Just Go to the ER
posted by Frank Pasquale
Given my earlier points on SCHIP, I thought the following might be of interest:
Bush spent a fair amount of time talking about health care . . . . “The immediate goal is to make sure there are more people on private insurance plans. I mean, people have access to health care in America,” he said. “After all, you just go to an emergency room.”
As I noted earlier, this isn’t great medical advice. Bush is referring to hospital obligations under EMTALA, an act that requires hospitals merely to screen and stabilize those who come to the ER. Once you’re stable, EMTALA doesn’t offer much protection. So if you have a slowly growing cancer or some chronic condition that is gradually killing you, don’t expect the hospital to be legally obliged to help under EMTALA.
To the extent any of this was unclear, Bush’s HHS helpfully clarified matters a few years ago. From a summary of the regs:
The regulations further clarify that a hospital’s obligations under EMTALA end at the time that the hospital, in good faith, admits an individual for hospital inpatient care, regardless of whether the individual is experiencing an emergency medical condition.
As Paul Krugman notes, the media needs to interrogate attitudes like “just go to the ER” or “Americans have the best health care system in the world,” rather than simply reporting them. Laws like EMTALA are scarcely airtight guarantees of care.
July 17, 2007 at 4:01 pm
Posted in: Health Law
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Responses (3)
LM - July 18, 2007 at 1:29 am
Seems to me that the first half of the quote by Bush is just as revealing about his plans for health care as the latter (especially when considered in light of your post on SCHIP).
“The immediate goal is to make sure there are more people on private insurance plans….”
Translation: “We don’t really intend to support health care programs that would be detrimental to private insurance companies.”
Another Freudian slip on Bush’s part? Or perhaps I’m reading too much into things…
Frank - July 18, 2007 at 10:34 am
I don’t think it’s a Freudian slip, particularly if you look at the inefficient “Medicare Advantage” plans the admninistration is now subsidizing. These plans are designed to route more Medicare dollars through private insurers.
The House Democrats want to fund SCHIP expansion by cutting subsidies to these plans. The Administration is vehemently opposed to that. So in other words, they appear to prioritize the partial privatization of Medicare over getting insurance to poor and near-poor children. Here are some details:
(from
http://www.truthout.org/docs_2006/042007E.shtml)
“2003 Medicare legislation . . . sharply increased payments to Medicare Advantage plans, which . . . funnel Medicare funds through insurance companies.
[T]hose Medicare Advantage plans cost taxpayers 12 percent more per recipient than standard Medicare. In the next five years that subsidy will cost more than $50 billion – about what it would cost to provide all children in America with health insurance.
As a result, Medicare – originally a system in which the government paid people’s medical bills – is becoming, instead, a system in which the government pays the insurance industry to provide coverage. And a lot of the money never makes it to the people Medicare is supposed to help.”
Anon - July 19, 2007 at 7:45 am
Usually “free market types” use the “poor people can go to the ER” statement as sarcasm for how messed-up our system is–one where people can’t afford insurance but can go to the crazily-expensive ER. I suspect Bush was being sarcastic here and that you guys have not picked up on that. Or Bush could just be stupid. I admit that later is perhaps more likely.
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