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Type "Esmin Green" into YouTube (GOOG) and in seconds you will see what it took the National Center for Health Statistics a bit more time to figure out: People are waiting too long to get emergency care.

The hospital security camera footage from June 18 features Green, who was allegedly suffering from psychosis and who was taken to Kings County Hospital Center involuntarily by emergency medical service workers. Due to a shortage of beds, she waited alone in the psychiatric emergency room for more than 24 hours. Green eventually collapsed to the floor where she remained until staff failed to revive her almost an hour later.

The video is only the latest example of how the services granted patients in ERs can border on negligent. In 2005, the National Center for Health Statistics relayed that the number of emergency room visits increased to 115.3 million, and ‘boarding,’ or keeping patients in waiting rooms until beds become available, also increased. According to the Centers for Disease Control and Prevention, around 400,000 patients waited 24 hours or more in emergency departments across the U.S. that same year. In 2006, the Institute of Medicine released a report containing concerns about increased waiting times in the ER that prolong the suffering of ailing patients.

Such stats are enough to make one forego an ER visit forever, if only we had such a choice. Because visits to the emergency room are unavoidable, it is essential that you know your ER rights.

YOUR LEGAL ER RIGHTS
The Emergency Medical Treatment and Labor Act (EMTALA), is a 1986 federal law that gives patients the right to emergency care regardless of their ability to afford it. This law is applicable to all hospitals affiliated with Medicare and allows patients to receive screening, emergency care and appropriate transfers.

The EMTALA outlines that a medical emergency entails ‘acute symptoms of sufficient severity (including severe pain)’. Furthermore the condition is such that the absence of immediate medical attention can lead to: Placing an individual’s health in danger; Serious impairment to bodily functions; or Serious dysfunction of any bodily organ or part.

According to EMTALA, a patient cannot be transferred until he or she has attained a stable condition, unless they request transfers and are aware of the risks, or if a physician believes the merits of transfer outweigh the risks. Hospitals typically utilize forms allowing patients to provide informed consent to transfers.

The U.S. Department of Health and Human Services reported that the patient-dumping law applies to HMOs that illicitly require pre-authorization for ER visits: (In other words HMO patients who lack pre-authorization still must be given ER care.)

WHAT IS NOT COVERED
If a patient is not experiencing an emergency and cannot pay for treatment, he may be denied by a hospital, redirected to his/her own doctor or sent to a community health clinic. With no health insurance, a patient will have to make pay arrangements with the hospital for treatment of conditions that do not qualify as emergencies. Once a patient is stabilized, the hospital may move them to another facility.

LEGAL INTERPRETATIONS CAN VARY
Due to the nuances of EMTALA, it is possible that the law can be interpreted by hospitals for their convenience. Therefore it is important to conduct research and be aware of what treatment you may or may not receive.

States have different policies on how patients are treated in the ER which directly correlate to a health insurer’s willingness to pay for treatment. If you’ve received less than optimal treatment, contact the department of health for your respective state. If your health insurer denied payment, contact the state’s insurance department. Insurance companies are required to pay for ER care if a ‘prudent layperson’ considers the patient’s condition a medical emergency.

TIPS IF YOU MUST VISIT THE ER
Of course emergencies cannot be anticipated, but by planning ahead, and by being familiar with the ER drill, they can be managed more efficiently.

Always know where your medical history summary, your insurance card and other medical records are so you can bring them along. Also, predetermine whether the patient's condition might require an additional party to accompany them. (Mentally unstable individuals should always be accompanied by a family member who is mentally stable and aware of the patient’s ER rights, thereby qualifying the accompanying party to act as arbiter.) If possible, ask your doctor if your condition requires the ER or an urgent care center. If your doctor recommends the ER, then have them call the hospital prior to your arrival.

In the ER, each hospital should have a Patient’s Rights policy posted. Make sure you view the policy and if you feel your rights have not been granted, speak to the attending physician. Feel better soon!