IN THE US, IF YOU GO TO THE EMERGENCY AND HAVE NOT PAID FOR AN ADVANCED PAYMENT?
1. In case the child "pays enough money for emergency treatment"
In recent days, social networks have spread rapidly the clip “pay enough money to provide emergency care” for a 4-year-old baby at Nam Dinh Provincial General Hospital. Even though the specifics of the incident are unclear, this video cannot help but make people angry when they watch it.
Human life is the most important thing, so why do we have to ask for an “advance” to save it?
I don’t know what the truth is. However, I have heard people in the profession in Vietnam share that while doctors always want to save patients, sometimes they encounter difficult situations such as after being treated after a critical illness, but the patient escapes the hospital. As a result, the doctor and medical staff who saved that patient’s life had to pay out of pocket to compensate for their hospital fees.
Indeed, balancing the responsibility of saving lives and ensuring finances for the hospital is a difficult problem for the medical industry. Everyone wants to contribute to their profession without having to worry about such financial problems.
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Not only in Vietnam, this problem is also common in the medical industry of many countries around the world, including the US. Here, there are countless cases of illegal immigrants or low-income, uninsured people… admitted to the emergency department.
2. In America, how do doctors handle this situation?
In the US, there is an important law called EMTALA – Emergency Medical Treatment and Labor Act, enacted in 1986.
This is a federal law that ensures patients are not denied treatment in emergency situations, regardless of their ability to pay, insurance status, or legal status.
Key points of the EMTALA law:
2.1 Initial Medical Screening Examination (MSE):
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- When a patient arrives at the emergency department, the hospital is responsible for performing a full screening examination to determine whether the patient is in an emergency or not.
- Screening should not be delayed to ask for financial or insurance information under any circumstances.
2.2 Stabilization:
If an emergency is determined, the hospital Treatment must be stabilized before the patient is transferred to the hospital or discharged from the hospital.
For example: If a patient has an accident that causes severe blood loss, the hospital must be responsible for properly handling the blood loss before transferring the patient to a higher level.
2.3 Transfer to hospital according to regulations:
In case it is necessary to transfer the patient to another facility, the transfer must:
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- There is a good reason (for example, the current hospital lacks equipment or expertise).
- Ensure patient is stable, or transfer is necessary.
- Provided safely with appropriate care and facilities.
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2.4 Do not refuse care for financial or legal reasons:
The law clearly states that a hospital may not refuse Refusing emergency examination or treatment simply because the patient is uninsured, cannot afford it, or is an undocumented immigrant.
3. After treatment, who will pay?
3.1 In case the patient has insurance (Medicare, Medicaid, or private insurance):
- Insurance will pay according to the signed contract.
- Patients may have to pay a portion of the cost as a “copay”, “deductible”, or “coinsurance” depending on the insurance contract. Patients do not have to pay these parts immediately but can wait until the hospital sends the invoice home to pay.
3.2 In case the patient does not have insurance:
- The hospital still sends the full invoice to the patient after the emergency. At this time, the patient will be responsible for paying the entire cost.
- In cases where the patient’s ability to pay is limited (for example, people with low income or no income), many hospitals have financial assistance policies (financial assistance/charity care). Then:
- Patients can apply for reduced or free hospital fees based on income.
- Most states in the US have laws requiring hospitals to provide financial assistance to low-income people.
- If the patient does not cooperate in paying hospital fees:
- Hospitals can send invoices to collection agencies, affecting the patient’s credit score (In the US credit score is very important, if your credit score is bad, you will have a lot of difficulty getting a loan, renting a house, buying a car and even finding a job later this).
In addition, in cases where the patient still owes money from previous visits, the EMTALA law still ensures that the hospital cannot refuse emergency care in the future.
In short, EMTALA helps doctors and hospitals focus on saving lives. “Save people first, think about the rest later!”
This approach is an extremely humane policy that prioritizes protecting the health and lives of patients while still ensuring that the health system can operate without going bankrupt.
So what about the way to do it in Vietnam? Is there any law similar to EMTALA? Please comment and share more with me.
Hope this article brings useful information to you. What do you think about America’s approach to this issue? Please comment to share your opinion or experience!
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Dr. Christina Nguyen
Phoenix Medical Academy
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