From Edwin Leap, MD:
EMTALA, the Emergency Medical Treatment and Active Labor Act, was passed in 1986. For those who aren’t familiar with yet another acronym, EMTALA is a federal law that was enacted to keep poor, uninsured patients from being ‘dumped’ on indigent-care hospitals, or any other facility, for financial reasons. Although it was a good idea, it soon grew fangs, tentacles, claws, rose up to several hundred stories in height and developed a surly attitude and bad breath. It is, in fact, one of the largest unfunded mandates the US legislative branch has ever gifted on its subjects.
For those of us who practice emergency medicine, and by now any medicine in a hospital that accepts Medicare payments, no one can be turned away for financial reasons. On the surface, this seems fair. Certainly, the potential exists for gross harm and injustice if we refuse to care for the most needy in our populations because we aren’t getting paid. ‘Your child is having non-stop seizures, eh? Well, pony up $400 we’ll see what we can do!’ It makes sense to have a provision of protection.
However, because this law basically forbids hospitals and physicians from saying ‘no,’ (without a complex, time consuming, legally perilous screening exam that is rarely worth the effort), we see all those who come through the door. And because the ‘cat is out of the bag’ and has been for a while, many of our patients know this. So, we have these conversations.
For more, please follow the link, above.
Filed under: Uncategorized
