Preventing Patient Dumping

Another effort is under way in Sacramento to write legislation to deter hospital-patient dumping--the dangerous practice of moving patients in unstable condition to public hospitals because they cannot pay the fees. Approval of the law has already been delayed too long.

Assemblyman Burt Margolin (D-Los Angeles) is the author of AB 214, which would put teeth in the enforcement of existing laws--including appropriate sanctions against hospitals and doctors failing to provide required services. In its revised form the bill this year includes provisions for the development of precise protocols to define the circumstances under which patients may be transferred. Similar protocols have proved to be an effective device in reducing abuses of laws controlling emergency health care.

Under existing law all licensed emergency rooms are required to treat all emergency cases, including the delivery of babies, regardless of patients’ ability to pay. The care must continue until the patients are in a stable condition, when an appropriate transfer may be arranged if it is done with the prior approval of the hospital to which the patient is being transferred. But the practice falls short of the promise. Hearings before Margolin’s Special Committee on Medi-Cal Oversight have produced evidence of a widespread violation of laws against patient dumping--largely because other federal and state laws have no enforcement element.

Patient dumping is only part of the problem of providing better health care for those with limited means, but it is an important element. Other bills are pending to provide more adequate funding for hospitals that handle a disproportionate share of health care for which there is no compensation, either from the patient or from private or public insurance. That is part of the public responsibility to assure basic health care for all.