Monday, August 07, 2006


There is a debate out there as to whether medical care is a right or a privilege. Immediately, most people would say it is a right, but the argument is much deeper than that. Currently, there is a health care crisis mainly because of this argument. Patients and the general public believe health care is a right, while many of those in the medical profession, from nurses to doctors to pharmacists, think the contrary. Here's the dilemma...

Right or Privilege:
If health care was a right of every person, every patient, US citizen or not, would have access to medical care - whether they could pay or not. Actually, this system is already in place at every state-funded university or teaching hospital in the nation. Due to EMTALA (Emergency Medical Treatment and Active Labor Act), emergency physicians and hospitals are FORCED to see and treat people who can't pay. EMTALA defined- any patient who "comes to the emergency department" requesting "examination or treatment for a medical condition" must be provided with "an appropriate medical screening examination" to determine if he is suffering from an "emergency medical condition". If he is, then the hospital is obligated to either provide him with treatment until he is stable or to transfer him to another hospital in conformance with the statute's directives. So, we as ED physicians and the hospitals that house us, are forced by law to see and treat patients who can't pay for services, and then are still liable for litigation by those patients when there is a bad outcome. I'm sorry, but if I am to be forced by the government to see and treat you, than the government should be liable, not me. Better yet, don't sue, be thankful your even getting care, and stop being a drain on society.

What is supposed to happen in this system is that people get their medical care and the government picks up the bill; however, in our current system, this doesn't happen. So, people get their free care and who pays? Nobody. The physicians and hospitals supply all their services (nursing time, equipment, supplies) free of charge. Basically, the hospital and physicians are giving charity care, which should not happen. The end result, hospitals have to overcharge patients who CAN pay for medications and supplies in order to partially offset the enormous costs of giving away care to the millions that can't afford it.

In the last decade, over 400 emergency departments have closed while the number of patients seeking emergency care has jumped over 10 million - leading to problems with waits for beds and boarding of patients in EDs. Now, in a monitary economy such as ours, you would think that with such a demand for emergency care, emergency departments would be springing up like weeds. Simply put, medical care, in selected areas throughout the country is socialized and free. It is the non-paying American public (citizen or not) who is driving American health care into the ground.

Health care is a privilege, not a right. Every person deserves care for actual medical problems, but with so many people actively abusing the system (getting free care for non-life-threatening problems and wasting our time) my sympathy on the matter is gone.


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