From time to time we see an article (usually from LA) about hospital patients being “dumped” on street corners. I don’t know how wide-spread this problem is, but the systemic problem that leads to this is common and serious.
Most American hospitals are required to render emergency care to anyone who comes in the door. In practice, this means hospitals provide a great deal of uncompensated care. For example, if some guy with a couple of bullet holes is dumped in front of the ER by his “friends”, the hospital is required to stabilize him. But let’s say they then wish to transfer his care because he’s uninsured, or for any other reason. Who will accept him? You can’t just dump him in the ER of a public hospital—it’s wrong from both a legal and moral perspective. In practice, patients like this are cared for until discharge, sometimes for days, sometimes for months. Sometimes hospitals will receive public funds to compensate them for this type of care, but it’s never enough.
Lack of universal insurance encourages a choice between economically unwise behavior and morally repugnant behavior. Hospitals have to choose to cut services or close their doors if uncompensated costs rise too steeply, hurting employees and the people in the hospital’s catchment area. And those who are the most vulnerable are left to either burden the hospital, or risk being dumped on the street. If the patient is well enough to leave the hospital but not well enough to care for themselves, there’s no safety net. The hospital must keep them as a “border”. No nursing home would accept someone without means to pay, and our society has no good backup plan. Sometimes, Medicaid can cover patients like this, but often they cannot.
Our system, as it stands, actually encourages immoral behavior. How proud does that make you?