Should a public hospital have to treat anyone who comes in?
Posted at 6:00 AM on November 23, 2009
by Eric Ringham
(26 Comments)
Filed under: Economy, Health
Hennepin County Medical Center has announced that, due to budget cuts, it will stop treating uninsured people from outside the county except in emergencies. Should a public hospital have to treat anyone who comes in?
Comments (26)
This question illuminates the elephant in the room of the health care debate. If I may paraphrase a Mitt Romney comment; We already have 'universal' health care. We just provide it too late and in the most expensive manner.
As a previous commenter mentioned, theEMTALA law prevents anyone being turned away in an emergency room.
That does not mean people may have to wait for four hours, but they will be treated.
HCMC pts from other counties may not be seen at clinics, but they will have to be treated if they come into the emergency room.
This, of course, raises health care costs for everyone as the hospital eats the costs and tries to compensate with other payers.
Simple preventative measures, like drugs for psychiatric pts who depended on the funding that Governor Palenty just cut may keep people out of the emergency room and functional instead of a threat.
Do you want the person sitting next to you on the bus to have TB because he is untreated?
Don't you want your neighbor who needs his psych meds to have them instead of being paranoid and threatening to himself and others?
The old saying, "A stitch in time saves nine."
goes a long way in health care.
Your own health sometimes depends on those around you.
Well, duh. OF COURSE! It would be morally outrageous to not do so. We just have to raise taxes on upper income people.
I'm torn. I live in Hennepin County and pay taxes to support HCMC why should I be paying for people from other counties? Shouldn't they go their own county hospitals? On the other hand, treating the ill is a good public health goal. I think I would like to hear more about the types of injuries or illnesses of those out of county patients.
Still, this is what happens in an economic meltdown.
HCMC is an amazing hospital that has benefitted from its ability to treat those patients that aren't the highest insured. As other area hospitals have chosen to decrease their patient population due to various reasons in the past decade, HCMC has continued to be a premier hospital in part due to the dynamic and diverse clientele to whom it provides top medical care. Outside of the advances in medicine that HCMC has been able to make because of the situations and population that it has served, those in Hennepin county, Minnesota, and all those that put stake in the practices of modern medicine have benefitted from the mission, vision, and creativity of the individuals of HCMC.
It is an unfortunate day when the decisions regarding what factors allow a doctor, a hospital, or a community to determine who is a legitimate patient are being made by less creative, innovative, and compassionate individuals acting under the facade of balancing a state budget.
Though I do not hold HCMC accountable for their decisions and need to adopt different practices in this time of crisis. Much of their budget has been cut and continues to be in jeopardy, as the slow institutional changes have been implemented over the last five years that make this decision less in the hands of the medical professionals, the county - and more in the hands of the elite few. I am sad to see this story covered in a tale of balancing the ins and outs as related to a dollar equation that HCMC is facing. Why aren't we covering the more holistic sacrifices that we as stake-holders in our medical services, our community, and a civilization are making to justify oversights in sustainable state fiscal responsibility?
Should the public library provide information to anyone who comes in and needs reference assistance?
Should the police serve and protect only some of those who may seek their help?
Other developed countries are able to figure out how to provide healthcare to all without regard to whether or by whom they are employed. Funny thing is that they are able to do so and still pay the professionals providing care appropriately.
Only in America, it seems, do we question whether an individual is worthy of care and formulate elaborate schemes for blaming and taxing the unfortunate for their plight. Only here do we ignore the massive tax subsidy enjoyed by those whose employers foot the bill that allows them to obtain insurance tax free and then complain about the burden placed upon them by those who are not entitled to such subsidy.
Only in America do we waste so much money that should be going into care on such a highly inefficient payment system. Other countries simply do not shoulder the crippling cost of employing hundreds of thousands if not millions of individuals in order to provide a payment mechanism for their healthcare systems.
Only in America is everyone taxed in order to pay for the healthcare of government workers and subjected to additional hidden healthcare assessments hidden in the cost of just about every good and service they purchase, but many are denied the same level of care that they fund for others. The uninsured pay for care but receive precious little in return.
What good is an advanced healthcare system if it is too expensive for people of ordinary means to access? Our mechanism for funding healthcare is broken and will remain so even after anything likely to emerge from Congress is passed.
In our local/sustainable efforts, maybe we can broaden the definition of "pay". Treating everyone then becomes easier. Build in work-it-off options and take trades for payment. This will require much more from our accountants, but may also make public hospitals better rooted in its public.
Of course hospitals should treat all who come to them. We have 'Christians' holding up health care reform over abortion because abortions aren't in line with their religious values. Why do I not see these same Christians demanding health coverage for all as vociferiously, when Christ very clearly implored his followers to care for the sick and the poor?
The response is not so easy as some would have it. HCMC says they will continue to accept emergency patients, even if those patients cannot pay. If we expect them to cover all patients, all the time, should I be able to cancel my insurance and rely on HCMC to care for me, whether or not I am able to pay?
I wonder if there's more to this story than can be covered in a 'question of the day.' For instance, are other hospitals dumping on HCMC when patients show up at their facilities for care? Is HCMC the first facility to take this step, the last, or somewhere in the middle?
Sadly, the fact we express this question shows what a dog eat dog society we have. We have a right to life. Living requires health care, requires treatment when we are sick. Yes, hospitals need to be able to pay their bills, but when did it become so difficult to do? It is fashionable to 'look out for number one.' When number one is sick and can't get heath care, the tune changes fast. We need to be able to be independent, but that's not so that we stand alone; it's so we are able to stand responsibly within a community. One of those responsibilities is providing care when someone shows up at the hospital!
So the question is "should a public hospital have to treat anyone who comes in?"
That depends. Do we want to live in a civilized country?
I think that, rather than inviting an answer, this question is useful for revealing the depth of the problems with our health care system. Of course I believe all humans are entitled to health care! Of course I also believe that hospital workers ought to be paid a living wage, and that a hospital can remain financially solvent.
I am deeply saddened by the hospital's decision, and would like to believe that, were I an administrator there, I would have dealt with the financial crisis in another way.
Of course they should have to treat anyone that comes in. I don't want to know anyone who would stand at the front doors of a hospital and say "I'm sorry, please leave."
Once you determine health care is a right you demote those who provide health care to slavery. Whether it is a for profit hospital, charity or private citizen. Do hospitals and doctors have a moral obligation to treat people regardless off ability to pay? Yes. Do we as a society have a moral obligation to assist in this process? Yes. But substituting legal rights and requirements for moral obligation ends in failure.
How can a hospital work if they can't pay their staff? The public hospitals are not fully funded by the state. If they can't recuperate their costs they have to turn patients away.
I guess we will be able to find out in March when the Governor's reduction in health insurance for the poor takes effect. It's been said that an indicator of a civilized society is how well it takes care of those less fortunate. What does this say about us?
When I was young most hospitals were run by charitable organizations such as the Catholics and Lutherns hench the reason so many hospitals carry names like St. Lukes, St. Marys, St. Joes, etc. Danny Thomas was most noted for his children's hospitals. Here in Mankato the first hospital was donated by a Civil War officier by the name Tourtelotte. When hospitals were run by charity no one was turned away. Then big business bought them all up and now we have what we have.
I'm secretly hoping the current healt care reform effort fails, so that there will be an abundance of crises precisely like this. Then maybe we'll finally learn that the Free Market (good as it is for some aspects of the economy) is incapable of providing access to quality health care for all. What it takes is MORE government involvement. Either the system must by highly regulated, or the government must run the system; otherwise, Big Business will use it to extract all the profits it can from sick people.
It's not rocket science. Dozens of other countries are doing it successfully, but we refuse to learn from their examples. We need to swallow our pride and admit that America does not have a monopoly on all the good ideas.
Should restaurants and grocery stores be required by law to give food to the hungry? Or hotels and apartments be required to offer shelter to the homeless? Where does it stop?
No easy answers to be sure, but what percentage of an individual's time and money should be dedicated to others besides his family and friends and the groups they choose to help?
Yes, of course. Look at this example. You are traveling out of the country and you get sick. It's not an emergency, but sick enough to go to a doctor. Your private health insurance card is denied by the hospital because they cannot verify it is a valid account. Would you demand to be treated? Of course you would. In civilized countries around the world this scenario could never happen. It is only in Minnesota that this is even considered. Some say we have the best medical system in the world. Obviously, they need to be educated as to the truth. We don't, not even close to it. One political leader of this state,Governor Pawlenty, has created this situation, and pathetically failed us to gain favor from the King Makers of the GOP.
I believe there SHOULD be public hospitals and clinics which treat anyone at a fair price, whether they have insurance or not.
The tricky question is whether this should include those who live outside the county. Presumably, if it is county taxes that pay for hospital and clinic shortfalls, then out of county individuals without insurance and who cannot pay the "fair amount" should not be treated. HOWEVER, I don't think that local taxes supplement public hospitals and clinics.
Insurance reform would even out prices to hospitals and clinics and costs to individuals. Insurance reform, might mean less bonuses for those who work in the insurance industry.
The fact that we can discuss this with a straight face shows just how out of line, politically and morally, we are from the rest of the developed First World. In Britain, France, Scandinavia, Italy...most people would not be able to take the question as a serious one.
I am not sure why this is up for debate. How could we think turning away patients is acceptable?
Of course they should. The idea that health is a privilege reserved for those who can afford health insurance is appalling to me. Regardless of what county someone is from, Americans deserve to be healthy.
Yes. EMTALA.
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