Archive for March 8th, 2014

by lizard

Ronald Reagan planted a bomb and it’s still blowing up hospitals. That bomb’s name is EMTALA:

The Emergency Medical Treatment and Active Labor Act (EMTALA) is an act of the United States Congress, passed in 1986 as part of the Consolidated Omnibus Budget Reconciliation Act (COBRA). It requires hospitals to provide emergency health care treatment to anyone needing it regardless of citizenship, legal status, or ability to pay. There are no reimbursement provisions. Participating hospitals may not transfer or discharge patients needing emergency treatment except with the informed consent or stabilization of the patient or when their condition requires transfer to a hospital better equipped to administer the treatment.

The recent closure of another Georgia hospital has combined modern day Republican cruelty of denying Federal medicaid dollars with a Reagan-era BIG GOVERNMENT mandate to just say yes to the uninsured.

The policy is one thing, the reality in the ER is something else.

Here in Missoula, I don’t think it’s a secret St. Pat’s ER is the triage center for the chronically homeless, especially during the winter. The combination of EMTALA and medicaid no-thankya from foot-shooting ideologues in Montana’s legislature will continue negatively impacting one of Missoula’s largest employers.

I have seen and participated in the burnout of useless triage. I have seen how difficult it can be to convince an ER doctor that the chronic drunk he’s seen a hundred times really might do it this time. Of course taking the drunk’s threat of self-harm seriously means waiting the time it takes to sober him/her up so that a mental health professional can properly assess risk. Today I learned if your BAC is around .3 that means about 8 hours in an ER bed.

Forget the whole bleeding-heart liberal appeal to improving services. Broken systems are incredibly expensive. It would be fiscally conservative to find a cheaper fix to what we’re doing now, right?




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