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Legally, it’s not supposed to matter whether emergency room patients have insurance or not. The Emergency Medical Treatment and Active Labor Act, passed by Congress in 1986, guarantees that all people brought to the emergency room receive all the treatment they require, independent of their ability to pay.

And yet, a study just published in the Archives of Surgery found that patients lacking insurance are 80% more likely to die from traumatic injuries than those with private insurance, including commercial health plans, health maintenance organizations, and Medicaid.

Trauma physicians said they were surprised by the findings, even though a slew of studies had previously documented the ill effects of going without health coverage. Uninsured patients are less likely to be screened for certain cancers or to be admitted to specialty hospitals for procedures such as heart bypass surgery. Overall, about 18,000 deaths each year have been traced to a lack of health insurance. –LA Times

While the researchers from Harvard University and Brigham and Women’s Hospital in Boston were expecting to find some disparity in risk between insured and uninsured trauma patients, they were shocked at just how large the disparity was.

The researchers offered several possible explanations for the findings. Despite the federal law, uninsured patients often wait longer to see doctors in emergency rooms and sometimes visit ERs at several hospitals before finding one that will treat them. Other studies show that, once they’re admitted, uninsured patients receive fewer services, such as CT and MRI scans, and are less likely to be transferred to a rehabilitation facility. –LA Times

Whatever the explanation, findings like this make it clear that we need to do away with a health care system that effectively makes second class citizens out of the uninsured.

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