The Emergency Medical Treatment and Active Labor Act was passed by Congress in 1986. It mandates that hospitals provide emergency room care, with a number of caveats, regardless of the patients ability to pay. Given the status of American health care (nearly 20% of the population without medical insurance), it seemed like a pretty good solution to getting folks needed medical services.
The law has also serves, for some, as an arguement that health care reform really isn't necessary. The argument goes like this; while there's a big number of Americans without medical insurance, there are still provisions that allow them to receive medical care in emergency situations. The rebuttals to that argument are that emergency room treatments are most often a last resort and, thus, inordinately expensive and the costs of those emergency room visits are passed on to those that buy insurance, making premiums even more expensive.
A new study out today suggests there's another good argument that relying on the emergency room to treat those without insurance is a bad idea. From the LA Times:
An analysis of 687,091 patients who visited trauma centers nationwide from 2002 to 2006 found that the odds of dying from injuries were almost twice as high for the uninsured than for patients with private insurance, researchers reported in Archives of Surgery.
The research team from Harvard University and Brigham and Women's Hospital in Boston used information from 1,154 U.S. hospitals that contribute to the National Trauma Data Bank. The team found that patients enrolled in commercial health plans, health maintenance organizations or Medicaid had an equal risk of death from traumatic injuries when the patients' age, gender, race and severity of injury were taken into account.
The risk of death was 56% higher for patients covered by Medicare, perhaps because the government health plan includes many people with long-term disabilities, said Dr. Heather Rosen, who led the study while she was a research fellow at Harvard Medical School.
The risk of death was 80% higher for patients without any insurance, the report said.
As the Times article notes, there are lots of possible reasons for the higher mortality rate, including the general health of the person prior to the emergency room visit and the type of medical emergency. But the study makes it pretty clear that mandatory treatment by an emergency room isn't the solution to the health care crisis.
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