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cthulu2016

(10,960 posts)
Mon Oct 15, 2012, 11:36 AM Oct 2012

You show up at the Emergency Room with abdominal pain...

It’s true that EMTALA, the 1986 law requiring that emergency rooms treat you regardless of insurance status, requires a medical screening exam and stabilization of any emergency medical conditions. It does not, however, mandate admission to the hospital for treatment of conditions that are not currently emergent (e.g. cancer, kidney disease, and other more chronic conditions except related to certain complications). For example, if someone were to present to one of our emergency departments with some mild bloating and be found to have an abdominal mass, they may very well be discharged home for outpatient follow-up and treatment. If that person doesn’t have insurance, they will likely have difficulty obtaining that care.

I agree with your example of someone delaying care because they are uninsured (it happens with regularity), but thought another avenue to describe how uninsured people could die despite emergency care being mandated by EMTALA would be informative.

http://krugman.blogs.nytimes.com/2012/10/15/ways-the-uninsured-die/
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begin_within

(21,551 posts)
1. They should take abdominal pain seriously because a burst appendix can easily cause death.
Mon Oct 15, 2012, 11:38 AM
Oct 2012

And an appendectomy is a simple, quick operation. And I would classify appendicitis as an emergency medical condition that needs to be stabilized, by surgery.

cthulu2016

(10,960 posts)
2. The point is that cancer, versus appendicitis, is not an emergency
Mon Oct 15, 2012, 11:44 AM
Oct 2012

If they found that you had a large mass in your gut that was not an acute infection, but was probably cancer, they would suggest you see an oncologist.

They would not treat it. Nor should they... they are the emergency room.

And if your problem was kidney failure they wouldn't put you on a dialysis regimen. They can't. They are the emergency room.

And so on.

cbdo2007

(9,213 posts)
4. Or they give you a bottle of Pepto and charge the govt $5,000 for your ER visit
Mon Oct 15, 2012, 11:59 AM
Oct 2012

Socialized health care. We're all paying (more specifically OVER-paying) for ER visits of the uninsured.

At least if we gave those people Medicaid the govt could control costs rather than getting hosed.

mikki35

(111 posts)
5. And on and on and on and on...
Mon Oct 15, 2012, 12:01 PM
Oct 2012

The list is very very long of syndromes, conditions, diseases, etc, that can be causing abdominal pain, but does not qualify as an emergency, thus no treatment mandated in the ER. Many of them WILL kill the patient...eventually. Point is, the patient will be sent home with instructions, prescriptions, and follow-up appointments that they will not be able to afford. Eventually, unless they are very lucky, they may well die from that condition at home without medical care.

I have seen people arrive in the ER with such advanced states of preventable disease, it makes you sick because it is utterly shameful that ANY of this occurs in what is supposedly the richest nation on earth. Cancer of the EYE - so advanced the eye was hard as wood and the patient died of brain metastasis. Decubitus ulcer measured at 29 cm X 34 cm X 4-8 cm deep across the coccyx and hips and spine (that's about a FOOT across, btw) - died of wasting and infection. Pedestrian struck by car because could not get out of the way fast enough - why? Right leg muscles wasted from herniated lumbar disc. Looked like he'd had polio. He was trying to get to work - 17 years as a janitor, didn't qualify for medical insurance, still trying to pay bill for the diagnostic tests that told him years ago what was wrong with his back/hip/leg. He died too. I could go on and on and on and on and on....These are the people that have been tossed aside. This is the overwhelming pain and agony they must endure so that the rich can get richer.

renate

(13,776 posts)
9. those specific examples are incredibly moving... and frustrating
Mon Oct 15, 2012, 12:09 PM
Oct 2012

Everybody but, apparently, Romney knows that ERs don't help people get preventive care, but those specific examples of people dying for lack of insurance are so sad and so powerful... much more so than statistics.

Even a dancing horse wouldn't solve these folks' problems....

 

ErikJ

(6,335 posts)
10. Deductibles can wipe you out. Mine's $10G's.
Mon Oct 15, 2012, 02:32 PM
Oct 2012

And they have been slowly increasing deductibles along with insurance premium costs. The reason I chose high deductible is because I will go to Thailand or Costa Rica for much, much cheaper out of pocket treatments.

 

HopeHoops

(47,675 posts)
11. It's the hospital stays and MRI, CT, blood, and other tests that do me in.
Mon Oct 15, 2012, 02:52 PM
Oct 2012

I'm in the "high risk" category. Even AFTER the deductibles, I get bills and after 30 days the collection agency vultures start mailing and calling. I just tell them to fuck off. I won't feed that system. I'll pay the bills directly to the hospital, lab, or ambulance service and cut the vultures out of the loop.

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