Is it true that if you refuse to buy insurance, you won't get emergency room service?

[apples and oranges]

I heard some people talking about this today. They basically said that anyone who ignores the mandate will be turned away if they show up at an emergency room. Is that true?

[pinto]

1. No.

:hi:

[Donnachaidh]

5. you really don't think hospitals will use the mandates as an excuse to turn people away?

They look for excuses now - I can see all sorts of problems for those 17 million who will not be covered by this bill. Starting with the medical community saying *tough shit* to those people. And using the mandate as cover.

[pinto]

13. No. It's against the law to turn anyone away from emergency care.

:hi:

[Go2Peace]

38. That's not true. Private hospitals can. Non Profit hospitals cannot refuse

[Doremus]

42. Not if the patient isn't stable.

Even private hospitals cannot turn away an emergency if the patient isn't stable enough for transport.

[cbayer]

49. EMTALA is a strict federal law that applies to all hospitals that have emergency rooms.

Private, public or not profit, it is illegal to turn away a patient that presents without giving them an examination and stabilizing treatment. You can't even ask them about their means of payment.

What you are saying is not accurate and you should report to the feds any hospitals that you know have turned away patients from the ER because they could not pay.

[apples and oranges]

52. Hospitals regularly break that law. It's nice to know there are

laws against it.

[Go2Peace]

55. They must, I have read about people in serious condition being refused and sent to another hospital

how long ago was that law made?

[TexasObserver]

46. The net effect will likely be for-profits increasingly turning away uninsured.

Also, it will likely prevent many of the poor from going to some ERs, if they think they might be given a citation for failure to have insurance. Anyone who thinks we will cite and fine people for not having mandated auto insurance, but not end up doing likewise with mandated health insurance is probably wrong.

[Richardo]

2. What do you think?

Really. Sit and think for two minutes.

[harun]

3. No.

[cbayer]

4. Completely untrue. EMTALA, the stringent law that governs patients presenting

to an emergency room, will still rule.

[Donnachaidh]

9. that's in the bill? the new bill? n/t

[cbayer]

16. No, EMTALA is the law now and will not be changed as part of this bill.

It requires all emergency rooms to provide medical examinations and stabilizing treatment for anyone who presents to them.

[Go2Peace]

39. Including "for profit" emergency centers? I thought it only affected Public or non-profit?

[Sgent]

45. It requires all emergency rooms

that are part of hospitals (not freestanding centers) which take Medicare or Medicaid to treat everyone who shows up -- regardless of non-profit / for profit status.

If the hospital doesn't accept Medicare/Medicaid they can turn people away, and if its a free standing "emergency center" they probably could depending on the relationship with the hospital.

Also, EMTLA only requires a screening exam to see if your stable, and only requires treatment until you are.

[Brickbat]

6. What do YOU think?

[spanone]

7. yea, the bodies will pile up at the entrance to emergency rooms..stinking rotting corpses

:sarcasm:

[OneTenthofOnePercent]

8. No... but I think, if uninsured, you should receive a bill for the ER visit.

Of course emergency services should be provided. Worry about the money after the care is given.
If you don't have insurance, YOU pay the bill. Not negotiable or waiverable.
This policy should go for EVERYONE in the coutry too. Not just the American citizens.

[Donnachaidh]

11. and if you are one of the 17 million not covered by the bill?

You send them a basic *fuck you, pay the bill*?

Nice.

Welcome to the NEW corporate America. Title for the new anthem - "Fuck You - I've got MINE"

[OneTenthofOnePercent]

14. What 17 million?

There is a mandate for affordable insurance.
If one can't afford insurance then there is a subsidy availble to pay the insurance.

As far as I know, everyone is required to have insurance under the bill.
People who choose to pay the fine and self-insure should be able to afford the ER bill.

[Raineyb]

18. The mandate is for insurance. There's no guarantee you can actually afford it.

There are no cost controls, nothing to keep insurance companies from charging you more for preexisting conditions and a loophole to allow them to not pay based on "fraud"

Oh and after shelling out money for the cheapest insurance you'll still have to shell out thousands of dollars in co-pays and deductibles.

Your definition of affordable needs work.

[cali]

26. Under this legislation primary care at NO cost or at what you can afford

will be expanded for millions of people. That include diagnostic care, mental health care and dental.

[Raine]

54. EXACTLY nt

[Donnachaidh]

23. do the Math -- approximately 46 Million w/out health Insurance

this bill being pushed only covers 30 milion -- that leaves approximately 16 to 17 million with NOTHING.

Math is a silly thing, but should be applied when purchasing (or being sold) something. :sarcasm:

[OneTenthofOnePercent]

Well then, perhaps the bill should have been a little more comprehensive.

I am really not a fan of this bill and would loose no sleep if it gets shitcanned so they start over.
The american people thought they were voting for universal healthcare... silly them, what were they thinking. :eyes:

[MattBaggins]

30. I also agree with you

An affordable public option should be available. My belief that people who opt out of insurance should be given a bill for services is predicated on a true public option existing.

[frazzled]

36. 8 million of those are illegal immigrants

Whether you agree with excluding illegal immigrants from the subsidies or not (and personally, I wish they could be included), there is no way in hell Congress is going to pass a bill that gives tax subsidies to undocumented workers. That's just political reality in this country.

I do agree with Luis Guiterrez and others that they should at least be allowed to buy into the exchanges with their own money (no subsidies).

So really, we're talking 8 million out of 300 million people. That's actually 97% coverage. The 3% who won't be covered include people who qualify for Medicaid but don't apply; people who pay the fine instead of getting the insurance; and (the unfortunate ones) people who are excused from getting it because, even with a subsidy, it will amount to more than 8% of their income.

[Go2Peace]

56. I don't consider a 30 or 40% copay "fully covered".

Many people will be forced to buy those from the exchange. I was surprised to see such high deductable alternatives even being offered. Anyone who has had to spend a night in a hospital knows that one stay at that rate of copay could bancrupt many.

[napi21]

15. Oh...EVERYBODY DOES get a bill! Wether it's s for your copay

or the entire bill, you'll get a bill. The problem is that most people just don't have any $$ to pay it! All those costs that the hosp. has to write off when there is no other alternative have to be covered by somebody pr all the hosps would close down, so all of those insured have to pay a % of those costs.

[MattBaggins]

27. This should be the case

If you refuse insurance you should receive a full bill for services. That should be backed up with those individuals waving bankruptcy protection. Perhaps there should be a waiver if people can show that they have HSA at a certain reasonable funding level to handle emergencies.

[Raineyb]

35. And if they couldn't afford the insurance you think they can afford the bloody bill for services?

People are uninsured because THEY CAN'T AFFORD THE INSURANCE. Medical bankruptcies occur with people who have insurance put the co-pays and deductibles (not to mention the occasions when the insurance companies up and refuse to pay) eat up all their money.

This bill doesn't change that.

You can make it against the law to not have insurance but that doesn't change the fact that if I don't have the money for premiums I won't have insurance.

[MattBaggins]

40. I stated upthread that I would suggest only with a true public option in place.

[Raineyb]

51. But this bill doesn't include that. n/t

[mdmc]

10. no

[DesertFlower]

12. i had to go to the emergency room last year.

i waited almost 3 hours. during that time no one asked for my insurance card. they asked when i was in a room with an IV in my arm.

[apples and oranges]

17. I think latinos are more likely to be asked for insurance

prior to getting care.

[DesertFlower]

31. i found it interesting that there

was only 1 latino in the emergency room. she was a teenage girl who was with her boyfriend.

[Heddi]

47. It is a violation of EMTALA laws to ask for financial information prior to treatment

regardless of race. In many hospitals, registration (the people who care about insurance) aren't even notified of the patient's status of being in the ER until they've been IN A ROOM and SEEN BY THE DOCTOR.

[Raineyb]

19. Last time I went to the emergency room they damn sure asked for my insurance. n/t

[MattBaggins]

33. What were they going to do if you said you had none?

[Raineyb]

34. Charge the shit out of me I'm sure.

They do charge the uninsured something like 4x what they bill the insurance companies. The assertion was that they don't ask for insurance at the emergency room. That is a crock.

[cbayer]

50. If they asked you for this prior to providing a screening examination, you should report them.

It is a violation of federal law to do so.

[peace13]

22. I hope you are doing better today!

:) Oh sorry, I read that as you went to the ER last night!! Better go get my brain checked!

[DesertFlower]

28. lol. that happens to me all the time.

[DesertFlower]

29. self delete. dupe

[stray cat]

20. No - you and I will still have to pay for those who decide not to get insurance

the mandate just means a fine. I think people should instead be able to sign a do not treat order instead of having a mandate.

[Bluenorthwest]

32. You do understand that unpaid hospital bills are like any other

in that they go into collections, and are pursued with vigor. Those that do not pay those or other bills suffer the same results, bad credit. Every service you use, from telephone to financial products cost more because of those accounts which go delinquent.
You and I no more pay for others to have strings free health care than we pay for people to not pay their electrical bills. Which we do. But those who do not pay do not go without repercussions, and those bills are collected just like other bills.

[apples and oranges]

53. That's if you provide your real info to the hospital

Fake name/fake social === no bill

[Statistical]

21. No. It currently is illegal for Hospitals to turn people away and Senate bill doesn't change that.

The Hospitals claim this is why mandates are needed.

While some future legislation may change this as of now Hospitals are required to provide Emergency Room care.

Also can you imagine how difficult that would be to implement?
Person gets robbed, double gunshot wound. No wallet, no ID. Are you going to run his prints? DNA? against some big brother database to see is he rufused insurance and then let his corpse cool slowly in the waiting room?

[Ozymanithrax]

24. No. Emergency rooms are required by law to treat people

If you are not among the working poor and their families who qualify for Medicaid, among the millions who purchase health insurance through work plans, among the millions who purchase health care from private plans because their companies do not supply it, one of the unemployed who use Cobra while between work, a veteran, and you just don't buy health insurance because you bet your too healthy to need it, then you will pay a fine at tax time.

Emergency rooms, by law, must help you if you come to their door. Because you choose to pay the fine at tax-time, you will get health insurance once the mandate kicks in and that insurance will be paid by your tax fine.

[jobycom]

25. No. Just fewer uninsured people will have to visit the emergency room.

The way it works now is that a hospital can't turn away someone without insurance at the emergency room, so people without insurance go to the emergency room for every minor ailment. They have the flu, they go to the ER claiming they have chest pains. They frequently give false names, so the hospital can't send them a bill.

So not only do hospitals get stuck with the bills, but the bills are exagerated since the patient really only needed minor care. Worse, the ERs are clogged with patients needing minor care and they can't get to the people with genuine emergencies. You might remember a case a couple years ago where a woman died of a ruptured organ in the ER because the nurses thought she was faking? That's why it is so often assumed they are faking, because the normal routine is to exagerate symptoms to get attention.

Universal Health Care (which isn't really on the table, but anything that gets us closer to it is a good thing) would cost so much less than the current system. It's a shame conservatives don't get it, because they could really save this nation a lot of money, elevate our hospital care, and do the right thing for people by supporting UHC. But, you know how they are--penny wise, pound ignorant.

If people had full coverage, there would be fewer ER visits, hospitals would be more efficient, and even rich Republicans would get better care and lower taxes. And those not covered by a plan would still take advantage of the system, but there would be fewer people in that category to do so. You can't turn someone away from the ER. Only an uncivilized nation would do that. And despite the eras of Bush and Reagan, we are trying to become more civilized.

[Bill McBlueState]

37. blah

There may be good reasons to be disappointed in this bill, but mandate paranoia is not one of them.

[SoCalDem]

41. "...some people talking..." = key phrase..

Until the ink is dry and the plan implemented, we won;t know for sure what is included and what is not.

In a hospital that has an ER, I can't really see them turning people away who need care..

This plan pre-supposes that npot ALL uninsured/covered people will end up with coverage, so I'm pretty sure there will still be uninsured patients, and those people will enter hospital-billing-hell..just as happens now....but they probably will get the life-saving care.

[nadinbrzezinski]

43. You mean go back to the 1980s? That was what happened back in the 1980s

and people died.

That would mean repealing the laws that made that practice illegal.

[Love Bug]

44. Sounds like right wing talking points to me, like "death panels"

[Heddi]

48. I encourage everyone in this thread to read up on EMTALA laws

This law states that if an emergency room receives medicare/medicaid reimbursement, that they are required to do certain things:

1) they are required to treat and stabalize anyone who is suffering from a medical emergency
2) they are required not only to treat and stabalize anyone who is suffering from a medical emergency, but they are required to transfer the patient to another facility of the one the patient is at does not offer services needed (trauma, burn, pediatrics, OB, psych, etc)
3) they cannot deny care to anyone because of inability to pay
4) they cannot use ability or inability to pay as a way of prioritizing care
5) anyone presenting to the ER has the right to a medical screening exam to determine whether they are suffering from a medical emergency.

I am an RN in a busy little ER, and I am well versed in EMTALA laws.

The hospital that I work for now has a system in place where registration (the people who collect insurance information) aren't even aware of the patient until they have been placed in a room and seen by a MD. That way there is no way that anyone could infer that they were treated/not treated because of ability/inability to pay. Many other hospitals follow this system or one similar to it as well.

http://www.emtala.com/

http://www.emtala.com/faq.htm

http://www.cms.hhs.gov/emtala/

http://en.wikipedia.org/wiki/Emergency_Medical_Treatment_and_Active_Labor_Act

[saltpoint]

57. Yes, it's true. Even if somebody is mortally wounded and screaming

in pain so loud their skull bursts, if they haven't got insurance the entire emergency room staff including the janitor, will spit on them, collect outside in the admissions lobby and kick them and hurl derogatory remarks, then shove the person out into the gutter and leave them to die.

ABC television is rushing to complete a pilot for a revival series called MARCUS WELBY: HEARTLESS BASTARD.

[Lagomorph]

58. Not true....

...they'll stop the bleeding, stabilize your breathing and only then will they dump you off at a homeless shelter.

[FrenchieCat]

59. It's gonna be like the concentration camps.

and then, there's the death panels to worry about you know.... :sarcasm:

[eridani]

60. Not true. The IRS, however, will go after you n/t

[treestar]

61. No, but they'll have caught you and send you to jail

Those insurance jails are going to fill up fast.