As anyone in hospital medicine knows, the EMTALA law (Emergency Medical Treatment and Active Labor Act) is an enormous unfunded mandate for emergency physicians, hospitals and anyone who takes call in a hospital which receives Medicare funds.  Basically, to review, the law has been in place since the eighties, and it says that no one can be asked for payment as a requirement for emergency care.  They can be billed later, but not compelled to pay.

It was initially a good idea, designed to protect the poor.  Except for one teensy, weensy problem.  The government put this burden in our laps without providing any funds to pay for the ‘free care’ they so graciously granted America.  Nevertheless, physicians and hospitals who treat non-paying patients are not in any way protected from liability.  So it’s a genuine Catch-22, as it were.  In fact, many hospitals and trauma centers have closed as a consequence of the economic madness that anyone, anytime can receive care for almost anything without a requirement of payment.

Now, my partners and I are always happy to see the truly sick and injured, the working poor, the undocumented, those trying and having a tough time.  However, word gets around so hospitals and ER’s are constantly overwhelmed with…well, with everything from people seeking narcotics, to folks who didn’t want to wait for their primary care appointment for minor problems and everything in between.  And that causes lots more hay we have to sift through to find the genuine needles; that is, those in danger or severe pain.

But today, dear colleagues, it’s all better.  I saw the public service announcement by Hilda Solis, Secretary of Labor under the Obama Administration.  Here’s the link to a site where you can view the video:

In this earth-shattering turn of events, she says to all workers in America:  ‘You work hard and you have the right to be paid fairly.’  Excellent.  We all agree

Likewise, she opines:  ‘It is a serious problem when workers in this country are not being paid every cent they earn.’  FYI, the average emergency physician sees about $140,000 in uncompensated care each year.  We constitute 4% of physicians, but see about 60% of uncompensated, uninsured patients.

And last but not least, ‘Every worker in America has the right to be paid fairly, whether documented or not.’  Well, that’s reassuring.  But let me be clear; I am documented.  Documented by my college, medical school, residency, specialty board, specialty society, state medical board, state controlled substance authority, DEA and hospital.  Certainly documented by every local, county, state and federal tax authority.  This is me!  I’m here!

I’m blessed; I make a good living.  For that I am endlessly thankful.  But since the driving force of the progressive left seems to be a concern for ‘fairness,’ well I’d say I’m in a kind of unfair situation.  I’m doing the work the government takes the credit for; propping up an over-regulated, over-burdened, under-rational health-care system and doing it for a fraction of the market price.  So fair is fair, right?

Not generally a fan of the current administration, I’d like to applaud Secretary Solis for her courage in tackling the rampant abuse of physicians that this administration, and several prior administrations, have created and sustained.

She has graciously offered us a phone number to call:  866-487-9243.  Likewise, the appropriate Department of Labor website is:

Since we’re tasked with providing care to all of the workers, documented and undocumented, that she is concerned about, I guess that makes us workers too.  Heck, I wear a shirt with my name on it.  If that ain’t blue collar, nothing is!

So let the games begin!  If you feel that EMTALA is an unfair, unreasonable law, and if you feel that being compelled to work without compensation is also unfair and unreasonable, then contact the honorable, and most excellent Secretary Solis and voice your opinion.

What a bright shining day it is!


Edwin (documented health-care worker)

PS  Before you call me a greedy doctor, remember that this concept has implications for everyone who works in a hospital (not just physicians), and applies to all those whose job has been threatened, whose salary has been slashed, whose benefits have been cut; because all that money has to come from somewhere!

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