Occasionally, I read a post on some blog that is so reality-challenged that I suspect a hoax. Kevin, MD links to just such a post today. Having discovered (rather belatedly) that EMTALA doesn’t require any ER to treat a non-emergent patient once a medical screening has been performed, “girlvet” wonders why such patients are not given the bum’s rush. Her conclusion is as follows:
Money is made off of them. Lots of money. If you treat the indigent/poor for non-emergent conditions, then you have to treat the insured too. ERs count on those non-emergent insured patients to stay afloat.
On the outside chance that “girlvet” is not putting us on, I offer this unassailable fact: For most hospitals, the ER is the largest single money loser. If we in the hospital business were motivated by profits, most ERs would have been long since closed down. However, because our raison d’être is to provide health care to the community, we willingly absorb the ever-increasing losses associated with the ER.
I’m sure this assertion will get me denounced as a soulless minion of the “health care industrial complex.” Nonetheless, facts are stubborn things.
UPDATE:
Joe Paduda also has a post on EMTALA, and it is considerably more “reality-based” than the above-mentioned post. It does, however, contain one significant error:
EMTALA is hidden tax, requiring hospitals to treat patients without hope of reimbursement. The cost of treatment is then shifted to other, paying patients, further driving up their health care costs.
Actually, there is very little cost shifting to “paying” patients. These days, Medicare, Medicaid, SCHIP, and managed care patients comprise the lion’s share of a typical hospital’s case mix, and their services are paid (for the most part) at fixed case rates.
So, raising prices has no effect on a hospital’s net revenue, which means that the “hidden tax” is on hospitals rather than the public. This is one reason why so many hospitals (30%) are operating in the red.
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