Newspaper article St Louis Post-Dispatch (MO)

Don't Limit Emergency Care

Newspaper article St Louis Post-Dispatch (MO)

Don't Limit Emergency Care

Article excerpt

Critics of Senate Bill 223, which would regulate the managed-care industry, suggest that the "prudent layperson" definition of an emergency is not necessary and that managed care is capable of rationing emergency services appropriately, thereby saving enormous amounts of money. Both of these assumptions are wrong.

The bill defines an emergency as a medical situation whose symptoms would lead a prudent layperson, possessing an average knowledge of medicine and health, to believe immediate care was required. The definition is necessary to allow people to seek care without the fear that their insurance company will second-guess them after the fact.

Let me address the current method used by many managed-care plans to ration emergency services. I will illustrate with a real example: D.R. is a 54-year-old man who came into the emergency department with chest pressure and some mild shortness of breath. He was placed on oxygen and a heart monitor, an intravenous line was started and an electrocardiogram (EKG) was performed. The initial EKG did not show definite signs of a heart attack, but knowing that this is the case in about half of all patients who suffer a heart attack, blood tests were drawn and the patient was placed on medication that could help limit the heart attack, if one was occuring. D.R. was then admitted for a short stay to rule out a heart attack. This was done with repeated EKGs and blood tests. The following day, D.R. was told that his chest discomfort was not from a heart attack, and a stress test showed that his heart was in good shape. D.R.'s bill was not paid by his HMO because, in its view, he had come to the emergency department for a problem that was not life threatening, since he wasn't actually having a heart attack. The "prudent layperson" definition of an emergency would have helped D.R., and the many people like him, to be covered in situations like this, when extensive medical tests are required to rule out a serious illness. What about people with sniffles and a stuffy nose? Do you think that these symptoms constitute an emergency? I don't, and I venture to say that the vast majority of you don't either. …

Search by... Author
Show... All Results Primary Sources Peer-reviewed

Oops!

An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.