Letters to the Editor

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MEDICAID: Don’t limit access to emergency care

Letter by Stephen Anderson, M.D., Federal Way on Oct. 3, 2011 at 12:46 pm | 1 Comment »
October 3, 2011 2:37 pm

Re: “Washington can’t afford blank checks for ER visits” (editorial, 9-27).

Washington state’s plan to reject a list of more than 700 diagnoses as “non-emergent” for Medicaid patients puts the most vulnerable members of our society, including children, at risk of serious harm. To say medical conditions including chest pain, neurologic changes, shortness of breath, miscarriage and abdominal pain don’t meet the criteria of “real medical emergencies” is setting a dangerous precedent.

The symptoms of many of these medical conditions indicate life-threatening emergencies, and people with these symptoms should seek emergency care. Not doing so could lead to severe illness, disability and even death.

This list of conditions was generated over the unanimous objections of physician and hospital task force representatives. Evidence based science confirms over 200 diagnoses on this list are deemed emergencies 100 percent of the time.

Paramount to this entire discussion is access to care. A critical shortage of primary care physicians and clinics that will see Medicaid patients currently exists. For many of these patients, the only access to care is through the emergency department. Rather than limiting their access with the Health Care Authority’s “non-emergent” list, emergency physicians would like to work with the state on follow-up care and case management.

Federal laws exist which guarantee the right to be seen for what a “prudent layperson would deem an emergency.” This is there for everyone’s protection. Washington state does not need to experiment with its most vulnerable population to restrict this guarantee.

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