Every patient who crosses the threshold of the ER receives a medical screening before anyone asks any question about insurance or payment. And this medical screening isn’t mere triage. It is conducted by a physician and may include such things as blood work, x-rays, CT scans, etc.

If it is determined that the patient’s condition isn’t emergent, then the hospital is permitted (in theory) to ask the patient for payment before proceeding with further treatment. In actual practice, this almost never happens. The ER docs are so afraid of malpractice litigation that they just go ahead and treat the patient regardless of acuity.

So, despite what you read in the paper or on the web, it is a myth that patients are sent away from the ER untreated.

If really necessary to preseve life or limb you may get some “stabilization,” but otherwise, um . . . nah. Oh . . .and it also has to be

You really should read these things, David, lest you sound as though you know not of what you speak . . . and especially if you lose your insurance and then piss off some stereotypical cliched mobster, who I hear really get angry when people speak out their arse about EMTALA.

As to the ER, my broken kneecap would be treated without regard to my ability to pay. EMTALA guarantees that.

And access and coverage aren’t the same, but I’d be happy to break your kneecap if you will proceed to an ER and tell them you don’t have any health insurance and then see what happens.

They certainly aren’t facing the disaster of having about 16% of their population lacking coverage.

Insurance coverage isn’t health care. The inability of the “reality-based� community to grasp this reality is a constant source of amusement for me.

Outcomes are similar to or better in most areas as the US health care system, at far less total costs. Those are facts.

The Commonwealth Fund is an advocacy group whose methods of data collection and interpretation are open to considerable question (see this). Health Affairs, sadly, does little but parrot what the Fund feeds it.

Catron, you don’t seem very familiar with the peer-reviewed health policy literature. The Fraser Institute and blogs don’t make it. If you look at actual surveys and comparisons of care in different countries you’ll find that other countries with universal care aren’t stumbling from disaster to disaster, and they certainly aren’t facing the disaster of having about 16% of their population lacking coverage. Outcomes are similar to or better in most areas as the US health care system, at far less total costs. Those are facts.

International Comparison: Access & Timeliness
How does the United States compare with other countries on patient-reported access problems, continuity of care, and waiting times?
In a 2005 survey of sicker patients conducted in six developed countries, the United States ranked last on four measures of continuity of care and access problems reported by patients.
http://www.commonwealthfund.org/snapshotscharts/snapshotscharts_show.htm?doc_id=409110

How Does The Quality Of Care Compare In Five Countries?
Health Affairs, 23, no. 3 (2004): 89-99

It will come as surprise only to those who are ideologically wedded to some theory that some countries do well in one area and less so in some others. But considering the huge difference in health spending, the fact that the US does poorly in so many areas should be a warning that things aren’t great here compared to all the other theres.

Catron you can cherry-pick data or anecdotes, and in this you aren’t any different from Michael Moore, but the fact remains other countries have decent health care systems that produce acceptable to excellent results at lower cost.

What is your contribution to health care reform, Catron? How would you propose we change things?