Is rationing health care impossible in the United States?

As long as as 911 and EMTALA remain, the answer appears to be yes.

EMTALA is the flawed, unfunded, mandate forcing hospitals to provide a medical exam to anyone who presents to the emergency department. Emergency physician White Coat envisions a scenario where a family who is denied care can simply call emergency services, or show up in the ER, to get the care they want.

For instance, what if Medicare decides to deny dialysis to those over 90-years of age?

No problem: “Most families will just call ‘911’ and the red taxi with the spinning light on top will come to pick grandpa up at his home and take him to the emergency department. At that time, grandpa will receive thousands of dollars in lab tests to document that he really is in renal failure and that he needs dialysis. If dialysis is necessary, grandpa will receive emergent hemodialysis thanks to EMTALA. He might even need a day or two in the hospital to make sure that he is ‘stabilized.’ Then the red taxi with the spinning light on top will bring grandpa home where he will sit a few more days … until he needs dialysis again. One little phone call and the whole process starts all over again.”

This little charade will shift the burden of cost from the government to hospitals, which will cause more of them to simply shut their doors. And where will patients go then?


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