Talk:Emergency Medical Treatment and Active Labor Act

Untitled
In what country? --rmhermen

U.S. Symtym 20:16, 24 May 2006 (UTC)

I'm new to this, but this article really needs a redirect from EMTALA, which is, the majority of the time, is how it is referred to. I always forget that you won't pick up this article in Wikipedia because "EMTALA" is not listed. Symtym 20:16, 24 May 2006 (UTC)

Well I hope I did the redirect correctly. symtym 22:02, 24 May 2006 (UTC)

Seems to have worked, Wikipedia now has a 7th in page ranking on Google for "EMTALA" and was not listed previously. symtym 23:32, 24 May 2006 (UTC)

Neutrality
How do I question the neutrality of this article?

This article is horribly written, is not based in fact, and is completely slanted against EMTALA and America's immigrant population. There is nothing neutral about it.


 * Terrible article. It reads like an anti-immigration opinion piece and fails to provide even a basic overview of the statute. I deleted most of that and threw in the conspicuously-missing basic statutory requirements, so hopefully that will be the seed for a better, neutral article. This is a source for basic information about the statute, not a place for people with axes to grind to air their thoughts on how immigration is destroying the American health care system. Start a new article for that, or go to the main article on immigration and try to sneak it in there.68.73.56.11 16:14, 2 May 2007
 * As regards bankruptcy, Koch's piece is a working paper that has an interesting hypothesis but is by no means the central, undisputed truth in the area. Many policy scholars have concluded that the idea that EMTALA causes widespread bankruptcy is a myth. I'd add that data indicate that the decrease in the raw number of hospitals is due to a wave of hospital consolidations in the 1990s and increased efficiency (not increased burdens on institutions from EMTALA), and that the burdens on ERs are not the result of uninsured patients abusively seeking non-urgent care so much as an increased gross number of privately insured patients seeking appropriate care. See, for example "The Scapegoat: EMTALA and Emergency Department Overcrowding," Laura Hermer, Brooklyn Journal of Law and Policy, 2006(2).
 * Basically, EMTALA is commonly the source of intuitive fingerpointing as regards institutional problems in health care and insurance, but those conclusions don't hold up under close scrutiny--at the very least, they are under such heavy controversy that an unpublished working paper is hardly the final word on the matter for purposes of inclusion in an encyclopedia.68.73.56.11 17:40, 2 May 2007 (UTC)

05:37, 27 August 2007 (UTC) agreed. there is no counter that what would happen if the poor were not treated, they'd die on the pavement. also, one could be critical of the legislation that it requires unequally some hospitals more than others to fund free services, without helping to compensate for the added costs. What is destroying the USA health system is a lack of universal health coverage. —Preceding unsigned comment added by Robauz (talk • contribs)

I agree. This article's main thrust is that EMTALA is the primary source of rising healthcare costs, without attributing the rise of obesity, drug-seeking behavior, or malpractice premiums to the overall jump in costs. This article definantly needs a neutrality tag. —Preceding unsigned comment added by 207.5.235.198 (talk) 15:28, August 28, 2007 (UTC)

I agree as well. I added a NPOV template which was reverted despite this discussion. I found this part particularly biased: "However, because it requires only that hospitals stabilize the emergency, EMTALA is an incomplete safety net that fails to meet international standards for universal care." Whether a safety net is 'incomplete' is entirely subjective. Also, the international standards for universal healthcare is left without a reference - do such standards even exist? I'm going to add the template back again. --Vince | Talk 06:45, 22 October 2007 (UTC)


 * I have modified the sentence you referenced and provided two reliable sources for the characterization of the U.S. safety net as incomplete. There have been numerous international comparisons done which could probably support the broader assertion, but they are in peer-reviewed medical journals that I don't have access to. However, I believe the changes I've made should address your POV concerns. --Sfmammamia 18:09, 22 October 2007 (UTC)


 * I have made some changes. The prior phrasing implies that it is fact that "EMTALA is part of an increasingly strained, incomplete safety net for the uninsured." when policy papers were the citation. Clearly this depends on the definition of a safety net and what makes it complete - while in European EMTALA would be a poor hack of a solution, in the US it may not be viewed that way. I'm just trying to slowly make changes that will make this article more neutral. I think the policy opinions are important, but they needed to be cited as such.

--Vince | Talk 03:19, 23 October 2007 (UTC)


 * I'm fine with your changes. Is there other material justifying the NPOV tag or can that be removed at this point? --Sfmammamia 16:23, 23 October 2007 (UTC)


 * Sorry, I didn't see your message on my watchlist for some reason. I saw that someone removed it, and I think that's ok. I would say that this article should present some other policy assessments of EMTALA (it relies heavily on the Kaiser Commission on Medicaid and the Uninsured paper). Overall, it's becoming a good encyclopedic article. Good job everyone --Vince | Talk 21:12, 29 October 2007 (UTC)

Cleanup
I just made an edit that covered several areas of the article, so I thought I would explain the reasons for my edits. My edit summary was "rm wordiness, rm statement unsupported by reference; rm tangentially referenced Texas section; replace former external links; see talk page." Excessive wordiness was removed for concise text (readability); the statement about 90% of illegal immigrants being uninsured may be true, but I did not find it in the study linked to as a reference - removed as unreferenced; the section about Texas hospitals was only tangentially related to the material in the referenced article - removed as unreferenced; someone had replaced three very good external links with a link about Barbara Clark - reinstated former external links. The article really could use a (referenced) section about Texas hospitals. That would be very appropriate. It also could use some work explaining the requirements of the act, giving more of the body of the article to the act itself instead of problems related to it. Right now it reads as an article about what is wrong with EMTALA. I'll see what I can do about that later. 152.16.188.107 00:48, 4 September 2007 (UTC)

This article was awful, improved in early 2007, and is now awful again. It seems that the same person who wrote the original piece discarded more careful, improved language by just labeling it "vandalism." See the Aug. 10, 2007 revisions. http://en.wikipedia.org/wiki/WP:SOAP#Wikipedia_is_not_a_soapbox —Preceding unsigned comment added by 141.211.222.74 (talk) 00:28, 10 September 2007 (UTC)

Does anyone know the annual cost of EMTALA?
SesameRoad 16:19, 25 September 2007 (UTC)


 * One paper published by Duke University outlined a cost estimate approach (making it clear that it was based on a lot of assumptions) and came up with the following: "All told, EMTALA results in expected costs of $4.4 billion ($1.3, $11.0) and expected benefits of $2.1 billion ($0.4, $4.9)" The figures in parentheses appear to represent low-high ranges. In my mind, the figures are of dubious value because they involve so many assumptions. A May 2003 American Medical Association study said that emergency physicians and other specialists combined lost $4.2 billion in revenue in 2001 providing care mandated by EMTALA, but physician care represents only part of the cost of operating an emergency room, so an accurate figure for that year would have to have been higher than $4.2 billion. -- Sfmammamia 01:12, 26 September 2007 (UTC)

Question regarding article title and current name of law
The web page at the U.S. Department of Health and Human Services cites the name of the law as Emergency Medical Treatment & Labor Act (no word "Active"). Is there a reason Wikipedia does not follow suit? -- Sfmammamia 22:18, 5 October 2007 (UTC)

This line seems like conjecture, not a statement of fact...
At the end of the article, the line "Nevertheless, since non-citizens make up 21.2% of the uninsured, and they are the least likely of the uninsured to use emergencies rooms, their cost is at most $8.6 billion per year" seems like conjecture to me. I don't know how to clean it up though.

P.S. This is my first Discussion contribution, and I'm still learning. Please be gentle with me! :)

Freedomfreak (talk) 23:27, 15 November 2011 (UTC)

External links modified
Hello fellow Wikipedians,

I have just modified 2 external links on Emergency Medical Treatment and Active Labor Act. Please take a moment to review my edit. If you have any questions, or need the bot to ignore the links, or the page altogether, please visit this simple FaQ for additional information. I made the following changes:
 * Added archive https://web.archive.org/web/20120916005332/http://www.kff.org/medicaid/upload/Key%20Medicare%20and%20Medicaid%20Statistics.pdf to http://www.kff.org/medicaid/upload/Key%20Medicare%20and%20Medicaid%20Statistics.pdf
 * Added archive https://web.archive.org/web/20071129091346/http://www.kff.org/uninsured/upload/Threadbare-Holes-in-America-s-Health-Care-Safety-Net-report.pdf to http://www.kff.org/uninsured/upload/Threadbare-Holes-in-America-s-Health-Care-Safety-Net-report.pdf
 * Added tag to http://iom.edu/~/media/Files/Report%20Files/2000/Americas-Health-Care-Safety-Net/Insurance%20Safety%20Net%202000%20%20report%20brief.pdf
 * Added tag to http://iom.edu/~/media/Files/Report%20Files/2006/Hospital-Based-Emergency-Care-At-the-Breaking-Point/EmergencyCareFindingsandRecs.pdf
 * Added tag to http://www.zalelipshypatientdumping.com/category/emtala-articles-ut-southwestern

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On emergencies that occur at the hospital.
May need to delete all of this article that is supported by "EMTALA: Court Ruling on Meaning of Appropriate Transfer to Another Facility," www.nursinglaw.com - which is currently footnote 10 - cites to a page on nursinglaw (a blog? "Legal eye newsletter for the nursing profession").

The statements on nursinglaw are based on Lopez-Soto v. Hawayek, 988 F. Supp. 41 (D. Puerto Rico, 1997).

However, this case was reversed by

Lopez-Soto v. Hawayek, 175 F. 3d 170 - Court of Appeals, 1st Circuit 1999 https://scholar.google.com/scholar_case?case=15759067756734936195&hl=en&as_sdt=6&as_vis=1&oi=scholarr

Even if the case hadn't been reversed by a higher court, those are very strong statements about what triggers EMTALA that should have stronger support than a single district court (whose holding only applies to Puerto Rico). I have emailed the blogger/writer at nursinglaw.com and given him this information. Hopefully he will correct himself, but even if he does not, I recommend that this be deleted:

"A normal pregnancy delivery. In a case reviewed by courts, EMTALA did not cover the hospital stay.[10] If a patient is already in the hospital for another reason and develops an emergency condition, EMTALA similarly does not apply.[10]"

Ileanadu (talk) 17:17, 2 January 2018 (UTC)


 * Further support that this language should be deleted, see f.n. 29 in Hospital Liability by James Walker Smith (Law Journal Press 2017)

in section 6.01[3] 6-10: "child's birth in operating room triggered duty to stabilize." https://books.google.com/books?id=WhgYHTF3ftMC&pg=SA6-PA10&lpg=SA6-PA10&dq=lopez-soto+v.+hawayek&source=bl&ots=sNvGZ_hPyE&sig=E-YEZwhVd_-8gxWwsvroOqOkpfA&hl=en&sa=X&ved=0ahUKEwivo-C95LnYAhUFPN8KHUFhAZAQ6AEIOjAF#v=onepage&q=lopez-soto%20v.%20hawayek&f=false Ileanadu (talk) 17:37, 2 January 2018 (UTC)

The linked source (nursinglaw, source 10) is now a dead link (as is source number 9).Livingfractal (talk) 03:16, 26 June 2018 (UTC)

I think the biggest issue with this language is that "another reason" is lacking any precision. Is the patient there to be transferred? Whose patient are they? What type of patient are they? Is the "patient" there to buy flowers for a an individual admitted to the hospital? Furthermore, the language seems to imply that the hospital is not required to address the emergency, and so language could be added to specify that there are state laws requiring adequate services, and a link to the page describing the law which the governing body overseeing EMTALA says covers admitted inpatient and outpatient emergencies https://en.wikipedia.org/wiki/Deemed_status#Meeting_Conditions_for_Coverage_and_Conditions_of_Participation. Livingfractal (talk) 03:16, 26 June 2018 (UTC)

As for "A normal pregnancy delivery. In a case reviewed by courts, EMTALA did not cover the hospital stay." What case? What court? Also, what is "a normal pregnancy". A quick review of the literature points out that if a woman presents anywhere on a hospital campus, and appears to be in labor, then they are to be examined. If it is a "true labor", then they must be stabilized. I mean, it is even in the title of the law. To quote the written policy of hospital: ""Emergency Medical Condition” means ... 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;" http://www.wakehealth.edu/uploadedFiles/User_Content/AboutUs/Facts_and_Figures/EMTALA.pdf Livingfractal (talk) 03:16, 26 June 2018 (UTC)

Broken and redundant links for several citations
Several citations throughout this article are either redundant (like 7 and 9) or they are broken (like 7, 9, and 10).Livingfractal (talk) 04:07, 26 June 2018 (UTC)

Emergency Abortions
The "Emergency Abortions" section says this: "HHS issued guidance on EMTALA protections for clinicians applying regardless of state laws …" It says that "guidance" is out there, but doesn't tell us anything about what that guidance actually says. I'm adding a brief description. MiguelMunoz (talk) 03:44, 13 March 2024 (UTC)