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During the healthcare debate leading up to the passage of the ACA, I was told by some sources that Hosptials have to treat anyone who comes into the emergency room, and that they often take a loss when some of those people can't pay the bill.

I'm also told that hospitals will turn you away and leave you to die if you can't pay.

There to it than this. Can anyone help me understand this discrepancy?

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    I'm tempted to go all-Skeptics on you and VTC for "I'm also told". Without knowing who told you, specifics, and circumstances and details, it's hard to evaluate the truthiness of the second statement. – user4012 Jan 3 '14 at 18:26
  • @DVK and for most visitors who are just curious, that would probably be enough for them to assume no, the claim that they heard on the TV the other day is not entirely honest and/or properly informed, and that should be enough to satisfy their curiosity. Is this not what Stack Exchange is for? – Sam I am says Reinstate Monica Jan 3 '14 at 23:09
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    @DVK THIS SITE IS NOT SKEPTICS... – Affable Geek Jan 4 '14 at 0:29
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    @AffableGeek - [citation needed] – user4012 Jan 5 '14 at 22:55
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    @DVK 'k, Here's the citation – Sam I am says Reinstate Monica Jan 6 '14 at 3:18
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The first statement is largely true, and the second one is largely false.

They hospitals can NOT "turn you away and leave you to die", but it only applies to (1) emergency conditions and (2) Hospitals with ER and (3) hospitals that get federal money, including via medicaid etc....

Emergency Medical Treatment and Active Labor Act (EMTALA)

In 1986, the Emergency Medical Treatment and Active Labor Act known as EMTALA (Section 1867 (a) of the Social Security Act) and sometimes referred to as the "Patient Anti-Dumping Act" was passed by Congress and signed into law by President Reagan. The purpose of the Act was to ensure that acutely ill patients who are uninsured or underinsured receive appropriate emergency care and to prevent hospitals from refusing to treat certain populations of patients who present to the emergency department. Although EMTALA was passed to protect those who lack financial resources or medical insurance, it applies to all seeking care from a hospital's emergency department in all states and territories of the United States. However, not all hospitals have obligations under EMTALA. Only hospitals that accept federal funds from the Centers for Medicare and Medicaid (CMS), a branch of the Department of Health and Human Services (HHS), are subject to civil liability under the Act. The CMS and the Office of the Inspector General (OIG) enforce EMTALA. The OIG can fine Hospitals $50,000 per violation ($25,000 for hospitals with less than 100 beds) and possibly terminate their Medicare provider agreement. Individual physicians also may receive a fine up to $50,000 and be excluded from future Medicare funding.

The "duty to treat" that EMTALA imposes on hospitals with emergency rooms that accept Medicare and Medicaid reimbursement begins when a patient comes to the emergency department seeking help. In addition to the emergency department, EMTALA also applies to other properties owned by a hospital, such as ambulances. To comply with EMTALA, the participating hospitals must provide within its capabilities a nondiscriminatory medical screening examination (MSE) to determine if the patient has an emergency medical condition. An emergency medical condition is defined as "a condition manifesting itself by acute symptoms of sufficient severity, such as severe pain, for which the lack of immediate medical attention could reasonably be expected to result in placing the patient in serious jeopardy, serious impairment to bodily functions, or serious dysfunction of any bodily organ or part." [Smith, JM, "EMTALA Basics: What Medical Professionals Need to Know," Journal of the National Medical Association 94,6 (2002): 426-429].

(src)

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  • What about this case, when a hospital cut off the ventilator that was keeping a patient alive because the patient's family couldn't pay the bill? www.slate.com/articles/arts/everyday_economics/2006/01/do_the_poor_deserve_life_support.html Wouldn't that qualify as emergency care? – Keshav Srinivasan Jan 4 '14 at 17:58
  • Who knows? If they didn't get successfully sued for that,i'm going to have to assume it doesn't qualify. – user4012 Jan 4 '14 at 18:21
  • The best shot of the article (I HAD to double check that I'm reading Slate and not Breitbart at that point): "At that point, there's a powerful human instinct to come to the rescue. Well, more precisely, there's a powerful human instinct to demand that someone else come to the rescue. I'm guessing that in the wake of the Habtegiris case, nobody at the Daily Kos has taken to funding ventilator insurance for the poor". – user4012 Jan 4 '14 at 18:30
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Hospitals are legally bound to stabilize a patient, but that is all; so many life-saving operations still will not be performed. There also have been cases where patients unable to pay were transferred repeated between different emergency rooms until they died.

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    [citation needed] – user4012 Jan 6 '14 at 12:18

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