Is it illegal for hospitals to turn away uninsured emergency victims?

[Sitnam]

And if not whats the legalese for that?

Also what percentage of insured peoples premiums go to cover the cost of the uninsured’s treatment?

[friedo]

Hospitals in the US are required to provide “stabilizing care” to emergency patients regardless of ability to pay. In fact, they’re not even allowed to inquire as to your insurance coverage until you are stabilized.

The relevant federal law is the Emergency Medical Treatment and Active Labor Act, part of the COBRA 1986 reforms. Many states had equivalent laws for the same requirement before 1986, however.

[Kent_Clark]

According to this (warning: pdf) “uncompensated care” cost $40.7 billion in 2004. Subsidies from federal, state and local governments accounted for $34.6 billion – about 85%.

That left $6.1 billion which caregivers (mostly hospitals) had to get from paying patients.

I can’t find a nice, neat stat that tells what percentage of your insurance goes to cover that nut. By interpolating various figures, it looks like private health insurance accounted for $482 billion in health spending in 2004, of which roughly 1/3 goes to hospitals. That’s about $160 billion, which means roughly 4 percent of your hospital insurance payment goes to uncompensated care.

But there are many different ways to frame the numbers. If there were no uninsured patients, then there wouldn’t be any need for that $34.6 billion in tax subsidies. If more people had insurance either privately or through employers, there would be fewer patients on Medicaid, which is also subsidized by taxpayers.

Does anyone have more current (and accurate) numbers?

[Cliffy]

The number the Dems were throwing around on the House floor this weekend was $1,100 a year for the average person. (Average family?) Which in fact sounded kind of low to me.

–Cliffy

[Kent_Clark]

How about that. $34.6 billion in taxpayer subsidies works out to very nearly $1,100 for the average person.

[outlierrn]

I won’t know if you have insurance or not unless you tell me, even if you do, I’ll refuse to accept you cards until after we’ve cared for you.

I don’t have an answer for your last question, but a more alarming stat would be how much the uninsured that don’t default have to pay for those that do. Insurance co. and medicare negotiate a percentage of the bill they recieve, private pays are on the hook for the full (some would say inflated) amount.

[loshan]

how much the uninsured that don’t default have to pay for those that do. Insurance co. and medicare negotiate a percentage of the bill they recieve, private pays are on the hook for the full (some would say inflated) amount.

Want evidence of how much more? I received my final bill for a 7 day stay in the hospital back in January today.

Total bill from this hospital - $38,808.76
Total Insurance payments - $14,988.06

That’s $23,320.70 I would have had to pay if I had no insurance. :eek:

As it stands now, I owe a $500 copay.

[md2000]

@loshan

Want evidence of how much more? I received my final bill for a 7 day stay in the hospital back in January today.

Total bill from this hospital - $38,808.76
Total Insurance payments - $14,988.06

That’s $23,320.70 I would have had to pay if I had no insurance. :eek:

As it stands now, I owe a $500 copay.

Just curious - how much of that was an actual operation, and how much just lying in the hosiptal and getting dressings changed, nurse care, etc.? You can see why it’s probably cheaper to go home as soon as the doctor doesn’t need to look at you, and have a full-time nurse come in with retail medical supplies… One clinic I heard of many years ago put up their non-critical patients in a 4-star hotel across the street with nurse visits, because it was cheaper.

[John_Mace]

Note that:

EMTALA applies to “participating hospitals”, i.e., those that accept payment from the Department of Health and Human Services, Centers for Medicare and Medicaid Services (CMS) under the Medicare program. However, in practical terms, EMTALA applies to virtually all hospitals in the U.S., with the exception of the Shriners Hospitals for Children, Indian Health Service hospitals, and Veterans Affairs hospitals[citation needed]. The combined payments of Medicare and Medicaid, $602 billion in 2004,[2] or roughly 44% of all medical expenditures in the U.S., make not participating in EMTALA impractical for nearly all hospitals. EMTALA’s provisions apply to all patients, and not just to Medicare patients.[3][4]

So, it’s not so much that it’s illegal, but that it’s a pre-requisite to getting federal funds under the listed programs. Sort of like states having to keep the drinking age at 21 or else lose federal funds for highways.

[Hari_Seldon]

The theory behind the fact that insurance companies pay only a fraction of the bill is that payments are guaranteed (when they pay, which didn’t used to be an issue). So it is likely that none of the current insurance payments can be attributed to what the insurance companies pay.

It is important to understand that once you are stabilized, you can be turfed out if you cannot pay your bills.

[outlierrn]

@Hari_Seldon

It is important to understand that once you are stabilized, you can be turfed out if you cannot pay your bills.

I’m not saying it doesn’t, but I can’t remember the last time I saw that happen.

[The_Great_Philosopher]

@kunilou

How about that. $34.6 billion in taxpayer subsidies works out to very nearly $1,100 for the average person.

Victory! This health care stuff is easy after all.

[The_Great_Philosopher]

Since the thread is basically answered: I’ve always found it odd that doctors, nurses and hospitals haven’t pushed harder for insurance reform. After all, these people have gone into their profession because they want to help people, not refuse to help them because they can’t pay. Who wants to be the guy that has to say, “I know you need fairly urgent care, and yes I’m qualified and equipped to provide it, but unless you pay me, you need to get out”?