Getting around EMTALA

Great idea and I see a lot of advantages to this but I also would expect the regulators, trial lawyers (for anyone turned away), and the competing, EMTALA saddled ERs quickly finding new ways to kill these off before they gain any support with the public.

This isn’t a totally new idea and I don’t think they’re likely to be “killed” off anytime soon. Virtually all service obligations put on health care providers are done so under the guise of being requirements to accept Medicaid or Medicare payments. That’s likely the way it will continue to be. There isn’t going to be some new law placing limitations on these ERs.

As well, the liability risks of these EMTALA free ERs is almost certainly greatly reduced. For instance, all research seems to find patients’ socioeconomic status as significant in the potential for a med mal suit; with an inverse relationship. I would imagine these EMTALA liberated emergency rooms are serving a specific population. Namely a population less likely to bring a suit following any bad outcome versus a more “traditional” public emergency room population. That’s just a single example of the decreased risk these ERs probably face.

What may limit this kind’ve model (and all practices which try to operate away from Medicare and Medicaid) is the speed at which the Medicare and Medicaid population is growing. How many of these ERs (or in a broader discussion physician practices) can survive without taking Medicare? Not many in any geographic area. Medicare controls too much of the market as a payer and such is only going to grow. The population of non-Medicare/non-Medicaid, insured patients with which to support such ERs is dwindling too quickly to make this type of business model a major player. While nifty, these ERs aren’t going to become anywhere near the norm.

The Injun’s are off the reservation and the calvary is on their way to suppress their revolt. The leviathan of the modern tyrannical US government can no more allow this rejection of their authority to stand than they could allow Chief Joseph to get to Canada.

“All within the state, nothing outside the state, nothing against the State”
–Mussolini anticipating Hilary Clinton