The Glade 4.0

How is that arbitrary? They aren't denying access to medical care, they are denying receipt of it to those unable to pay. We're not talking about not liking Latinos, or Asians, or black people or whatever and not giving them treatment.

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"It's real, grew up in trife life, the times of white lines
The hype vice, murderous nighttimes and knife fights invite crimes" - Nasir Jones

Why would it be limited to that? The only reason to not require hospitals to provide emergency care is under the philosophy that the hospital is someone's property and they can decide who they will and will not service. Under that philosophy, there's nothing to prevent arbitrary denials. I'm not saying it would be common but a lot of people would be willing to take a substantial financial hit when it comes to revenge.

1. The owners of for profit hospitals aren't in the business of any revenge but a good life.
2. They aren't in the ER waiting for their "rivals" to come in.
3. They would set policy to make them the most money.
4. The above policy would not allow individuals in the ER to turn away paying customers because they do not like them.

Or to put it in another way - its run like any other business out there.

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"...but there exists also in the human heart a depraved taste for equality, which impels the weak to attempt to lower the powerful to their own level and reduces men to prefer equality in slavery to inequality with freedom." - De Tocqueville

I beg to differ. History clearly shows that businesses are willing to sacrifice profit to uphold their prejudices. They are run by people, after all. Even today some businesses won't deal with homosexuals. Their money is as good as anyone elses.

Right, like how Ford didn't sell to jews.

OH WAIT.

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"...but there exists also in the human heart a depraved taste for equality, which impels the weak to attempt to lower the powerful to their own level and reduces men to prefer equality in slavery to inequality with freedom." - De Tocqueville

Didn't realize doctors were compensated based on relative value units..no wonder we have a shortage of primary care physicians. The system is set up for them to lose. The more patients they see the more they make. Understandable why they see you for 5min now. Reworking this system would definately be good. I agree that matching disease process to compensation would work for doctors..it's working for hospitals. Quality is improved, and there is incentive for that quality.

Hospitals also are not reimbursed for care due to things that occur after admission. If a patient develops a pressure ulcer during the hospital stay, there is no reimbursement for the care and supplies. This is incentive to increase quality and maximize reimbursement. More of these type sceanerios could be developed to keep hospitals accountable.

I also think it would help to have a patient coordinator, if you may, who is assigned upon addmission. This coordinator would then review the patients charts daily and keep care on track. Continuity is lost and there is repeating of tests that are not necessary. Having the review could help with that and keep all of the doctors involved on the same page .

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Dream as if you'll live forever...
...Live as if you'll die tomorrow

Vivere Senza Rimpianti

@Elmo:

Regarding a repeal of EMTALA; while it is possible and in some respects desirable from a limited government perspective, I posit to you that this is a list of likely-to-be-possible reforms. Repealing EMTALA is so unlikely politically as to be considered not possible.

Hence, I indicate reform of EMTALA itself is necessary. Firm up the definition of things like "emergency condition" and "life-threatening condition" and so on. Require citizenship tests. Find a way to exclude frequent fliers and those using the hospital as homeless shelter.


Again, uncompensated care is a small portion of the healthcare dollar in the US, and if we presume that the people as a whole desire a restriction on patient "dumping" (which was the origination of EMTALA in the first place), we must also assume that removing the law won't happen. Amending it in the way I've stated, combined with mandating a floor for charity care, would essentially remove the problems you're talking about, IMO.

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“The duty of a patriot is to protect his country from its government.” - Thomas Paine

I'm speaking only of the ideal solution. The road to the ideal is long difficult and likely not achievable in my lifetime. The path you've chosen works for more liberty for more people - the realist goal I've realized I would accept long ago.

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"...but there exists also in the human heart a depraved taste for equality, which impels the weak to attempt to lower the powerful to their own level and reduces men to prefer equality in slavery to inequality with freedom." - De Tocqueville

Those may be the only 4 your hospital participates in for reimbursement, but they're not the only ones. There's also Pregnancy, Children's Asthma, and Stroke. There's also the Surgical Care Improvement Program (SCIP) but that is procedure-based, not dx-based.

There's also the Hospital Outpatient Core Measures, but I can't remember if those are mandatory or not (I think they are).

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The Dude abides.