There shouldn’t be any controversy over President Trump getting the most prioritized of priority treatments for his Covid - he is the President after all, and governmental officials wield tremendous power and influence and their health or poor health can affect many people.
What I was curious about, though, was whether a U.S. hospital will get in legal trouble for putting a celebrity such as Brad Pitt ahead of others in priority - suppose some ethical dilemma where the hospital can either treat Pitt’s moderate injury now, or some ordinary average American’s urgent/serious injury now, but it’s a choice between the two. Will the hospital put itself in legal hot water by saying, “Well, we gotta go with the A-list celebrity even though his injury is less serious?”
Having worked with pharmacists who did things like always make Medicaid patients wait an hour for their prescriptions even if it wasn’t busy, it shouldn’t exist. Triage should depend on things other than how or if they will pay, or “who they are.”
Yes, it’s very much mostly legal. The laws relate to not adequately treating people at all. So if Brad Pitt comes in with a sprained ankle while a poor heroin addict comes in with massive blood loss who will be dead shortly if not treated immediately there will be legal consequences if they treat Brad Pitt while the addict dies. But if the addict has something that can wait a few hours there is no problem at all giving Brad Pitt priority treatment.
But when you are talking about healthcare favoritism with reference to non-hospitals there is massive economic favoritism. A large minority of providers won’t take Medicaid insurance and some won’t even take Medicare.
The better example for this question would be a comparison between CItizen Trump and President Trump. Citizen Trump could afford the latest and best healthcare and President Trump is entitled to it.
If Trump wasn’t President and just an ordinary Billionaire (please no political shots here) would he be allowed to have such an advanced personalized healthcare facility as he has as President even if he could easily afford it.
Whether this question is inherently political and not a GQ topic is a matter of opinion, but one way or the other, the answer is clear: the quality of health care in America is absolutely determined by money. Because access to health care is treated as a commodity: the more you (or whoever pays on your behalf) can pay, the better health care you get. If there’s any doubt about it, this ought to settle it:
Note that Trump’s access to treatment was not a financial advantage but rather regulatory favoritism. He was able to obtain waivers of FDA restrictions that an ordinary person (even an ordinary wealthy person) probably would not be able to.
While it’s clearly true the treatment you get in the US is based on your ability to pay. I don’t think that applies to the OP as its taking about ER care.
I’m sure Brad Pitt (and other v rich people) have a doctor on call, and all the other stuff described in that article. But if he ends up bleeding at the side of the road, hes not being brought to that doc’s living room. He’s going to the nearest emergency room, (I’m not even sure if the one he gets brought to would be different as he’s a VIP, as the fancy “country club” clinic prob won’t be a very good ER).
While in practice I’m sure he’d get to the front of the line. If it turns out it was a busy night and there was more urgent patients he was seen ahead. Might that in theory be something they could get sued over? IANAL. It’s seems like it would be a pretty hard thing to show in court. In real life there are lots of doctors making triage decisions, and one patient getting a blatantly favourable decision even if you could prove it, wouldn’t necessarily result in a delay in your care.
Sure, why not. If you’ve got the money to fully staff a hospital, buy all the equipment, and pay for its operating costs but want them just to hang out until you need them it may be dumb but ai can’t think of why you couldn’t.
From what ai can tell online having a level 1 trauma facility at your b3c and call costs about $10 mil per year. then up-front you’ve got another $1.5 million per bed though you probably couldn’t build a single bed facility and the level 1 trauma center ot seems that the average level 1 has about 30 ICU beds so that probably gives a minimum size. So $45 million up front and 10 million a year for life you can have the best trama care all to yourself as long as you don’t go more than 10 minutes from your facility.
You don’t even need them to be idle. Let them see patients. Just make sure they have a fully staffed and equipped suit of rooms for your use on stand-bye.
If the hypothetical Trump Medical Centre has enough to treat its expected patient load plus a little surge they don’t need much more than one or two additional pieces of specialised equipment plus some rooms and a small pharmacy.
Yeah but that won’t help Mikey Megabucks when he rolls into ER bleeding. Surviving a situation like that isn’t about getting the latest experimental drug flown in from a trial in Switzerland, its about being treated by an experienced medical team that has seen this exact injury 10 times already this week and knows exactly how to escalate it to a surgeon who has also performed this exact operation 10 times this week.
EMTALA is the law that requires Medicare-participating hospitals with emergency departments to screen and treat the emergency medical conditions of patients regardless of their ability to pay, insurance status, etc. It only applies to hospitals that participate in Medicare and have an emergency department. So if I’m billionaire and I want to set up my own private hospital with an emergency department just for me and my family/friends, I’m free to do that. As long as I don’t seek to participate in Medicare.
And while EDs generally treat in order of need ( heart attack goes before sprained ankle) ,it’s not uncommon for the waiting room to be filled with cases that can wait a couple of hours - and I’m pretty certain that’s where the favoritism comes in. Sure my heart attack will be treated before Pitt’s sprained ankle - but his sprained ankle will be treated before my sprained wrist, even if I was already waiting six hours before he got there.
ED’s do treat in order of need but there is some wiggle room as determining which patient needs assistance first is based on perception & opinion. I’ve moved to the front of the line before by simply telling the receptionist I feared my wife might be having a stroke (which was the truth). ER’s are also legally bound to treat everyone, regardless of ability to pay.
However, there’s another component which can trump which minor injury arrived first: HIPAA. Privacy rules are very strict and, outside of life or death situations, are always in play. If you are a famous person they will bring you into the ER before other non-life threatening injuries to attempt to shield your privacy.
I don’t think HIPAA requires them to shield your privacy to that extent - HIPPA applies to a celebrity the same as it does to anyone else and if HIPPA * prohibited leaving the celebrity in the waiting room , it would also prohibit leaving me in the waiting room. But I’m sure part of the reason a famous person wouldn’t have to wait would be to avoid a circus in the waiting room.
and HIPAA allows certain information to be disclosed under certain circumstances - for example, there is no general prohibition against calling patients in from the waiting room by name.
It’s not the same situation as you wouldn’t know my full name, occupation, etc. just by seeing my face.
It’s true they do allow names to be called in a waiting room but most places limit this to first name. Often both names isn’t enough to reveal the patient’s full identity either. E.g. you might know I was named Jacob Smith but unless you know me by my face you still don’t know which specific Jake Smith I am.
Any information which reveals the identity of a patient to the public is to be protected. If this is a face, so be it. I suppose they could ask Brad Pitt to wear a paper bag but most hospitals instead have VIP protocols in place (for HIPAA and to avoid a circus) to admit them first.
I’ve taken a lot of HIPAA training, and there’s no mandate that health care providers have to somehow camouflage a patient’s identity in the waiting room. It’s about personal identifying information and personal health information. Someone’s appearance isn’t PII, unless they’re literally taking a picture of them and including it in their medical record.
They can’t say “John Smith with the jock itch please come to the desk”, or “Sally Doe with the violent flatulence come with me to exam room 3”. Those would be giving up someone’s actual medical issue to the public. But they can certainly say “Mr. Pitt, please come up to the desk” or something like that. HIPAA rules don’t change because someone’s a celebrity.
I’ve also had a lot of HIPAA training and I’ve worked in Healthcare IT for the last 10 years. I don’t think we’re disagreeing about the law itself, just interpreting it differently.
I do believe a celebrity in the ED is a different situation. Say Brad Pitt is sitting across from me in an ED waiting room with a bloody nose. I not only know which particular William Bradley Pitt (out of all of them in the US) is being treated but also the particular medical issue he is being treated for. As I understand it this qualifies as a breach of privacy and healthcare providers should attempt to limit or stop it.
There is a certain level of “favoritism” that takes place and it’s certainly legal but its mostly window dressing.
I’m not rich by any means, but my late partner and I used to work for a whole bunch of really wealthy people, the kind of people that have their name on hospital wings. And a lot of them REALLY liked him for some reason, especially the one that was some big shot in oncology.
When he (my partner) was diagnosed with pancreatic cancer, he was flown by private plane to a major hospital, where the head of the oncology department spent the day with him, walking him through an expedited work-up and discussing options for treatment and symptom relief.
But it didn’t make any difference, disease was the great equalizer. But there was certainly nothing illegal about that hospital giving him special treatment, and I wouldn’t be surprised if they offered a celebrity that type of service instead of making them spend hours cooling their heels in waiting rooms…but everybody’s probably getting the same underlying treatment.
The treatment we ultimately decided on was one offered as an option to everyone, so he didn’t get better treatment in the medical sense…but the bells and whistles of privilege exist.
When HIPAA was first implemented, some people asked if patients’ stretchers or wheelchairs would be covered by tents while they were being transported.
Unless there’s some very good reason why other people couldn’t or shouldn’t see them, they said that was not necessary.