CMA’s Opposition to ‘Anti-Dumping’ Bill Criticized

Democrats on the state Assembly’s Health Committee sharply criticized the California Medical Assn. Tuesday for opposing a bill that would penalize hospitals for shuttling poor patients from one emergency room to the next for economic reasons.

The committee discussed at length a proposal by Assemblyman Burt Margolin (D-Los Angeles) to strengthen existing state laws that require hospitals to care for emergencies regardless of a patient’s “insurance status, economic status or ability to pay.”

The bill fell one vote short of the seven needed for approval and will be up for another vote next Tuesday.

The CMA opposes the bill unless the state can guarantee that physicians will be paid for their services to the poor and the uninsured, testified George F. Cate, a medical association spokesman.

“This is the worst example of testimony from a physicians’ group that I have ever heard,” said Assemblyman Bruce Bronzan (D-Fresno). “All (the association) seems to be concerned about here is money.”

Some hospitals are motivated to transfer emergency room patients to public hospitals--a practice called “dumping”--out of fear that the patients will not be able to pay for their care or that government payments, such as Medi-Cal, will not cover the actual costs. Studies have documented instances in which such transfers have delayed needed medical care and resulted in further injury and death.

If enacted, Margolin’s bill, AB 3403, would give California one of the toughest “anti-dumping” laws in the nation. It would supplement a federal “anti-dumping” law approved by Congress on March 20 and awaiting President Reagan’s signature.

Margolin told the Assembly hearing that his bill is narrowly focused to help enforce existing laws. These laws are hampered by penalties that are either too weak, such as a letter of reprimand, or too strong, such as suspending an emergency room’s license, Margolin asserted.

‘Intermediate Penalties’

Margolin has proposed what he termed “intermediate penalties,” including fines of up to $25,000 and jail terms of up to one year for each violation, as well as making public a summary of all violations.

Committee debate focused on whether the anti-dumping bill should be amended to include a requirement that private hospitals be reimbursed by county and state governments for emergency medical care for the poor and uninsured.

“It’s not a question of humanity, it’s a question of reimbursement of institutions for services provided,” said Assemblyman Gil Ferguson (R-Newport Beach).

Such a mandate could cost as much as $40 million a year for physicians’ fees, plus additional millions for other emergency room costs, according to the committee staff.

Margolin said halting illegal activities that jeopardize patient’s lives should not be confused with the wider issue of providing adequate state funds for health care. “That’s best left to the budget process,” he said.