Need To Go to the ER? No Insurance? No Worries, You’ll Get Sent Home to Die Anyway!

Summary

Jamie, a single mother without health insurance, was turned away from the ER with only steroids for her high blood pressure, despite the risk of heart attack.

Abstract

The article describes the experience of Jamie, a single mother who went to the ER with high blood pressure and symptoms of a possible heart attack. Despite her condition, the ER doctor turned her away with only a prescription for steroids and no further tests or treatment, citing her lack of health insurance. The author criticizes this treatment as unacceptable and highlights the legal requirement for hospitals to provide emergency care regardless of insurance status.

Opinions

The author believes that Jamie's treatment was unacceptable and that the ER doctor should have provided more comprehensive care.
The author cites a law passed in 1986 that forbids hospitals from denying care to uninsured patients in an emergency.
The author notes that many doctors make adjustments to their clinical decisions based on a patient's insurance status, which can lead to suboptimal care.
The author suggests that Jamie's case is not unique and that millions of Americans have experienced similar treatment in the ER.
The author questions the practice of stabilizing patients and then sending them home without further treatment or follow-up care.
The author highlights the irony of prescribing steroids, which can cause high blood pressure, to a patient with high blood pressure.

Need To Go to the ER? No Insurance? No Worries, You’ll Get Sent Home to Die Anyway!

Unless you’re on your death bed, stabilization is all they’re required to do.

My dear friend Jamie has one of the greatest sense of humor of all time. She can stand above and beyond the greatest known comics of even the late Richard Pryor and George Carlin.

She’s an exceptional single mom in her very early 40’s and with a beautiful 8-year-old daughter. She works extremely hard at cleaning major hotels and motels in South Dakota, never bitching about the long hours or the many days that call her in at the last minute. She accepts no charity, no food stamps or anything else.

For whatever the reason is, her daughter has health insurance from her dad, but she has none offered to her at her job. And if they did offer her the same, it would be a hardship to pay for.

Last night she called me explaining that her left was hurting and had a ‘squeezing’ feeling of her armpit and above that started yesterday. No big deal you say? You best yet think again! This nurse knows that left arm squeezing may be the first sign-of an impending heart attack.

She told me she was at her daughter’s school picking her up, and I told her to immediately go to the nurses’ office and have her take her blood pressure. It was 179/131. This is far beyond and above the normal! Normal bp’s in this nurse’s book (other nurses or emt’s may disagree) are approximately 120-130/70-85.

I told her to immediately go to the ER. She did express she was afraid she’d be turned away because she had no insurance. And I replied, “You will be no good to your daughter if you stroke out or die! What’s more important?” She immediately went.

Upon reaching the hospital they immediately took her in. An EKG (electrocardiography) that shows the electrical activity of your heartbeat) was normal as was her cbc (complete blood count). There was no mention if her bloodwork was checked for Tropinin levels that the heart puts out detecting a heart attack. And considering that Thyroid issues run in her family; especially her daughter who just had hers removed; no Thyroid test was done nor do the levels come back tested. So, no thyroid tests no ultrasound no MRI and no chest X-Ray to check for pneumonia infection which can affect the heart. Why you say? Because and I quote directly from the ER doctor: “You have no insurance,” period.

Her assessment, take these steroids in the prescription I’m giving you and come back if your BP bottom number goes above 100 again. Upon leaving, her BP was 157/98. How much more did the Dr need?

This treatment she received was unacceptable in my book and I’ll tell you why. In 1986 the following law was passed, and I quote:

…. If you are seriously ill with an acute symptom or set of symptoms you can go to an emergency room and they are required to stabilize you. Once stabilized they will send you on your way if you do not have adequate health insurance or the money to pay for your continuing treatment. Even if the emergency room has treated you without insurance or payment they are still going to send you a bill for the visit and treatment. If you do not pay the bill they will turn it over to a collection agency and ruin your credit if you do not pay. Millions of Americans can confirm this fact.

Stabilize, huh? Pathetic! And that’s just what they did not do to my friend. Now I’m not a doctor nor am I a physician assistant, or a nurse practitioner. I’m a nurse with over 20 years' experience and I’ll say it again.

I couldn’t find the exact percentage of patients who were ‘stabilized’ that ended up being sent home and then dying in 48hrs, but I’m sure that is notred for a reason, huh?

So back to Jamie. She has made an appointment at her Dr’s who by the way, gives her a substantial discount, for tomorrow as they wanted to see her right away. And I just left one little teeny tiny fact out.

The prescribed steroids? One of the side-effects is….. drum roll…high blood pressure. Imagine that!

Thanks for reading! Has this affected you in a personal way or someone you know? Let me know in the comments.

Credits to:

USA Today, pbs.org, WebMD, patientadvocate.org, Quora.

Need To Go to the ER? No Insurance? No Worries, You’ll Get Sent Home to Die Anyway!

‘Public and private hospitals alike are prohibited by law from denying patient care in an emergency. The Emergency Medical and Treatment Labor Act (EMTLA) passed by Congress in 1986 explicitly forbids the denial of care to indigent or uninsured patients based on a lack of ability to pay.’

Studies have shown that nearly 90 percent of physicians admit to making adjustments to their clinical decisions based on what kind of insurance (or lack of insurance) a patient has. ...