Comments on: Extending the Emergency Room Rules to the Entire Health Care System http://healthblog.ncpa.org/extending-the-emergency-room-rules-to-the-entire-health-care-system/ Health Care Policy and Reform Insights | NCPA Wed, 23 May 2012 12:15:49 +0000 hourly 1 http://wordpress.org/?v=3.3.2 By: Ken http://healthblog.ncpa.org/extending-the-emergency-room-rules-to-the-entire-health-care-system/comment-page-1/#comment-46523 Ken Sat, 26 Sep 2009 16:58:27 +0000 http://www.john-goodman-blog.com/?p=5563#comment-46523 Larry, whatever it would look like, we are going to get even farther from it with ObamaCare. Larry, whatever it would look like, we are going to get even farther from it with ObamaCare.

]]> By: Larry C. http://healthblog.ncpa.org/extending-the-emergency-room-rules-to-the-entire-health-care-system/comment-page-1/#comment-46520 Larry C. Sat, 26 Sep 2009 16:41:04 +0000 http://www.john-goodman-blog.com/?p=5563#comment-46520 Imagine what the health care system would look like if we had not completely suppressed the price system. Imagine what the health care system would look like if we had not completely suppressed the price system.

]]> By: Joe S. http://healthblog.ncpa.org/extending-the-emergency-room-rules-to-the-entire-health-care-system/comment-page-1/#comment-46509 Joe S. Fri, 25 Sep 2009 23:23:45 +0000 http://www.john-goodman-blog.com/?p=5563#comment-46509 Very good post. This is a very insightful way of thinking about the health care system. Very good post. This is a very insightful way of thinking about the health care system.

]]> By: Dennis G. Vollmer http://healthblog.ncpa.org/extending-the-emergency-room-rules-to-the-entire-health-care-system/comment-page-1/#comment-46506 Dennis G. Vollmer Fri, 25 Sep 2009 21:44:21 +0000 http://www.john-goodman-blog.com/?p=5563#comment-46506 Mr. Graham is correct about EMTALA facilitating "patient dumping": hospitals and physicians can call to transfer a patient to a "higher level of care". By law, the sending physician, not the receiving one--who ostensibly has more expertise, hence the justification for the transfer--is the person who gets to label the transfer as an emergency and medically necessary. If the receiving physician balks or refuses he/she may be personally liable for thousands of dollars in fines. Hospitals refusing transfers are also at risk. As a result of EMTALA, large tertiary centers (county hospitals, university medical centers and Level I trauma centers etc.)are especially vulnerable to "cherry picked" transfers of patients from Drs. & Hospitals who allegedly cannot provide the appropriate level of care. EMTALA has far more unintended and negative consequences than positive results...what does that imply for the Baucus bill? Mr. Graham is correct about EMTALA facilitating “patient dumping”: hospitals and physicians can call to transfer a patient to a
“higher level of care”. By law, the sending physician, not the receiving one–who ostensibly has more expertise, hence the justification for the transfer–is the person who gets to label the transfer as an emergency and medically necessary. If the receiving physician balks or refuses he/she may be personally liable for thousands of dollars in fines. Hospitals refusing transfers are also at risk. As a result of EMTALA, large tertiary centers (county hospitals, university medical centers and Level I trauma centers etc.)are especially vulnerable to “cherry picked” transfers of patients from Drs. & Hospitals who allegedly cannot provide the appropriate level of care.
EMTALA has far more unintended and negative consequences than positive results…what does that imply for the Baucus bill?

]]> By: John R. Graham http://healthblog.ncpa.org/extending-the-emergency-room-rules-to-the-entire-health-care-system/comment-page-1/#comment-46504 John R. Graham Fri, 25 Sep 2009 21:12:56 +0000 http://www.john-goodman-blog.com/?p=5563#comment-46504 EMTALA was supposed to stop "patient dumping". Instead, it made it worse. Judges are now micro-managing care for mentally ill homeless people in Los Angeles (http://tinyurl.com/ckpz95). A source told me that certain of these folks walk into LA ERs and demand treatment, or "I'll call the sheriff". After they get the drugs they demand, they leave and the TV cameras catch them walking shoeless in the streets. The hospitals cannot get it right in this system. Their response? Lobby for more government money. Incredible. EMTALA was supposed to stop “patient dumping”. Instead, it made it worse. Judges are now micro-managing care for mentally ill homeless people in Los Angeles (http://tinyurl.com/ckpz95). A source told me that certain of these folks walk into LA ERs and demand treatment, or “I’ll call the sheriff”. After they get the drugs they demand, they leave and the TV cameras catch them walking shoeless in the streets.

The hospitals cannot get it right in this system. Their response? Lobby for more government money. Incredible.

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