I don't know if people understand how much this puts women at risk, especially women who are uninsured or of lower-income. One thing that immediately comes to mind when I read about HR 358 is EMTALA (the Emergency Medical Treatment and Active Labor Act). This law states that all patients presenting with an emergency must be screened and provided with stabilization if needed, regardless of that patient's insurance coverage or ability to pay. This law was a response to what is often referred to as "dumping" where patients with emergencies and women in labor were being denied services or transferred to another hospital instead of receiving the care that they needed due to lack of insurance coverage or ability to pay.
If a hospital can choose not to provide life-saving treatment in the case of a woman who needs an emergency abortion, what is there to stop such choices being made based on insurance coverage and income level? Our nation continues to disenfranchise women and the poor and this legislation does nothing but contribute to this downward spiral.
Please contact your Congresspersons and tell them NO to HR 358. Here's one resource to do so.
Also in women's news, Topeka, Kansas has decriminalized domestic violence. Read more here.
No hospital provides every service. That would be a ridiculous government requirement. For example, small hospitals most often don't provide cardiac catheterizations for heart attack patients. Many hospitals, even large ones, don't offer brain coil embolizations for stroke patients. These are life-saving procedures, and considered the best standard of care, but hospitals don't have the resources to offer everything. Instead, they stabilize patients and transport them to hospitals that provide these services.
ReplyDeleteDecisions to transport will sometimes be based on who the payor is. In large cities like Chicago, there are institutions such as Cook County Hospital that receive state and federal grants to care for the uninsured. Teaching hospitals also receive government support through their residency programs. Private hospitals receive no special monies to care for the uninsured.
In suburban areas like my community, transfers based on ability to pay don't occur much. We watch our transfers-in, and if we suspected a hospital was cherry-picking patients and transferring only the uninsured, we could report them the Illinois Department of Public Health. The hospital would be audited and could be fined heavily. So far, I've never seen it happen.
In your post you mention hospitals "that receive federal funding." For clarification, this refers to every hospital that accepts Medicare. All hospitals accept Medicare. "Federal funding" as used in legislation, does not exclusively refer to the government grants given to public hospitals like Cook County.
What I see more likely than payor-motivated transfers are transfers because of ERDs (Ethical Religious Directives). The ERDs of some church-sponsored hospitals conflict with most types of contraceptive services. Let me also point out that "emergency abortions" are not split-second decisions to operate the way that appendectomies and gun-shot wounds are. In the healthcare system where I am employed, a proposal to perform an abortion to protect the life of the mother would be subject to a medical review. If it were determined that the mother's life were in danger, an abortion would be approved. The ERD policies of each Catholic hospital are determined by the local archdiocese.
While I find the previous comment enlightening, I have to disagree. Yes, some hospitals do not have the money or equipment to provide specific care. That is par for the course. However, if a hospital has an ER, they are required to provide ALL necessary care to stabilize and/or treat a patient.
ReplyDeleteWhat Amanda is talking about is real. Even where I live, with a major hospital less than 2 miles from my home - in small town America - the hospital practices dumping. They dump patients on the local urgent care, if they think that it can be treated without any help from them. They dump patients on other local facilities if any treatment or surgery was performed in another facility (I was dumped on a hospital over 45 miles away because I had pneumonia - after I was released from another facility after major surgery).
And yes, the government does indeed give specific monies to hospitals. They are grants and other funding designed to assist a hospital like Cook County.
What is being ignored here are the facts - Women, children and the poor are the ones that suffer from the "dumping" and failure to provide care for those patients that don't have insurance. It happens often and in almost any hospital or facility that does not do research.
Also, ERD's are what creates issues. A friend of mine lost her daughter because a hospital decided that the ruptured ectopic pregnancy was not worthy of an abortion - because she also had a twin that was not ectopic. They allowed the girl to die, to protect their values. The girls son is being raised by a cousin because the grandmother - my friend - is not well.
At what point does the oath "do no harm" and the requirement to provide "all necessary care" to patients, kick in?
Also, who gets to decide, honestly, that a girl waiting in a room, with her body being torn apart by a fetus that will not ever be a person, can't have a necessary medical procedure? A panel of what? Doctors? Or money men?
Also, laws that require a woman to accept violence in their homes and upon their persons are despicable. Good grief, are we living in the dark ages?
Megan,
ReplyDeleteNo hospital is required to offer every service. No hospital is equipped to provide every service. Yes, only hospitals who accept Medicare are required to be EMTALA-compliant and all hospitals, to my knowledge, accept Medicare. I should have clarified that in my post. I have worked for two emergency departments and my husband has been working in emergency services for over 10 years. Before working as a social worker in another facility, I did billing and financial counseling to emergency room patients at a local hospital. I should have been clearer in my description of the issue instead of assuming people would know what I was referring to. Thank you for clarifying.
Patients with emergent conditions can only be transferred to another facility if the facility in which they presented with the emergency is unequipped to handle their specific issue. Under EMTALA, a hospital equipped to handle a certain emergency cannot transfer, divert an ambulance, or refuse to screen/stabilize a patient who is in need of stabilization or whose life may be significantly altered if immediate intervention is not taken, based on that person’s insurance coverage or ability to pay. Once a person is stable, they can be transferred to another facility that accepts their insurance.
Under Pitt's proposed law, a hospital would be able to refuse stabilization as well as refuse to transfer to another facility that could perform an abortion if a woman needs an emergency abortion to save her life. I agree that religious views will come into play with this. However, I do not see why a woman's ability to pay for the abortion (should a particular hospital offer it or be able to transfer to her to one that does) would not factor in as to whether or not she would be treated. This seems especially at risk to become a reality when considering the fact that her specific need for an emergency abortion would make her exempt from a law that was specifically designed to keep patients from being discriminated against due to ability to pay.
"Let women die" is a great nickname for this bill!
ReplyDeleteI often wonder if, as Lori wrote, we are indeed living in the dark ages. What's next - witch trials?