I’m sure many readers have been horrified by headlines blaring that a Baltimore hospital allegedly “abandoned” an older and/or indigent patient at a bus stop in freezing weather. Unfortunately, the reality is likely to be very different to what’s being presented by the news media.
Under the 1986 Emergency Medical Treatment and Active Labor Act, popularly known as EMTALA, any hospital accepting Medicare funding must provide emergency medical assessment to anyone, irrespective of their ability to pay. The law is very specific in its requirements – but it makes no provision for funding those requirements. Basically, hospitals are on their own. If they don’t provide the required facilities and/or investigations, they can be stripped of Medicare funding. If they do provide those things, it’s on their own dime – which is one reason why hospital charges have skyrocketed since EMTALA was introduced. They’re not charities. They’ve got to cover those costs somehow – and our politicians weaseled out of paying them out of government funds, by forcing the hospitals to recover them from all their other patients. In so many words, EMTALA is blackmail, forcing hospitals – i.e. you and I, their other paying customers – to pay for what the government is not willing to fund.
As inevitably happens, indigent people have learned to “game the system”. I’ve been on duty as a pastor and a volunteer in emergency rooms when such people come in, loudly complaining of this or that or the other imaginary ailment – usually something that’s hard to quantify or assess. When tests are inconclusive, they demand to be admitted, fed, and treated like guests at a hotel, without paying a penny for it. Sometimes hospitals are forced to comply, particularly in cities where social justice warriors make it very difficult for them if they don’t. In other cases, particularly when they’re swamped with truly ill people, hospitals simply can’t cope. They’re forced to turn away such people – and if they won’t leave voluntarily, they have to be evicted. That’s one of the functions of hospital security staff. It happens on a daily basis, across the country. There’s nothing unusual about it.
In the case in question, we don’t know exactly what happened; but I’m willing to bet the lady’s “symptoms” could not be adequately assessed, and medical staff had concluded that there was basically nothing they could do to help her. If she then refused to leave, because it was cold and nasty outside, what was the hospital supposed to do? Allow her to take up space and facilities required for someone who truly needed them? That’s not on – so they probably tried to move her on in the most human manner open to them. The hospital is not a charity, and not a shelter for the homeless. It can’t be. It has to serve its primary customers – patients – not the indigent. This makes a lot of people uncomfortable. I’m sorry about that . . . but it remains the truth.
Aesop, who works in an ER, points out (rather profanely – I’ve had to censor his post to reproduce it here):
This only happens about daily to weekly in every ER I’ve worked in, going back a mere twenty years, especially from October to March.
And the ****wits that complain about this kind of bull**** without knowing their ***** from a hole in the ground can’t figure out why they’re still sitting their fat ***** in my waiting room 6-8 hours later, because I can’t get a fat troll like this to put on her clothes, gather her forty-seven shopping bags of ****, and GTFO so I can decon her room and see a real patient, until three security guards and two techs “help” her hit the bricks.
And if she had met the criteria for a mental health hold, the same ***holes would be bitching that she was incarcerated against her will and her civil rights violated for keeping her in the hospital.
Damned if you do, damned if you don’t … Thank your congress ****weasel for voting EMTALA into law.
She should be chained up in leg irons, and forced to shovel snow on the public roads to pay her bill and fine and cover the cost of green bologna sandwiches, in lieu of six months’ jail time.
There’s more at the link. He’s largely right. I’ve been there, and seen it for myself.
Whenever you see a hullabaloo about hospitals allegedly “dumping” patients, ask yourself why any sane, normal person would do that. A sane, normal person wouldn’t. Neither would a sane, normal hospital. They’re doing it because they’re caught between a rock and a hard place, thanks to EMTALA and the refusal of our politicians to pay for care for the indigent. They’d rather blackmail hospitals into doing it “free” – meaning, at our expense, because we’re the ones ultimately picking up the tab.