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Patient Dumping--Are We Back to That?

Earlier this week a woman dressed only in a hospital gown and socks was left at a bus stop by four security guards from a Baltimore hospital in the dead of night, in the freezing cold, without anyone to help or care for her.

The incident was captured on video and posted to Facebook by Imamu Baraka, a mental health counselor who works across the street.

“I just witnessed this with my own eyes,” Baraka wrote in his post. “I had no choice but to give this young lady a voice in this moment.”

As reported by the Baltimore Sun, the incident is being investigated by the University of Maryland Medical System. In a prepared statement, officials there said they shared the “shock and disappointment” of others who saw the video.

The women was being discharged from the emergency department, they said.“This unfortunate event is not representative of our patient-centered mission,” the statement said. “While there are many circumstances of this patient’s case that we cannot address publicly, in the end we clearly failed to fulfill our mission with this patient, no matter the circumstances of her case or the quality of the clinical care we provided in the hospital (which is not depicted in the video).”

Patient dumping, of which this appears to be an example, apparently has a long history. And while I had never heard of such a horrible practice, here's how it is described by Wikipedia:

Homeless dumping or patient dumping is the practice of hospitals or emergency services releasing homeless patients on the streets instead of placing them with a homeless shelter or retaining them, especially when they may require expensive medical care with minimal government reimbursement from Medicaid or Medicare. Many homeless people who have mental health problems can no longer find a place in a psychiatric hospital since the trend towards mental health deinstitutionalization from the 1960s onwards.

The term "patient dumping" was first mentioned in the New York Times in articles published in the late 1870s describing the practice of private New York hospitals transporting poor and sickly patients by horse drawn ambulance to Bellevue Hospital, the city's preeminent public facility. The jarring ride and lack of stabilized care typically resulted in death of the patient and outrage of the public. Notwithstanding the passage of city ordinances prohibiting the practice it continued.

"Patient dumping" resurfaced in the 1980s, nationwide, with private hospitals refusing to examine or treat the poor and uninsured in the emergency departments (ED) and transferring them to public hospitals for further care and treatment. This refusal of care resulted in patient deaths and public outcry culminating with the passage of a federal anti-patient dumping law in 1986 known as the Emergency Medical Treatment and Active Labor Act.

As I wrote yesterday, the Trump administration is allowing states to impose new requirements on Medicaid patients -- typically low-income Americans. Some states are attempting to impose new emergency room fees and premiums even on individuals with incomes of $5,100 per year.

Will this lead to a new round of patient dumping if they can't pay those fees? Will it lead to more incidents like the one in Baltimore?

Once again, I ask: Is this how we #MAGA?

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