EMTALA Violations in the Healthcare System
The Emergency Medical Treatment and Active Labor Act (EMTALA) was introduced because of concerns that patients who needed emergency medical treatment were being denied access to that treatment due to inability to pay (Schecter, 2010). The law basically requires any hospitals that receive federal funding to provide emergency medical care under specific circumstances. However, despite the clear language of the law, hospitals and healthcare providers continue to willfully violate EMTALA. This leads one to wonder whether a for-profit healthcare system compatible with the goals of the EMTALA, or whether a for-profit healthcare system increase the risk of EMTALA violations, putting the health of the nation's least advantaged citizens at risk. While a profit-driven healthcare system seems to increase the likelihood that indigent patients will not receive appropriate care, even with the EMTALA's protections, that does not mean that the EMTALA is not a valid and…...

mla

References

42 U.S.C.S. § 1395dd (a).

Ballard, D., Derlet, R., Rich, B., & Lowe, R. (2006). EMTALA, two decades later: a descriptive review of fiscal year 2000 violations. The American Journal of Emergency Medicine, 24(2), 197-205.

Bonnici, J. (2007). The marketing concept, patient dumping, and EMTALA. International

Journal of Pharmaceutical and Healthcare Marketing, 1(3), 234-246.

While this cannot be expected to work in the larger emergency department, in small institutions this method might prove productive. The pay is further calculated by units according to duties perfumed while the physician is on-call. (Physician Compensation Duties, 2001)
V. EVALUATION of STRATEGIES

The strategies reviewed in this work include on-call pay for emergency room physicians as well as punitive reduction of pay for refusal to take calls. The primary factor supporting call-duty compensation is the fact that the physicians are busier than ever before and this is particularly true of those who are specialty physicians who "simply don't have time to accept such duty unless paid additionally for it." (Physician Compensation Report, 2003) While many hospital emergency departments expect their physicians to be on-call without receiving extra compensation, this is not a reasonable view for the busy emergency room department management. Appropriate compensation for on-call physicians will motivate these…...

mla

Bibliography

EMTALA - an Overview (2006) Acute Care, Inc. Online available at  http://www.acutecare.com/emtala.htm .

Understanding EMTALA (the Emergency Medical and Active Labor Act) Ethics Resources Center - AMA. Online available at www.ama-assn.org/go/erc.

Hospital Auditing and Monitoring: Sample Programs for Key Risk Areas."(2006) as cited by MdPro Tip: Auditing common EMTALA Pitfalls. Online available at  http://www.hcpro.com/content/71.cfm .

Call-coverage Pay on Rise but Remains Minority Policy (2003) Physician Compensation Report. Find Articles. Online available at  http://www.findarticles.com/p/articles/mi_m0FBW/is_3_4/ai_98571892

Conflict Reduction Strategies
According to EMTALA (Emergency Medical Treatment and Active Labor Act), hospitals are responsible to ensure on-call physicians respond in a reasonable time frame and medical staff bylaws, or policies and procedures, must define the responsibilities of on-call physicians to respond, examine, and treat patients with emergency medical conditions (On-Call Responsibilities for Hospitals and Physicians, 2013). And, "when feasible, requests for consultative services should be made in accordance with patient's preferences and/or health plan" (EMTALA and On-Call Responsibility for Emergency Department Patients, 2013). The conflict in Betty's case involved the orthopedic resident's response time of two hours, indication of surgery by Thursday when the physician was not in office before ednesday, the physician did not treat hands, therefore another referral was made a week later, and after returning to ER, the physician's assistant did not respond to questions concerning the availability of the physician.

The first thing that is suggested…...

mla

Works Cited

Complying with the New Leadership Standard LD 2.40. (November 2007). The Joint Commission: The Source, 5(11), 1-3 Retrieved from http://extranet.acysweb.com/vsitemanagers/MunroeRHC/...

EMTALA and On-Call Responsibility for Emergency Department Patients. (2013). Retrieved from American College of Emergency Physicians:  http://www.acep.org/content.aspx?id=29434 

On-Call Responsibilities for Hospitals and Physicians. (2013). Retrieved from American College of Emergency Physicians: http://www.acept.org/content.aspx?id=30122

William, S. (no date). Conflict Management-Style and Strategy. Retrieved from Wright State University:  http://www.wright.edu/~scott.williams/LeaderLetter/conflict.htm

EMTALA stands for Emergency Medical Treatment & Labor Act and was passed in 1986 to guarantee the public has access to emergency services irrespective of the ability to pay. The main reason for its implementation is section 1867 of the Social Security Act. This part imposes concise requirements on any Medicare-participating hospitals that provide MSE/emergency services. Before EMTALA, people were turned down for medical treatment if they could not pay, resulting in death and health complications.
The main reason for passing the law was healthcare dumping which was as previously mentioned, ridding the hospital of patients unable to pay for emergency care. The other two, lesser known reasons were "the impact of the 1983 Medicare prospective payment system" and "some hospitals were no longer obligated to provide indigent care under the Hill-Burton Act" (Fried, 2011). The act made treating low-income and uninsured people no longer mandatory for hospitals to receive funding.…...

mla

References

Fried, E. (2011, April 5). How EMTALA Transformed Health Care - Hospitals and Health Networks. Retrieved from  http://www.hhnmag.com/articles/5010-the-law-that-changed-everything-and-it-isn-t-the-one-you-think 

Machado, A. (2014, May 7). Why Many Latinos Dread Going to the Doctor - The Atlantic. Retrieved from  http://www.theatlantic.com/health/archive/2014/05/why-many-latinos-dread-going-to-the-doctor/361547/ 

Smits, K. (2016). Applying Political Theory: Issues and Debates.

Bobby and achel Liability
There is potential liability on the part of the various parties in the scenario involving Bobby, the nurse, the surgeon and City General Hospital. In this essay, the author will consider each party's responsibility and potential liability/neglect separately. We will define comparative negligence and discuss its application to the analysis of liability in the scenario. As we shall see further on, there is an inherent contradiction between the cost containment of managed health care and the law, but this does not excuse the gross negligence of the medical staff or reduce the ability of the plaintiff for civil damages.

EMTALA (Emergency Medical Treatment and Active Labor Act) requires almost all hospitals to provide an examination and needed stabilizing treatment, without consideration of insurance coverage or ability to pay, when a patient presents to an emergency room for attention to an emergency medical condition that requires immediate attention. Specifically,…...

mla

References

Daniels, N., & Sabin, J. (1998). The ethics of accountability in managed care reform. Health Affairs, 17(5), 50-64.

Li v. yellow cab co. -- case brief. (n.d.). Retrieved from http://www.lawnix.com/cases/li-yellow-cab.html.

Rothenberg, K.H. (1989). Who cares?: the evolution of the legal duty to provide.

Houston Law Review, 26(21), 21-76.

While it may not be just to hold an organization liable, absolutely, for every instance of employee negligence, there is a rationale for imposing such liability in many cases. For example, many types of industries entail potential danger to others that are inherent to the industry.
Individual workers are not likely to be capable of compensating victims of their negligence, but the employer benefits and profits financially by engaging in the particular industry. Therefore, the employer should not necessarily escape liability for compensating all harm caused by their activities, regardless of fault in particular instances.

10.A nurse is responsible for making an inquiry if there is uncertainty about the accuracy of a physician's medication order in a patient's record. Explain the process a nurse should use to evaluate whether or not to make an inquiry into the accuracy of the physician's medication order.

Like other highly trained professionals, experienced nurses develop a…...

mla

References

Abrams, N., Buckner, M.D. (1989) Medical Ethics: A Clinical Textbook and Reference for the Health Care Professionals. Cambridge, MA: MIT Press

Caplan, a.L., Engelhardt, H.T., McCartney, J.J. Eds. (1981) Concepts of Health and Disease: Interdisciplinary Perspectives. Reading, MA: Addison-Wesley

Starr, P. (1984) the Social Transformation of American Medicine.

New York: Basic Books

Ethics is knowing the difference between what you have a right to do and what is right to do" (1). Ethics and its subsequent practice have been a very contentious issue in American society of late. Our current economic resulted almost entirely of excessive greed and unethical actions of key financial institutions. As a result of their lack of integrity, the entire world economy has subsequently suffered in a very severe manner. Many have lost their homes; even more have lost their retirement savings, while still others have lost their livelihoods. Such is the power of ethics and how its practice can have both positive and negative consequences on society as a whole. With all the attention placed on the financial community and in particular, Wall Street, many are often neglecting the unethical practices of the health care industry. I believe a very ubiquitous and widespread issue apparent within…...

mla

References

1) "Ethics Quotes - BrainyQuote." Famous Quotes at BrainyQuote. Web. 04 Aug. 2011. .

2) "VM -- Refusal of Emergency Care and Patient Dumping, Jan 09 ... Virtual Mentor." Virtual Mentor:: American Medical Association Journal of Ethics | Virtualmentor.org. Web. 04 Aug. 2011. .

3) "EMTALA - Primary Law." EMTALA.COM - Resources and Information. Web. 04 Aug. 2011. .

4) Public Citizen." Public Citizen Home Page. Web. 04 Aug. 2011. .

That is to say that relationships are considered above and beyond medical reasoning. "Futility would not be measured by the medical effect on the patient but by the effect on social relationships" (2000, p. 140). This means that even if a physician were to believe from his or her educated medical perspective that treatment would not prolong life or have any impact on integrated functioning, there is still a purpose in treatment in that it services relationships.
The case of Baby K. was quite controversial and the court's judgment was equally as controversial as they held that it was not within their realm or that it was way beyond the scope of their judicial duties or function to consider the moral decorum of whether or not an emergency room should offer emergency care to sustain life in infants with anencephaly. There are several implications in the case of Baby K,…...

mla

References

O'Rourke, K.D. (2000). A primer for health care ethics. 2nd edition. Washington, D.C:

Paola, F.A. & Walker, R. (2009). Medical ethics and humanities. 1st edition. Burlington,

MA: Jones & Bartlett Publishers.

com). A certain amount of errors is to be expected, but there should not be so many that it demonstrates a certain level of skewedness about the model in its entirety. Thus, if the NHI model is the one which is selected, then it needs to be tested against a range of different scenarios. The following demonstrate some truly relevant what-ifs: what if the doctors only move half the projected volume; what if medicare slashes rates; what if competitors open a comparable program (dgapartners.com).
There are a range of factors which can change or adjust once a healthcare facility opens their doors for business. And as much as this facility is attempting to engage in a solid humanitarian effort, at the end of the day, it's still a business and people need to get paid. Thus, before engaging in further developmental activities, one needs to determine in what ways the model…...

mla

References

Brakatu Ofori-Adjei, a. (2007). Microfinance: An Alternative Means of Healthcare Financing for the Poor. Ghana Medical Journal, 193-194.

Burnstein, L., Harris, R., & Love, L. (2012, August 30). Top Four Legal Issues to Consider When Opening an Urgent Care Center. Retrieved from Mondaq.com:  http://www.mondaq.com/unitedstates/x/194082/Healthcare/Estate+planning+is+important+step 

Burnstein, M., Harris, R.L., & Love, L. (2012, August 20). Top Four Legal Issues to Consider When Opening an Urgent Care Center. Retrieved from Mondaq.com:

S. is the issue of waiting times. Wait times for services are affected by several factors. Both countries are plagued by excessive wait times for certain services, such as specialists, surgery, or specialized treatments such as that for specific cancers or heart conditions. In both the United States and Canada, waiting times are determined in part by the number of providers available to provide that service in a certain geographic area. However, in the United States, wait times can be slowed by access to funding or the unwillingness of a provider to perform a certain service at the price set by the insurer, be it private or public. In Canada, price does not figure into the wait time. The urgency of the need of the person and the availability of services in a certain geographic area are the only factors that figure into the wait time.
Emergency room waits tend to…...

mla

References

CBS Staff Reporter (2009). "Medical Debt Huge Bankruptcy Culprit - Study: It's Behind Six-In-

Ten Personal Filings." CBS. 2009-06-05.

 http://www.cbsnews.com/stories/2009/06/05/earlyshow/health/main5064981.shtml .

Coverme. (n.d.). Newfoundland and Labrador Government Health Insurance Plan Offers Limited

Health Politics
"What is the role of Congress in policy making process"?

Policy is a plan to identify goal or possible course of actions with administrative or management tools to accomplish these goals. n the other hand, policy is the authoritative decision made by the U.S. executive, legislative, judicial branch of government to influence the decision of others. Government is a key player in decision-making process and congress plays important roles in decision-making . In the United States, both House of Representatives and House of Senate fulfill the congressional policy responsibilities, and congress plays important role in health policy, which includes obesity prevention measures or health insurance program. Congress is an important arm of government that makes law. Important strategy that congress uses to make policy preference is by passing a bill into law. Typically, the congress could make a decision to pass or not to the policy of the president into…...

mla

Oregon Department of Human Services.(2008). The impact of federal policy on Oregon's health care reform efforts: Opportunities and barriers within Medicaid and the State Children's Health Insurance Program. Medical Assistance Programs.

Waller, M. (2005).Block Grants: Flexibility vs. Stability in Social Services. Brookings Institution Policy Brief.

Zuckert, M.P. (2002). Launching Liberalism: On Lockean Political Philosophy. Lawrence: University Press of Kansas.

(Shactman; Altman, 2002)
4. ecommendations for Overcoming these Barriers:

Some of the suggestions for overcoming these barriers are (i) appointment of a General Practitioner -- GP officers to work as a Liaison Officer between the ED and the community so that the communication is streamlined as well as processes of referral and feedback and development of clinical pathways. (ii) Expansion of community off-peak facilities, including the setting up of the capacity for community access to X-rays, Scanning, ultrasound, blood tests and observation beds. (iii) Initiation of a project to deal with frequent attenders to the ED through the development of management plans contributed to by the patient, their GP, the ED as also their specialist (iv) Education of the local community such that are aware as to when and under what situations to access ED care or alternative care in the community. (Ardagh; ichardson, 2004)

eferences

Ardagh, Michael; ichardson, Sandra. (2004) "Emergency department…...

mla

References

Ardagh, Michael; Richardson, Sandra. (2004) "Emergency department overcrowding- can be

fix it" Journal of the New Zealand Medical Association, vol. 117, no. 1189, pp: 27-31.

Brewster, Linda R; Rudell, Liza; Lesser, Cara S. (2001) "Emergency Room Diversions: A

Symptom of Hospitals under Stress-Increased Demand for ER Services" Center for Studying Health System Change. Issue Brief No. 38. Retrieved May, 2009 from  http://www.hschange.com/CONTENT/312/

Futile medical care is the ongoing provision of medical treatment or care to a patient who does not show any hope of recovery. It is either that his condition is not curable and therefore the treatment that he is receiving is of no benefit. The common examples of these are that a surgeon is performing a surgery on a patient with terminal cancer. Patients who have terminal cancer have gotten the cancer spread all throughout their body. It is only until time that their organs will go into failure and they will pass away. Another example is of keeping brain dead people on life support for other reasons. As it would be expected, this is quite a sensitive area and it would involve arguments with the patient's relatives and friends.
It is understandable that the loved ones do want to do anything they can to keep the patient in front…...

mla

References

Appel, J. (2009). What's So Wrong with "Death Panels"?. [online] Retrieved from:   [Accessed: 26 Jul 2013].http://www.huffingtonpost.com/jacob-m-appel/whats-so-wrong-with-death_b_366804.html 

Doyle, D. (2010). WebmedCentral.com:: Baby K. A Landmark Case In Futile Medical Care. [online] Retrieved from:   [Accessed: 26 Jul 2013].http://www.webmedcentral.com/article_view/969 

Gardent, P. And Reeves, S. (2009). Ethics Conflicts in Rural Communities: Allocation of Scarce Resources. [e-book] Lebanon, NH: University Press of New England.   [Accessed: 26th July, 2013].http://geiselmed.dartmouth.edu/cfm/resources/ethics/chapter-09.pdf 

Pomerance, J., Morrison, A., Williams, R. And Schifrin, B. (1989). Anencephalic infants: life expectancy and organ donation.. Journal of perinatology, 9 (1), pp. 33-37.

goal of their ethical calling, physicians, nurses and other health care workers are obliged to treat the sick and potentially infectious patients and, in so doing, they are to take some personal risk (Murray 2003). This was the bottom line of the assessment and stand made by Dr. Henry Masur and his colleagues at the National Institute of Allergy and Infectious Disease (NIAID), particularly during the outbreak of dread global SARS in Canada and Hong Kong last year. They also referred to other epidemics, such as the HIV / AIDS.
Masur emphasized that this primary goal and obligation is voluntary and sets the medical profession apart from other professions, precisely because of the involvement of some personal risk in fulfilling that obligation. esides physicians, medical professionals are nurses, dentists and health workers. Records of the first SARS outbreaks in Toronto and Hong Kong showed that a huge 50% of those…...

mla

Bibliography

Katz, Laura L. And Marshall B. Paul. When a Physician May Refuse to Treat a Patient. Physician's News Digest, 2000.  http://www.physiciansnews.com/law.202.html 

Levin, Aaron. Doctors Willing But Not Ready to Treat Deadly Bio-terror Agents. Health Behavior News Service: Center for the Advancement of Health, 2003.  http://www.cfah.org/ubns/news/bioterror09-17-03.cfm 

Murray, Terry. Health Care Staff Have a Duty to Treat. The Medical Post: Rogers Media, 2003. http://www.medicalpost.com/mpcontent/article.jsp.jsessionid=NJCJNDCEAGHH?content=20020515_09

Schulman, David I. The Dentist, HIV and the Law: Duty to Treat, Need to Understand. Dental Treatment Consideration, 2000. http://www.hivdent.org/dtcblaa082001.htm

Schlesinger describes four main themes relating to the notion of a shared household. These are:
Collective responsibility for medical care or cost-

Family members have collective responsibility and commitment in regard to certain burdens (such as paying the rent or household chores). In a similar way, politicians first argued at the end of the Progressive era that the American nation -- qua family -- owed special responsibility in regard to its duty: medical services. esponsibility in regard to the nation providing social insurance reappeared during the Great Depression era where oosevelt argued that "Americans were ready, in the Depression and after, to abandon individual responsibility for the costs of sickness during and after the Depression" (Schlesinger, 973).

Shared institutions for health care and finance

Just as the household may collectively sit down to meals and share other common experiences, so is the household expected to collectively share in providing for their insurance and…...

mla

References

Brooking Institute (2008) "Meeting the Dilemma of Health Care Access" (PDF). Opportunity 08: A Project of the Brookings Institution. Retrieved on 11/26/2011

http://www.opportunity08.org/Files/FD.ashx?guid=98a417e5-5972-4031-b361-e11e00981f55

Consumer Affairs. Com. (2007). Study Finds 24% of Americans Underinsured Retrieved on 11/26/2011

 http://www.consumeraffairs.com/news04/2007/08/cu_insurance.html