Patient Dumping

     Currently, I am employed at a non-profit hospital which may have shielded me from the normal occurrence of what is known as “patient dumping”. Patient dumping is transferring a patient that is uninsured or does not have private insurance to a different hospital once stabilized. In my midterm report about misuse of the emergency department, we discussed the The Emergency Medical Treatment and Active Labor Act of 1986. The act was implemented to prevent transferring a patient with a potentially life threatening condition or injury before stabilizing them because of inability to pay or their type of insurance. According to the article written by Mrs. Galvin (linked below), the frequency of patient dumping for inability to pay brings up an issue of ethics whether they have a life-threatening, emergent need or not.

     If patient dumping is a national concern, what is our solution? Who will foot the bill if the highest quality hospitals perform services for those who are unable to pay? I think this brings up a few issues. The first issue is the cost of medical service and medications. How inflated are these services and what can we do to bring these cost down? Are hospitals overcharging our insurance companies and therefore causing us to pay higher premiums or are hospitals trying to make up losses they are accruing somewhere else? Some might believe that the answer to this issue is universal healthcare that is controlled by the government, which would lead to a higher level of regulation of medical cost. I don’t necessarily believe that this method is right or wrong, but healthcare in America makes up 20% of the GDP, while other countries use less than 10% of their GDP for healthcare. However, it is pertinent to mention that many of the countries with universal healthcare have residents who opt to purchase supplemental insurance for a higher level of care. Some other concerns mentioned are longer wait times, higher taxes and the motivation or lack of motivation of physicians to provide quality care.

     The second issue is cutting down waste. I believe most would agree that public education about health conditions, choosing a healthy lifestyle and using a primary care physician rather than emergency medicine would have a positive impact on our current healthcare cost. However, a lot of these services are offered by the local health department. So what is preventing individuals from using these local services? Sometimes, it is as simples as transportation or having insufficient room and staffing to support such a large population. What if, the local health department had primary care providers(PCPs) in house? If this service was provided would the wait time for an appointment be to lengthy and would this service become strained with overuse? Some would argue that the savings obtained from the use of a PCP over emergency medicine would afford multiple PCPs on staff to meet the demand.

    The last issue that I would like to discuss is the benefits offered to healthcare workers. Some might say that healthcare is expensive because doctors and specialist make too much money. Naturally, I would disagree with this idea, because doctor’s pay a surreal amount of money for education, often dedicating more than 8 years of their life to study, working an often long and erratic schedule with high premiums in liability insurance. However, there should always be a balance between money earned and the ability to enjoy one’s life. Maybe, ensuring that physicians could have a life outside of the hospital with a decent schedule would be worth a small pay cut. However, that is left to those willing to spend the time and money to become doctors.

    In summary, the issue is patient dumping which is the act of transferring a patient to a non-profit institution because they are uninsured or don’t have a private insurance. This must be done in compliance with the Emergency Medical and Active Labor Act of 1986, which prevents people with life threatening injury and illness being sent away before being stabilized. The common theme is that private hospitals do not want to foot the bill for these services and the question remains: is this ethical?

DQs:

Should there be consequences for patient dumping?

Should we move to universal healthcare or attempt to fix our current system?

Is it wrong for hospitals to not treat patients who are unable to pay? Should we expect them to take a loss? What would the consequence of this be?

Patient Dumping Article
US Current Healthcare Model
Pros & Cons Universal Healthcare