In 1986, the Emergency Medical Treatment and Active Labor Act declared that hospitals cannot refuse care to critically ill patients and that an on-call physician must treat them. While this sounds great in theory, it doesn't quite work out this way in practical terms.

Some doctors have reported that up to 20% of the patients they treat at hospitals are uninsured. So what does this mean for these patients? It means unequal treatment. It means that they get shorter consultations with doctors, which could lead to inadequate care.

A 2006 study conducted among physicians reported that 90% of them admitted to changing patients' clinical management based on their insurance status. In some ways, this decision has a negligible effect, such as opting for generic versions of drugs as opposed to more costly name brand varieties.

But what about the heart surgeon who schedules uninsured patients last and regularly bumps them to the next day if his insured patients take longer than expected?  It’d have a detrimental effect on patient health. Or how about the gastroenterologist who routinely is quick to perform colonoscopies on insured patients, but is very reluctant to do so on uninsured patients? You’d think that the Hippocratic Oath would outweigh the profit motivation in modern medicine, but surprisingly in many cases you would be dead wrong.

Not only are uninsured patients regularly discriminated against by doctors, but they are also less inclined to do recommended tests and treatments. Another study, this one conducted in 2003, found that patients without health insurance were 30 % less likely to undergo routine screenings. Over the long run this means that illnesses that could be corrected early or managed with medication are left untreated and eventually become life threatening and expensive to treat. This puts a tremendous burden on our nation’s resources at a time when we can hardly afford it.  

The fact of the matter is that in America we have 47 million people without health insurance. When we consider the current economic climate, with thousands of people losing their jobs and thousands more losing their employer-based health insurance, this figure is sure to rise. We need solutions to this crisis immediately -- and emergency room care is not the answer.

For complete article: http://www.washingtonpost.com/wp-dyn/content/article/2008/10/10/AR2008101002679.html?nav=rss_health

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