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This is just sad. We all know how many people suffer due to a lack of insurance - we see it here every day.

EMTALA exists to prevent this from happening. However, hospitals use it only as a starting point. If you are uninsured, and are in need of emergency care, the hospital is only obligated to make sure you are stable before dumping you on a charity hospital which will follow-up on the remainder of your care. As long as the primary hospital fulfilled their legal obligation, they are free to do as they please. 

A must read:

(Nov. 16) -- It's federal law: All seriously injured emergency and trauma patients must be given equal lifesaving care, whether or not they can pay for it. But that's not happening, according to a new report. The study, conducted by Children's Hospital Boston research fellow Dr. Heather Rosen and colleagues from three other hospitals, found that uninsured trauma victims ages 18 to 30 are dying at an annual rate 89 percent higher than insured victims with identically severe injuries.

As the health reform tornado continues to swirl on Capitol Hill, the data could provide fresh ammunition for those pushing for expanded health insurance coverage.

The study, published today in the Archives of Surgery, examines the survival rates for patients brought to about 900 U.S. trauma centers between 2002 and 2006, analyzing some 690,000 patients who had suffered penetrating trauma -- such as wounds inflicted by a gun or knife -- or blunt trauma from vehicle crashes and falls. Earlier research found 18,000 extra deaths a year among uninsured victims of such injuries. Rosen and the other researchers chose to focus on the 18-to-30-year-old subset because they had fewer existing conditions -- comorbidity -- that muddy the evaluation of the cause of death.

See:

http://www.sphere.com/2009/11/16/trauma-victims-face-far-worse-odds-when-uninsured-study-says/

 I'd like to say,when I was working as a nurse for 16 years I saw a lot of bogus charges to medicare and medicaid from nursing homes I worked at and hospitals.

One doctor at this nursing home would not examine the patient,just asked the nurses what they needed and charged for visits,many services were charged that patients never received.Music therapy,occupational therapy,etc etc.these were services ordered by the nsg.home/hospital.I reported as many as possible.My own mother suffered with dementia and was bedbound the last 2 yrs.of her life and the facility was charging medicare for all kind of services my mother could not possibly participate in,we reported them.You know,the nsg.homes are the worst at racking up charges,getting kickbacks from hospice companies,rehab.services and the list goes on and on.

hospitals are b.s.cause you get charges like ten dollars for two tylenol,8 bucks for a band aid, and insurance rates go up for all this b.s. however there is a system in place that keeps doctors from ordering unnecessary tests in a hospital.

I was lucky enough that when my spouse died I was given medicare at 53y/o,I do have a son age 20 and we cannot afford insurance for him.if insurance rates are high it's because so many have put bogus charges on them the innocent have to pay,however I do pay for my medicare and am against a government healthcare system.

I can't blame any doctor I go to for abusing the system,I go twice a year cause I had cancer and need to get lab work.and I tell my friends do not let them operate on your back,knee,etc w/o getting a second or third opinion.most physicians are ethical but there's a bad apple in every bunch.you just can't go along with a doctor unless you're in an emergency situation.I mean if you know your diagnosis and trust the treatment,that's different.hope I made a point w/o offending anyone.

You know I just had to chime in on this one. Working as a medical biller, I have to submit billing to insurance companies sometimes 5 and 6 times BEFORE I get a response from them. Often times the response I get is: patient is not a member, patient only has pharmaceutical benefits, there are billing errors, etc. The reason why they do this is because we have 90 days to submit the bill to the insurance company or it has to be written off.

I know in some cases organizations will forward the bill to the patient. This is unfair to the patient. It is not the patient's fault their insurance company sucks.

This is why I tell people to have their insurance information when they register at their doctor's office, the hospital, or the ER. Make sure it is correct and up to date. If it isn't, someone is going to screw up and the patient will get a bill - usually one they cannot afford. It is much easier to prevent the problem, then to try to fix the problem after the fact.

You have to understand it all begins with registration. Most people in registration (if they are new) are basically there to take information - that is all. They cannot tell you anything, about your benefits, that is NOT on the computer in front of them. It is rare that they know anything more than which is the primary insurance and which is secondary.  It is up to the patient to know this information.

It is up to the patient to check with the doctor to verify if: 

• They are a participating physician with the insurance company they use.
• Will the procedure be covered?  
• Is all your personal information correct? ( names [spelling], address, phone, insurance id #) including ss# - yes, I know some people do not want to give out their ss# , but believe me, not only does it make the whole process easier, but the odds of your information getting stolen from a hospital are just as high as it getting stolen from your bank or credit card company. 

If the information gets screwed up in registration, you can bet it is going to stayed screwed up - until you are notified by the billing/business office or receive a bill.

If/When you do receive a bill - go through it with a fine toothed comb! If there is anything wrong, send a letter! Yes, you can call, but letters are kept on file and keep a copy for yourself. Make sure you follow up to verify any misinformation has been corrected. 

If the business office has the incorrect information, it takes time to correct it. I deal with 1000's of accounts and several different insurance companies. Trying to get them all paid on a timely basis is an impossible task if I have incorrect information.

Once it is corrected though, you can bet we do our best to fight the insurance companies to pay their share - which is NEVER 100% of the bill. 

Yes, there are co-pays and deductibles - which are the patient's responsibility. In most cases these are NOT written off.  You can, however, make payment arrangements with the business office. Most billers will be more than happy to make arrangements and work with you. 

 What I have noticed though is that a lot of people choose a higher deductible when choosing their insurance coverage. The reasoning behind this, I suppose, is because it makes their premiums lower. DON'T DO THIS! Sure you may be paying $10 for your insurance premium, but what are you going to do when you have to have emergency surgery and have to come up with $5000???? Pay the higher premium and lower deductible. 

If you have to go to the ER and your insurance has run out - DON'T lie and show an old insurance card. Tell registration you have NO INSURANCE. Tell them you will need help with your bill. Most hospitals can make arrangements for a discount on your bill or write the bill off altogether - this will depend on your finances. They will work with you BUT YOU HAVE TO ASK!!!

Another note: Hospitals cannot refuse you treatment if you are uninsured and in need of emergency care. They have to stabilize you before they transport you to another facility. 

 Also be sure that you need an ER. Some insurance companies have a 24 hour help line on the back of their card. If you are unsure about needing a doctor, call the 24 hour help line first. A few instances where you should get help immediately: IF your child has swallowed something, there is uncontrolled bleeding, symptoms of a heart attack or stroke  - CALL 911 or get to an ER immediately. 

2 cases where your health insurance is NOT needed: when you are injured at work or injured by a car. In either of these cases, your personal insurance CANNOT be billed - it is considered FRAUD. Even if you smash your fingers in a car door (in NYS - check your states to be sure) you have to give your car insurance information. If you are injured at work, your employer has to give their workers compensation carrier's information. 

One last thing and I'll shut up...

In cases of single parents: 

IF you are a single parent make sure you get child support and medical coverage for your child. If you are married and get separated, get medical coverage from your spouse. It is not only your legal right and their obligation, it is a necessity. There is nothing worse than needing to take your child to the doctor and worrying how you are going to pay for it. The thought shouldn't even cross your mind. 

Yes, this is a lot to remember, but if everyone utilized the resources available to them and worked with the institutions things might be a little easier for some. I know how the insurance companies behave and their refusal to cover their patients infuriates those of us in the billing industry as well. After all, where do you think we get our insurance from? 

I don't think people are making a big fuss about it as we all know it has existed at least some of us but for those that don't here is something to think about.

You are welcome Emil.

I agree with you Emil and why because it is more profitable for the big drug companies, insurance companies, elected officals look at their pay to support something for them and not for us. And until the American people hound the reps, the President and other officals nothing much will change. 

I know my doctor is heart and lung as a rule will not give out anitbotics for little cold etc nor have you be one them for long time. I was had it with another doctor out here for cellulitis and my doctor said you had enough of them stop taking them. I had allergic reactions to the stuff and ended up in emergency and the doctor there gave me repeats of the same. I had to stay around to tell him he messed up and rewrite the prescription. I learned long ago if at the doctors or hospital better write your questions out and ask. One old lady was in the bathroom her doctor came in how are you and left. She got out of there quick and called him back with her notes as I had written. Point - you better be quick to respond and have a brain or they will overdose you , give you things you don't want drugs. Man, I called my doctor in middle of the night on somethings pulled or forgot about in the hospital.

My doctor has always had patients that were of the lower class and gave each one 20 minutes or more of his time. His practice was in areas of the lower income. It wasn't here 5 min. gotta get to the other like skin cancer doctor I had. I had to trip him about to make him look at things he missed.

I wish I had a better answer.

The rich always get better treatment and sometimes not in case ie of Micheal Jackson. Here he told them what he wanted and it ended in death.

Hey the post office got me out due to my leg problems, took two years and wrecked my nervesl Once they saw the picture of it at the end I had two weeks vacation and never had to go back but I should have been given a job there. But better to pay little retirement and weed out people as they were doing to make way for the optical readers machine to do the work I was doing.

So where do people work when machinery takes over that are out of work??

It is like let the sick die off and that will take care of the social security money that won't be around. 

Yes our officials are stupid to lose money on non productive individuals .

I know of one lady lost her daughter to misdiagnoses by HM0 one  I wouldn't use.

If I had cancer I think the cure is worse that the disease or would hit it to as in my blog rationale therapy . 

Take care Emil and let's write the reps as Micheal Moore points out in his films and others say the same. He questions the health care system and go to Cuba and the people he took got help , here they didn't.

Starshine

I am confused why people are raising such a fuss about government death panels.  Do they not realize that the very same panels already exist within the insurance industry making those very same decisions on whether or not you receive care based on their profit and loss?

Thank you, Starshine.

So your doctor said his "business" was down.

Here is what happens - when health care is considered a "business" as any other business...

1. Our health depends on our income - rich kids and grandmas are healthier than poor kids and grandmas.
2. Doctors are more loyal to their business partners - insurance and drug companies. 
3. A case of cancer is a "business" case - to be decided by private insurance "death panels."
4. Private insurance "death panels" decide grandma's life or death.
5. You get to be healthy only when you have a steady job with a large enough employer.
6. No job, no income, no health care (why would we, as a society, "loose" money on non-productive individuals... we're not stupid... uhh?).
7. Sick people are "out of business", sorry - but, at least we (as red-blooded Americans) were warned - our smart ass mothers and fathers have always told us that life was not fair. I wonder who told them so - must be their employers.

I wonder too... why is it that our elected officials are stupid enough to opt out of the wonderful "business" based health care system. Why would they have their own goverment health care? Hmmm... why would they let government "death panels" decide life or death for their own grandmas?

I have heard of people going without health care coverage and relying on the health food store to keep them well as they can't afford medical insurance. But hadn't heard about the couple in the article over divorcing over the medical bills.

I just heard from my doctor when he called as I have known him since I was 24, he said his business is down by half as people lose their there jobs and the health insurance with it.

Thank you for bring this article to our attention, Emil.

Starshine