The Your Health column is written by health and medical experts at the University of Texas Medical Branch at Galveston. The column focuses on topical health issues that we believe are of interest to your readers. It is e-mailed every Tuesday. 

Your health
By Michael Warren 

A victim of the recession, you have no job and no health insurance. One evening, very late, you think you’re having a heart attack. You go to the nearest emergency room, worried you cannot pay for treatment. What can you do? 

The first person you should see when entering an emergency room is a medical person, the so-called “triage” nurse, doctor or other health care provider. It is against the law for anyone to ask you about your financial status until you are about to leave the facility so some arrangements for payments can be made. 

Keep in mind that no emergency room has a right to refuse care, regardless of your ability to pay, if it has the appropriate equipment and expertise. If such care is not readily available, you can be transferred to an alternate facility. However, the emergency room must make those arrangements; it is not your responsibility to find another, better-equipped hospital. 

However, there is an unfortunate reality to such a scenario. You have arrived at the second emergency room, you have been properly cared for and then the hospital begins to make plans for your follow-up care. It is inevitable that the second facility will request information regarding your ability to pay health care costs. It embarrasses me to admit that many facilities, upon learning that you are neither independently wealthy nor covered by health insurance, suddenly realize that they cannot accept another patient. 

Sometimes, a hospital’s inability to offer treatment is completely legitimate. Perhaps it is understaffed, or the specialist you need is not available. But, facilities that base their decisions on a patient’s inability to pay are beyond my comprehension (and tolerance level).

Of course, hospitals that depend solely upon patient fees for survival cannot give away their services consistently; they need income in order to exist, and that is understandable. However, emergencies should be considered on their individual merits; doctors are committed to saving lives. 

Fortunately, federal legislation requires a hospital to accept a patient if that hospital’s facilities exceed the capabilities of the referring hospital. Failure to do so invites the imposition of severe penalties. 

As the patient, you have a right to emergency care and, if an emergency room refuses to provide treatment, you must complain, very loudly and until someone takes notice. Talk to politicians and legislators; to your doctor or clergyman; to someone at your local newspaper. 

Don’t be intimidated; know your rights and act swiftly and decisively in your own behalf. 

Dr. Michael M. Warren is Ashbel Smith Professor of Surgery in the division of urology at the University of Texas Medical Branch at Galveston.