Beth Israel Deaconess Medical Center and the Harvard Medical Faculty Physicians are drawing criticism for a $30 fee that is being instituted for patients who are seen between 10 PM and 8 AM.
The hospital system says that the surcharge “is designed to offset the cost of 24-hour, 7-day access to emergency medical services.”
The SEIU, who is behind the protests, claims that “a fee based on the time of [a medical] emergency crosses the line.” As an aside, the SEIU is apparently trying to increase its presence in Boston and its modus operandi is to make things difficult for hospitals just prior to organizing drives. See also here and here and here.
First of all, most visits to the ED aren’t “emergencies.”
Second, hospitals will have difficulty collecting the fees from many patients.
But those two issues are aside from the point.
We’re a nation of fees. We’re charged a “convenience fee” for purchasing concert tickets online. We’re charged fees for luggage that weighs too much. We’re charged fees for using ATMs. We’re charged fees if we use our cell phones before 7PM. We’re charged fees if our lawyer calls us and we pick up the phone. We’re charged fees if our lawyer calls us and we don’t pick up the phone.
Why should a hospital emergency department be any different?
UPDATE SEPTEMBER 25, 2009
Poof!
Even though the late-night fees are common practice according to ACEP, the Boston hospitals dropped the late-night fee after news of the fee hit the newspapers.
Game … SEIU.
Why not? You pay more at a convenience store for security and utilities, why not at a hospital? And if you’re really, really sick, they’re gonna haul you in in an ambulance and you’ll never notice it with all the other charges.
Because medical assistance is a basic and human right and it would be free and universal. Don’t compare it with cell phones and concerts, please.
Just wondering…where is it written down that medical assistance is a basic and human right? Because while I agree medical care is a service that is needed, there was nothing that forced all of doctors and nurses and other medical care providers to enter that profession and nothing that makes them stay.
In the grand scheme of things, yes it is just like a cell phone or a concert, medicine is now a business because of the cost of all the medical equipment, medicine, etc that is used to treat us. It has to be paid for somehow.
Why not frame it like the insurance companies? If a patient is admitted, the ER fee is waived.
I rather like that idea…if you’re going to the ED simply because you dont WANT to wait, you’re paying the overage, just like a STAT lab test costs more than a standard lab test, a STAT medical visit should cost more than a regular medical visit.
I’m in FAVOR of universal health care, but this seems like a reasonable way of letting a hospital cover the late night drunk tank.
Free market at work, simple economic formula.
Those who are in a position to change their behavior because of the extra 30 bucks, probably don’t really have a life-threatening emergency.
If they don’t like the surcharge, go to a different ER. Simple, unless you’re in an ambulance (a minority).
Leo–Medical assistance is NOT a basic human right. Basic human rights do not require anyone else to do anything but leave the human alone. Free speech is a right. Freedom of religion is a right.
Medical care is a service that needs to be paid for, yes, just like your water bill and your sewer bill and your electricity bill. You want premium service, you pay more. You can’t afford it, plan ahead.
Oh America, you are so nutty.
Smart idea I reckon. Maybe waive the fee for actual medical emergencies, but for people who think being too irresponsible to make sure they have enough medication to last the weekend is a medical emergency, they should definitely be charged a fee – more than what their doctor would charge them. Maybe it’ll discourage inappropriate use of emergency resources.
agree with you philosophically but the non-urgent cases with fast turnaround (in the commercially insured) are big moneymakers for the hospital. as much as we complain about nonsense visits, the hospital definitely isn’t interested in discouraging inappropriate ED use.
As a Canadian medical student, i’m damn happy i live in this country!
Free market medicine works if everyone knows what’s wrong with them..the ED is there for a reason and most visits are non-emergent for a reason..that reason is that people don’t know what the hell is going on because they are not physicians.
Yeah, all the $1 copay-paying toothacheurs, chronic paineurs, chronic migraineurs, vaginal dischargeurs, healthy young adults with coughs and colds…I’m sure they ALL think they’re dying. You’re a medical student, so I’ll give you a reality-check pass just this once.
Brought my 4 yr old with breathing problems to the ER at 2am on a Saturday. His doc told us to go to the ER. So no choice. Got charged a “late night” fee. All local hospitals are part of the same network so no choice to go somewhere without the fee. Unless of course I wanted to drive 60 minutes away.
Can they charge the fee sure? Is it a cheap tatic and annoying? You bet. Did I have to pay the fee? No, I have insurance. Good for me, bad for the folks who don’t have good insurance.
I wonder how many of these fees are recouped or if it drives up adminstrative costs because insurance companies won’t pay and covered folks aren’t required to pay?
Because health care should be different from ticketmaster. If you haven’t grasped that yet, it’s no wonder you don’t understand the push for health care reform.
And you want health care reform brought to you by the same bunch of geniuses that gave us the hallmarks of government efficiency such as the post office, DMV & TSA? Or more relevantly social security & medicare (both soon-to-be bankrupt)? That’s even worse than the current system…