The topic about Hillary’s story of the pregnant woman being turned away from a hospital ER has already had several diaries. I have posted comments in at least 3 of these. I now feel motivated to post a diary because it seems to me that the main problem with this issue is being missed.
Here is another blog that reiterates the story:
http://www.dailykos.com/...
Most folks seem to be concerned about whether or not Hillary should have verified the story before retelling it. That is one issue, and I’m not sure every story from every source needs serious detective level verification. If it were simply that, I would say, ok, mistake, move on.
But, to me the main issue is that Hillary should have known upon first hearing the story that it was totally implausible. When I first heard her tell it during a stump speech (on TV) I jumped up off the couch and yelled "no way that is true" ---- because of EMTALA - a federal law passed in 1986 that forbids turning away pregnant patients from any hospital ER for which the penalty is to cut off all Medicaid and Medicare payments forever, thus effectively closing the hospital.
Here is a web page that explains EMTALA pretty well:
http://www.emtala.com/...
One of the specifics of the law regarding pregnant women can be found in this excerpt:
- What is an "emergency medical condition"?
An attempt is made by the statute to provide a definition, but as usually happens, the legal definition leaves much to be desired. The determination is ultimately a medical one rather than a legal one. That is not to say that it is sheltered from review. As is the case with any medical decision, it must often be made quickly, with such information as is available, and is subject to critical retrospective review by physicians testifying as expert witnesses in the alien setting of the courtroom, in the event of litigation.
The definition provided under the statute is:
"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 --
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,
serious impairment to bodily functions, or
serious dysfunction of any bodily organ or part, or
"With respect to a pregnant woman who is having contractions --
that there is inadequate time to effect a safe transfer to another hospital before delivery, or
that the transfer may pose a threat to the health or safety of the woman or her unborn child."
Another pertinent section mandates the requirement for the basic rules of EMTALA to be posted:
Another section [42 CFR 489.20(q)(1)] requires that the hospital post a conspicuous sign which notifies patients and visitors of the right to be examined and to receive treatment. The sign must be in a form approved by the Secretary of Health and Human Services.
I have practiced OB/Gyn in hospitals in various states since 1987 and no one working in any of these ER’s would even do anything that would appear to violate EMTALA. We take this law very seriously. The penalty is way too great to risk it for a measley $100. The fact that the law is posted also contributes to our reluctance to violate it.
My problem with this story is that Hillary is the self-proclaimed expert on what is wrong with health care in America. If she really had 1/10 of the knowledge she claims, she would know about this federal law and would have known about it during her hubby's presidency when she was working on health care reform in 1993. She really should know what parts of health care are broken and what parts are already fixed if she alleges she can fix it. EMTALA has already fixed the "problem" referred to in her story. Her new health care proposal is not needed to fix that. There is plenty wrong with health care, but that's not it. She should have known. If she really believed the story, and had known as much about health care as she states, she would have been under an obligation to have the hospital investigated. As it was, she frivolously accused a hospital of violating a federal mandate. She should have known the real problem with EMTALA is not violations, it is the fact that it is an unfunded mandate. It puts the burden on many small not-for-profit community hospitals that are now just barely making it in this weak economy.
If this were simply a story that was not vetted for accuracy, I would personally have much less of a problem with it. Her repeating the story tells me she is all words and no substance because she has not done her homework with her own signature issue. She should have known enough to at least doubt the veracity of the story and therefore to perform a little due diligence. Because if the story is true, some hospital is in serious violation of EMTALA and this needs to be fully investigated. It makes me wonder how much she really knows about other issues.
UPDATE:
Apparently the truth is that is was not a hospital that turned the patient away - it was a clinic (which means a doctor's office). Clinics are not bound by EMTALA. Still my point stands that as told by Hillary, the story was implausible and therefore she should have shown due diligence in not repeating it until the truth was figured out. Sloppy.
But at an earlier time, Casto said, Bachtel lacked health insurance and ran up unpaid bills when treated at a clinic near her home in Middleport. When she returned for treatment when pregnant, the clinic demanded $100 per visit to help retire the outstanding debt, Casto said. Because Bachtel could not afford the fees and found it difficult to travel, her aunt said, she postponed receiving treatment.
http://www.nytimes.com/...