words, some things everyone should be entitled to regardless of money.

 

no its not, my god did you even go to school ? if they werent being paid, were chained to the operating table and worked 18 hour days that would be slavery

 

that is absolutely crazy, a symbol of the breakdown of america right there, your country is broken that is shocking they would just let the guys house burn down that wouldnt happen anywhere else its disgraceful

 

youre an idiot, medically the only person who could do that would be a psychopath, and you dont want to employ them as doctors generally. plus all doctors take an oath, youre probably best to stay out of grown up debates.

 

I don't know what you do for a living, but what would you call it if you were forced to do whatever it is you do for someone that you didn't want to work for and they didn't pay you for it?

 

you do get paid for it, doctors receive a salary regardless of who pays or doesnt, how stupid are you, every minute they are at work they are being paid, and paid quite well, therefore it couldnt possibly be any further from slavery if it tried

 

My grandfather was an MD, ganeral practice and basic surgery, in a rural area. He routinely helped poor people it was his duty as a physician and would take what they offered and yes sometimes that was food or work or some crafted item some were Amish he took a good amount of labor for healing. But he also padded the bill more for those that could pay a bit and everyone knew he added a bit to his standard rates. On the other hand doctors expected to have only three things support from the community with respect for their profession, always to have a job as in job security and live as good as a middle class union worker as in live well but not much better than a shop boss. It helped his medical education was dirt cheap by todays standards his bachelors was payable from his fathers wages with a bit of effort and a summer job, he got a loan for medical school and back then it was risk based they figured he had a B+ GPA from the University of Wisconsin - Madison and was accepted into medical school he was a sure bet to repay. Even if he didn't graduate holding bachelors meant a great job he could repay back then. And he repaid his modest debt rather fast.

Doctors that care will work to heal others is their calling but I think many want to live better than Middle Class even counting in debts perhaps they want to get paid to much. Just my two cents.

A solution could be a lot more LNP's and others to do care so people don't need to go to the ER for non-emergencies saving the doctors for serious cases.

 

OMG. Another one who can't read? Where did I say the government reimburses these ppl?