EMTALA

There's a federal law called EMTALA, the Emergency Medical Treatment and Active Labor Act of 1986, requires that all patients presenting themselves to an emergency department Must receive a "medical screening exam" to assess the presence of an "emergency medical condition."  If an "emergency medical condition" exists, then the hospital must provide "stabilization" or transfer to a hospital that can provide stabilization if said hospital doesn't have the capability or capacity to provide said stabilization...  All this must be done regardless of the patient's ability to pay.

The problem is is that the law does not define "medical screening exam" or "emergency medical condition."  And each hospital has had to interpret what these terms mean.

Some patients are pretty savvy and try to abuse the system.  They also assume that this means that emergency room treatment is "free."  It is, of course, far from free...  It is more expensive that any other outpatient treatment.  And, since they don't have insurance, they'd rather come to the ED where we don't ask for cash up front, than go to an outpatient clinic and pay $100 or less to see a doctor.  

This is why it costs so much to go to the Emergency Room...  All these people coming in for their "free" visit to the doctor.   And,  why emergency rooms are so overcrowded in this country and it takes hours to see a doctor after you arrive...

I can go on an on about this, but just wanted to get some initial words down about the subject.