Just Go to the ER

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.

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