I am writing about your article "No excuses for (patient) dumping," Dec. 7, p. 8. That "protections don't extend to patients with private insurance" may technically be correct in the sense that federal regulations do not address "private insurance," but COBRA language regarding patients who seek emergency room care specifically says "all persons."
Most hospitals depend on Medicare certification for financial viability; HCFA-imposed COBRA-based sanctions can effectively shutter them. Trying to sort out in the ER who is "privately insured" is difficult at best. Not affording those patients the same protections provided by COBRA is futile.
Hospitals and their medical staffs should make joint efforts to ensure that all comers to the ER are evaluated on a level playing field. Managed-care organizations need to recognize the process that ERs everywhere must undergo to appropriately evaluate their patients.
Executive vice president
Team Health West