The Emergency Medical Treatment & Labor Act was drafted by congress in 1985 as part of the Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985 which is a larger healthcare and social security law. The law passed in 1986.
It was well received in large when it was signed into law by President Ronald Regan in 1986. The need, benefits, and issues brought about that. The only negative was the potential to cheap the system and steal from hospitals by those who are able to pay but don’t. This issue is not really a major issue because patients still get billed and there are still repercussions for not paying bills but if the need for urgent care is real it could save your life; however about 6% of hospital services are never paid for, thus not completely an unreal threat.
This was touched upon a little in a previous question. Many cases of patient dumping were popping up around America. Patients in need of emergency medical care were being cast aside, ignored and delayed due to their inability to pay. In addition to the stab patient, Eugene Barnes that sparked this law, there were dozens of other cases where patients needed to be transferred to larger hospitals but the hospital refused to take patients without insurance, so the patients died. There were cases of people being asked right before surgery for a deposit, and being unable to pay were discharged with no surgery. There was also a very high rate of dead babies that were arising due to the fact that mothers in labor were being turned away because the patient was uninsured. It was then realized by the government that there were no legal duties for a hospital to treat people who are in emergency situations but cannot pay, only ethical and moral duties, which apparently weren't enough in some cases. This led to the birth of the EMTALA, requiring medical attention to all ED patients as well as transfers if needed to stabilize, including mothers in labor.
The Emergency Medical Treatment & Labor Act (EMTALA) goal is to guarantee everyone access to emergency care at hospitals (Medicare, Health & Human Services, or CMS participating ones) regardless of ability for the patient to pay for the services or not. This was aimed to open up equal access to critical treatment regardless of class, social standing, or wealth.
Those that cannot pay for healthcare services (or are suspected to not be able to) are the most vulnerable population as they can literally die because of their social standing getting in the way of care and treatment.
This policy applies to American law and patients who are in need of emergency medical treatment and is to be followed by all emergency departments and personnel alike.
It is said that EMTALA doesn't apply to ambulance services, technically this would be true. Yet, EMTALA does indeed effect our patients, and anything that effects our patients can effect us and should be a concern of ours as EMS providers. If EMTs are spending time in the hospital sorting out insurance issues and payment, that is more time they are out of service. Also, if the patient's treatment time is delayed, not only will the hospital be blamed, but so will EMS. If a patient is in cardiac arrest, EMTs will not be stopping and wasting time to find out insurance and payment issues from family members, that will be the last thought on their mind. They will be transporting and attempting to stabilize the patient. EMTs and EMS will not compromise the health of a patient due to insurance or payment issues, just like hospitals are now mandated to do.
It matters to public health greatly because without it, hospitals could refuse to provide critical treatment until they were satisfied that the patient could pay, which can result in death from delay or refusal of care.
EMTALA was enacted by Congress in 1986 and was part of the Consolidated Omnibus Budget Reconciliation Acts of 1985. Congress saw different cases around America where doctors were refusing medical care to patients who could not make a deposit at the time of their admittance to the ER. An example of this is a patient Eugene Barnes, who in 1985 suffered a stab wound and ultimately ended up dying because 6+ doctors refused to help him without payment or some form of compensation. This made national news and other cases began to come to light, such as at Baptist Hospital in Miami and many other areas. News outlets began to follow these cases and this caught attention of government officials. Shortly after, EMTALA was enacted.
This policy was received in good light by the public for the most part. Patients were only to benefit from this, especially those who lacked insurance. Even those with insurance didn't have to waste time proving it any longer, they were treated and stabilized and insurance issues and payment were brought up later. Any ethically sound doctors, such as the ones working in hospitals that were already implementing the actions set forth by EMTALA (before it was law) had no issues with EMTALA. No doctor should have any issues with it due to their duty to act as well as ethical and moral standards they should be holding themselves up to, written in their oath they took to become doctor. The only people that would stand to receive this act negatively would be the doctors who were actively turning away patients in need, who are clearly morally compromised. Yet, media, patients, a majority of doctors and staff found and received this act positively or with little reservation.