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The Right to Health Care

Most people agree that everyone deserves the basic right to health care, but how far that right goes has been the center of America’s health care debate. Within the existing social structure, inequities in access to health care are widespread. Because of numerous inequities in health care that often involve such factors as race, socioeconomic status, and gender, politicians have tried for many years to change the health care system.

• One the most recent and memorable setbacks to universal health care was the failure of President Clinton's health care plan for national health care coverage to pass through Congress in 1994. America’s health care system consists of a patchwork of health care programs and insurance that includes private health insurance, HMOs, Medicaid, and Medicare, among others. However, more than 40 million Americans are uninsured, and the government has been forced to pass various laws in order for America’s health care system to provide more equal care.
  
  
  • An example of such a law is the Consolidated Omnibus Budget Reconciliation Act (COBRA). The COBRA regulations are federal legislation that mandates an evaluation of patients who seek medical attention at emergency facilities. If an emergency care institution refuses to provide care, the institution and health care providers are held responsible and liable. These regulations prevent health care institutions from refusing needed care to people without money or health insurance.
  
  
  
  • Together, the COBRA laws and the Emergency Medical Treatment and Active Labor Act (EMTALA) refer to federal laws related to patient screening and transfer. They require Medicare-participating hospitals to do the following:
    
    
    • Perform an appropriate medical screening examination by a qualified provider to determine whether an emergency condition exists
    
    
    
    • Provide further examination and treatment to stabilize the patient, and if necessary and appropriate, to arrange a transfer
    
    
    
    • Consider patients in labor unstable for transfer
       
  • EMTALA requires that Medicare-participating hospitals screen anyone who is in active labor or is seeking emergency care. If such a screening reveals the presence of an emergency medical condition—such as severe pain, serious threat to life or limb, or active labor—the hospital is required to perform stabilizing treatment to the best of its capabilities.
  
  
  
  • In order to provide continuing health insurance for the recently unemployed, COBRA provisions also permit continuation of coverage through the workplace. Recently, many federal and civil lawsuits have been filed against HMOs for failing to provide needed care because of the drive to reduce health care costs. What the outcome of such lawsuits will be is unclear, but the quality of provided care is on the minds of all who obtain health care.