By Samuel Metz, M.D.
Health Affairs, Letters, October 2012
Sara Rosenbaum and coauthors describe one hospital’s unhappy experience with “patient dumping” (Aug 2012). The primary motivation behind hospitals’ aggressively transferring emergency patients to other facilities is to rid themselves of nonpaying or low-paying patients. The authors conclude with suggested steps to enhance provisions of the Emergency Medical Treatment and Labor Act (EMTALA), intended to prevent such practices.
Not discussed in the article was one method to reduce, if not eliminate, patient dumping: a universal health care plan. Vermont enacted legislation to create a statewide universal health care program; once fully implemented, the system will render every patient a paying patient and reimburse providers equally for all patients.[1] Under these circumstances, there will be little financial gain from patient dumping.
Statewide single payer systems for publicly funded universal health care are advocated in many states, including Colorado.[2] Should Colorado be fortunate enough to pass such legislation, the procedural suggestions of Rosenbaum and colleagues would be rendered unnecessary. Indeed, EMTALA itself would be unnecessary.
NOTES
1. Hsiao WC, Knight AG, Kappel S, Done N. What other states can learn from Vermont’s bold experiment: embracing a single-payer health care financing system. Health Aff (Millwood). 2011;30(7):1232–41.
2. White CR. Background of a Colorado draft proposal for single payer health care [Internet]. Lakewood (CO): Health Care for All Colorado Foundation; [cited 2012 Aug 28]. Available from: http://healthcareforallcolorado.org/?p=955&ID=343&d=1
Health Affairs, October 2012;mar 31:2355; doi:10.1377/hlthaff.2012.0950
http://content.healthaffairs.org/content/31/10/2355.3.full.pdf+html