While I understand the concerns of the legislature for people attending the Emergency Department for a stubbed toe or a simple cut that could be safely treated at home and applaud their efforts to contain healthcare costs, I feel strongly this bill will not achieve those aims.

Patients can not be expected to tell the difference in advance between benign and life-threatening causes, for many symptoms. These include chest pain, belly pain, fainting, headaches.

I have two degrees, eight years of post-graduate training and am board certified in Internal medicine and soon to be certified in Emergency medicine as well. I still can not tell a lot of the time if a patient has a life threatening condition when they first walk through the door.

If you wish to reduce stress on overburdened departments, help set up free/low cost primary care clinics so that diabetic patients can have access to care before they have DKA. So that patients can be treated for their blood pressure and high cholesterol before they have a stroke or heart attack.

Fight the insurance and drug lobby that contribute to higher costs and make old previously cheap medicines like insulin, Epi-pens affordable. Insulin was life changing when we managed to manufacture it in the early 20th century. The Epi-pen was develop by the military. Now they are used to line the pockets of the rich at the cost of the lives of the poor. The increased cost of IV acetaminophen (Tylenol) contributed to the rise in opiate addiction as you can’t give a vomiting person a pill. But hospitals restricted IV Tylenol due to cost - it is literally cheaper to give them morphine, dilaudid or fentanyl.

Putting more money into preventing severe illness, like kidney disease, before it becomes so bad that you need dialysis, will save the government money in the long run. Patients on dialysis often struggle to work due to their illness and time spent receiving treatment. They then need disability assistance, Medicare/Medicaid and if they stop working, stop paying taxes. Help them to stay healthy, and you save money in the long run.

This bill will defund the last safety net left in the US healthcare system. We (the ED) are the only doctors who CANNOT refuse to treat based on insurance coverage. And we shouldn’t stop doing that. But this bill will further erode our funding and people will suffer.