As far as I can tell, medical personnel are not required to stop and give care. In fact, I remember being told in medical school that we were usually protected from liability under good samaritan laws as long as you don’t charge, but there is no requirement to stop.
Prior to 1986 you had the Hill-Burton Act (1946) which provided funding to hospitals for new construction and improvements. Hospitals receiving such funds were required to provide an (ill-defined) amount of free care for 20 years after receiving funding. The law was amended in the 70s, making it forever instead of 20 years, among other changes. I’m having a hard time finding all the details at that point, but my understanding is that they had something like a quota system.
Doctors specifically are under no obligation whatsoever to stop and assist in an emergency. The vast majority would be useless anyway both due to the nature of their training and lack of equipment. Also, EMTALA applies to hospitals, generally speaking. Show up bleeding at a doctor’s office or his doorstep and they aren’t really obligated to do anything aside from call an ambulance, for much the same reason.
A lot of things people would consider a medical emergency are not considered emergencies by medical professionals and the law. If you break your leg, you get a splint. It doesn’t mean anyone has to operate on you to fix your bone. If you have colon cancer, same thing. Chemotherapy doesn’t count. Neither does radiation. Any elective surgery, by definition, doesn’t either. If you have stomach cancer that’s not an emergency. If you have stomach cancer that hurts a lot, it becomes a borderline case. If your stomach cancer perforates and you go into shock, that’s an emergency.
More importantly, many hospitals don’t have the necessary facilities or personnel to deal with certain problems, so they can pawn you off on someone else even if it is an emergency. If you have a rupturing aortic aneurysm for example, the local hospital might not have a surgeon who can deal with it. Or maybe he finds out you have no insurance, or he just doesn’t feel like doing it. He can say, “Hmm. I don’t feel comfortable treating this condition. You know who’s a real expert? The guys down at the county hospital/trauma center.” And the patient gets transferred there. There’s usually one or two centers in any given region, often a teaching hospital, that becomes the de facto dumping ground for these types of cases.
Now, there are generally mechanisms in place to deal with indigents who have life threatening but non emergent conditions. But never forget: they still send you a bill. Depending on the health care system/doctor involved, they know they probably won’t get paid, and they may or may not make efforts to collect, but if they do, it can still tank your credit in a hurry.
All this is very interesting and answers a lot of questions I had. A friend in Vermont sent me a propaganda film that spent 50 minutes tearing down the Canadian single payer system that has been proposed for Vermont. While many of the criticisms were correct, they don’t compare with the problems in the US system. Yes, you can wait months, even years, for elective surgery. And hours in the ER. But the ER will do a quick triage and a real emergency will be treated quickly. I waited hours when I broke my leg, but there was no real emergency.
But, whether it was a heart attack, stomach cancer, or broken leg, you get the treatment you need and there is no question of paying.
Not necessarily. Creditors can’t get blood from a turnip, and a lot of uninsured people are essentially judgment proof…ie, a collection lawsuit will result in a judgment in favor of the creditor, but the debtor has no non-exempt assets which may be seized and sold to satisfy the judgment. Those that are not judgment proof might file bankruptcy. Medical bills are unsecured debts, and dischargeable in a Chapter 7. In a Chapter 13, the creditor might get pennies on the dollar if anything.
and you pay double, if you drive someone into bankrupcy or whatever behavior that results from living under such a mountain of debt, society pays in the end regardless. you lose a productive citizen to the effort of dealing with insurmountable debt.