EMTALA is an unfunded mandate. This bill proposes a step in the right direction. Aggrvated DocSurg and GruntDoc comment.
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- EMTALA and "social admits"
- "EMTALA is a good law"
- Should EMTALA be overturned?
- EMTALA a hidden tax?
- Is EMTALA a money-maker for ER’s?
- Emergency call, post-EMTALA
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EMTALA is indeed an unfunded mandate for providers, including hospitals. It also renders profoundly ironic the calls for “universal” health care that continuously emanate from the mass media and various Washington demagogues. If patients were ever in the past denied care for lack of money (something I’ve never actually seen in my years in the hospital biz—and I’m the heartless finance guy), the idea that it happens to anyone now is nonsense. Thus, we already have “universal” health care of a sort.
This wouldn’t be all bad if EMTALA contained some provision for defraying the costs incurred by the affected providers. For hospitals, there is some (minor) relief through DSH (although CMS is taliking about cutting that threadbare lifeline), but there is no help at all for the docs. So, Congresswoman Bono’s legislation is a positive, not only to the extent that some providers could receive a tax break pursuant to uncompensated care, but also as a sign that someone actually realizes there’s a problem.
Another modification that EMTALA needs is that it needs to empower hospitals to deal with abusers who drain the system of resources to the actual detriment of the “patient”. Hospitals need to be allowed to make the judgement that certain specific indifividuals have been abusing the hospital for drugs or shelter or as part of a Munchausen’s process, and put them on a “no service” list if they do not follow aftercare and outpatient treatment instructions. I am talking about a very few persons well known to the hospitals of the community with many many admissions. These people would all get better healthcare if their access to it were actually highly restricted–and one of them can easily run hundreds of thousands of dollars in charges per year.
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