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Thursday, April 5th 2007

A Fair Shake

Okay, so Dr. Novak also reprinted this over on THCB, which actually might the more respectable venue actually…not that I have anything against the Ahwatukee Foothills. Work should equal pay shouldn’t it?

Would it be ethical for an employer to require overtime and not pay employees for the work? What if it is just really a busy time and the public needed access to the store? What would happen if the employer instituted this policy? Would it be easier or harder for the employer to find people willing to work there?

[W]hen we talk about health care, what we know to be morally repugnant – forcing people to work without pay for fear of sanction – does not seem to apply.

The piece specifically is on EMTALA…talk about an unfunded mandate.

EMTALA requires hospitals and ambulance services to provide care to anyone needing emergency treatment regardless of citizenship, legal status or ability to pay. There are no reimbursement provisions; as a result of the act, patients needing “emergency” treatment can be discharged only under their own informed consent or when their condition requires transfer to a hospital better equipped to administer the treatment. EMTALA applies only to “participating hospitals” which accept payment from the Department of Health and Human Services, Centers for Medicare and Medicaid Services (CMS) under the Medicare program. In practical terms, it applies to virtually all hospitals in the U.S., with the exception of the Shriners’ Hospital for Crippled Children, Indian Health Services and military VA hospitals. Its provisions apply to all patients, and not just to Medicare patients. The combined payments of Medicare and Medicaid, $602 billion dollars in 2004 or roughly 40% of all medical expenditures in the United States, make not participating in EMTALA impractical for nearly all hospitals.

The emphasis is my own.

In reality Dr. Novak’s complaints and points can be applied to all of health care. The lack of free market forces in health care is disgusting. Reimbursement is controlled by a cabal, with the government as payer as the centerpiece, which, if existing in other industries, would probably make Jeffrey Schmidt’s and the Federal Trade Commissioners’ heads spin.

Of course healthcare is too important to be considered a “business.” *rolls eyes*