19 June 2012

Obamacare and EMTALA

From today's LA Times:

ACA Strikedown would complicate who pays for ER care for the uninsured:

"Whether people know it or not, whether people appreciate it or not, access to emergency care became a right in this country in 1986," said Dr. Wesley Fields, an emergency room physician in Orange County. "But the law that did that never addressed the big question of whose responsibility it was to deal with the cost." 
That unresolved question — who pays? — helped shape President Obama's 2010 healthcare law and its requirement that Americans get health insurance. For years, it even convinced many Republicans, including former Massachusetts Gov. Mitt Romney, to champion an insurance mandate. But today, the insurance mandate is the central target of GOP opposition to the law. 
Within days, the Supreme Court will rule on whether the new law is constitutional. If the law is upheld, millions of newly insured patients will have many of their hospital bills covered by insurance. But if the law, or just the insurance mandate, is struck down, those bills will be passed on to taxpayers, hospitals and privately insured patients, as they have been for the last quarter century.
As they have for the last quarter century.

The whole thing is well worth the read, and nothing that I haven't been saying for years. The coda, however, is striking for its understated demonstration of the cognitive dissonance displayed by the opponents of the mandate:

In the past, the cost shifting was cited by many conservatives as a reason why the federal government should require Americans to have health insurance. 
"If a man is struck down by a heart attack in the street, Americans will care for him whether or not he has insurance," the Heritage Foundation's Stuart Butler said in 1989. "We will not deny him services — even if that means more prudent citizens end up paying the tab." 
Butler, like many Republicans, has since renounced the insurance mandate.
They don't care about healthcare. They just care about scoring political points.  And now we wait to see if that neutral arbiter, the Roberts Court, the umpire whose only job is to call balls and strikes, will rewrite 75 years of constitutional law to deny his political opponents a victory, thereby shifting the cost of care for the uninsured back onto healthcare providers.

1 comment:

  1. It's not really a question of who pays, it's more a question of how that payment is arranged and whose hands it goes through. Regardless of the details though, the payer remains the same. The payer is all the people that work and pay their taxes. The question of it that payment travels through state or federal hands, or both, or which agency or how long, or what you call it doesn't change anything.

    The federal government does not ever pay for anything, not does the state government. All they do is collect and process the payments.


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