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Have an emergency? Bring cash!

By Virginia Traweek, Contributing Writer

Some hospitals are now charging an up-front fee for emergency room (ER) usage if you have a minor ailment; if you show up in one of these hospitals’ ERs without cash and have minor injuries, you get turned away. Currently, the fees range from $150 to $250. Hospitals argue that the fact that so many cases are eventually turned over for bad debt effectively justifies this fee, so as to ensure that the ERs can continue to operate.


Photo by KOMU News

Most people think that you just go to an ER when you are really sick. In the same way that we expect there will always be an operator on the other end of a 9-1-1 call, we think that ERs are come one, come all.

But, it hasn’t always been that way. In 1986, Congress passed the Emergency Medical Treatment and Active Labor Act (EMTALA), which required that hospitals accept all patients that show up at ERs. The idea was that at least some form of care would be available to those in dire need. Ironically, the type of care that the bill guaranteed to all is the most expensive type of care. Keeping an ER running so that it can handle everything that walks in off the street (or arrives via ambulance) is expensive. Thus hospitals want to make sure that only well-paying customers go to the ER.

Additionally, having a serious enough disease to warrant dismissal of the fee doesn’t mean that you are going to get world-class treatment. The Incidental Economist explains:

“What if you crawl into an ER dying of cancer? EMTALA would require a screening and stabilization, which might include chemotherapy. But once the cancer was knocked back a bit, the hospital could discharge you without any commitment to further care, even if they knew the cancer would come back unless treatment continued.”

It is a brutal truth of the American health care system, and there are no easy answers. Certainly, there are some ways to lower costs for emergency care. You can go to a neighborhood clinic, get more preventative care, or wait until regular office hours. Hopefully these techniques will help relieve some of the pressure on ERs in America; but there’s also the fear that charging a fee means that people will wait until their minor ailments become major, ultimately costing hospitals and taxpayers more than the original fees.

Virginia is a contributing writer for GenWhyPress. She received her master’s degree in finance from Texas A&M University.  She worked for several years as a senior housing consultant before beginning the University of Alabama at Birmingham’s Master of Science in Health Administration program.  Virginia also runs a website, SeniorHousingMove.com, dedicated to helping seniors find the right retirement community. She can be reached for questions or comments at virginiatraweek@gmail.com.

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