What was life like before the Emergency Medical Treatment and Labor Act?

It was only passed in 1989, and recent events have gotten me wondering about this. What sort of events led to the Act’s passage?

what is the Emergency Medical Treatment and Labor act? Is it some sort of good Samaritan law that says you can’t be held liable for any adverse side effects from emergency aid you render to some random person in distress? If so, how far back before 1989 are you talking about? I was taught about such laws in school back in the 70s

It’s not a Good Samaritan law. It’s a law that requires emergency departments in hospitals that participate in Medicare ( which is probably all emergency departments) to screen and stabilize any patient without regard for their insurance status or ability to pay.
As far as what happened prior to its passage, apparently private hospitals used to dump patients without insurance on public hospitals without so much as screening them to ensure that they were medically stable for transfer.

So wait, even before the passage of the act, public hospitals were required to treat regardless of ability to pay? I didn’t think of it that way, so I can see how it might be, but I want to make sure.

Ah, Well no wonder I had no idea what it was. In Idaho it’s been the law for … well “forever” basically … that all hospitals are “public” and must treat regardless of finances. Its actually much more complex than that, but that sums it up.

my source is my sister’s master’s thesis on the topic of hospitals and health care in Idaho

It passed in 1986.

I don’t think there was a Federal mandate for them to do so, but I’m pretty sure that most cities or counties running public hospitals didn’t leave people to die on their doorsteps because they couldn’t pay. If you’re not going to treat people who can’t pay, then there isn’t much point in running a public hospital.

The key part of EMTALA is that it made it a categorical mandate for virtually all hospitals nationwide (anyone taking Medicare), rather than a state-by-state or system-by-system policy. The public-opinion sentiment behind its passage was that private hospitals if left to their druthers would first interview you or your family member about payment arrangements before doing anything for the problem, and what happens if there is a real emergency and you have to waste time being judged on whether you are a nonpayment risk and then waste further time getting to St. Elsewhere when it may not even be safe to do so. This was also around the time of the rise of Humana and other for-profit hospital systems so there was a real concern that this would become a regular practice, socking it even harder to the public/charity hospitals.

This is why in the early 1980’s when I was severely dehydrated and feverish from a bad case of the flu I had my friends take me to a Catholic hospital in Evanston rather than a private-owned Chicago one - the Catholics took all comers regardless of ability to pay, the private folks didn’t.

And that’s one aspect of what life was like - if you thought you were sick enough to go to the ER you worried as much about “will they take me?” as how to get there or what was wrong with you.

Short and brutal

Yanno, for me this was always a TV trope, not something I ever imagined actually happened much, if ever. I think you are the first person I’ve ever met that ever actually said anything like this. I’m boggled, almost. I’ve moved a few doctors out of the state and almost invariably they cite crappy health care regulations in ID as the reason for moving. Yet, Idaho has had state laws since the early 20th century forbidding this practice. Heck the county I live in will pay for your medical treatment if you can’t afford it regardless of the cost. well you do have to pay something like $2000 or in that neighborhood, but, that’s a lot more doable than the $150,000 that a friend of mine would have had to pay for her neck surgeries.

It was a concern in some of the Big Cities and as I mentioned exacerbated with the rise of for-profit hospitals. Probably feared more than actually experienced but real enough to enter public awareness to the point of passing a law under the Reagan administration. Not so much in the more rural states where awareness that medical centers may be few and far between would have led to this kind of regulation since back in the Progressive (old “good” sense of the word) Age.