For example, last week the American College of Emergency Physicians (i.e., ER docs), supported by the Washington State Hospital Association, the Washington State Medical Association and the Washington Chapter of the Academy of Emergency Physicians, filed a lawsuit in Washington State to challenge that state’s new Medicaid rules, which limit Medicaid patients – i.e., the poor - to three “non-emergency” visits to the ER each year. And that’s not all these rules do. In order to make double sure these struggling families don’t frequent the ER too much, they’ve created a special definition - just for them - of what’s an emergency. Here is what’s no-longer considered an emergency if you’re a Medicaid patient in Washington State: difficulty breathing, miscarriage, abdominal pains, and chest pains. In other words, if you think you’re having a heart attack, get an appointment with your primary care doctor. (Talk about “death panels.”) In fact, over 700 diagnoses that used to be emergencies are now considered “non-emergent.”
Then yesterday, the U.S. Supreme heard a case brought by doctors, health care providers and patients, challenging the state of California’s decision to cut reimbursement rates to doctors who treat Medicaid patients, and doing so without getting the federal government’s approval like they’re supposed to. NPR’s Nina Totenberg described the case this way:
In 2008 and 2009, California cut [Medicaid reimbursement] fees by up to 10 percent, and the cuts went into effect without being submitted to the federal Medicaid agency for approval as required by law. Health care providers went to court, contending that the cuts were solely for budgetary purposes and did not meet the federal requirements for balancing money issues and access to health care. On the steps of the Supreme Court on Monday, California Medical Association doctors said they simply can't afford to take care of substantial numbers of Medicaid patients when fees are so low.
The problem is that they may not have a right to bring a lawsuit at all. That's even according to Justice Ruth Bader Ginsburg. Imagine not being able to bring a lawsuit in a situation like this, when doctors have clearly been wronged, and when the poor are going to suffer for it, right?
If only the ER docs saw the same value helping poor folks get proper treatment like this as helping some of those same patients who are negligently injured. For example, last November, we wrote about Florida legislation that would give ER doctors who treat Medicaid patients "sovereign immunity," and cap their liability for committing medical negligence against the poor at $100,000.
For three decades, doctors and medical societies have pursued a relentless campaign to severely limit compensation for injured patients. Yet when a managed care company or the government treats doctors unfairly, they head straight to court – in fact, to the U.S. Supreme Court. This should be their right. It should be patients’ rights, too.