Healthcare in America: How Accessible is It?

Good day, family and friends!

I start today with the question, "Does everyone have access to healthcare in America?" The short answer is, "Statistically speaking, yes."

In 1986, the Emergency Medical Treatment and Active Labor Act (42 U.S.C., Chapter 7, Subchapter XVIII, Part E, § 1395dd, EMTALA) was passed as part of the Consolidated Omnibus Budget Reconciliation Act. This act mandates:

"In the case of a hospital that has a hospital emergency department, if any individual (or a person acting on the individual’s behalf, whether or not the individual is eligible for benefits) comes to the emergency department and a request is made on the individual’s behalf for examination or treatment for a medical condition, the hospital must provide for an appropriate medical screening examination within the capability of the hospital’s emergency department, including ancillary services routinely available to the emergency department, to determine whether or not an emergency medical condition exists."

It further goes on to define an "emergency medical condition" as either:

"(A) a medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in—
(i) placing the health of the individual (or, with respect to a pregnant woman, the health of the woman or her unborn child) in serious jeopardy,
(ii) serious impairment to bodily functions, or
(iii) serious dysfunction of any bodily organ or part; or

(B) with respect to a pregnant woman who is having contractions—
(i) that there is inadequate time to effect a safe transfer to another hospital before delivery, or
(ii) that transfer may pose a threat to the health or safety of the woman or the unborn child."

This EMTALA goes on to make it illegal for a hospital to have any sort of financially-based conversation with the individual until such time as the patient's condition has been stabilized and the conversation will not interfere with the diagnosis and treatment of the condition. Later amendments from Congress defined "individual" as "any person within 250 yards of the emergency room/department, regardless of the person's citizenship or legal status," and made it illegal for different levels of care to be provided, based on the definitions in the Act. In other words, whether you're a Mexican citizen living just across the border from a hospital in Texas, or the wealthiest American citizen in El Paso, TX with the greatest medical insurance in the world, you will both receive the same level of care if you have the same emergency medical condition and go to the same border hospital in El Paso.

Next time, we continue our look at how accessible medical care is in America. Until then, best regards...



© James P. Rice 2009