There is a key concept often left out of the health care debate and something that politicians seem to continually misunderstand or refuse to acknowledge: that we have an obligation to provide care. This does not necessarily translate to “we as a nation” but “we as clinicians,” who have a moral obligation and, in the case of hospitals, a legal obligation to provide emergency care under the Emergency Medical Treatment and Labor Act. There is a need to acknowledge the moral and deontological sentiment that exists here. This was borne out of many failures and Supreme Court decisions resulting from a refusal to treat people, who then died or had bad outcomes. Patient dumping led to overcrowding of emergency rooms in county hospitals, where turning people away may have been legal but was ethically reprehensible.
The continuing frame of thought that health care is a market-based product is doomed. We may continue on this path for some time, but the end is inevitable; either we finally recognize an obligation to providing care or we allow hospitals to turn people away. It is all well and good to be a congressperson and treat health care as a free-market product, but when you are face to face with the bad effects of this mind-set, you may think differently. When the major groups representing clinicians in the trenches are against what you are doing, you ought to take some time to contemplate this.
Ian Wolfe, Minneapolis
Star Tribune, May 5, 2017