May 17, 2020

How healthcare insurance affects medical care in emergency rooms

3 min
How healthcare insurance affects medical care in emergency rooms.jpg
Health Insurance and the ER A hospital's emergency room is sometimes a scary place, especially when patients with critical conditions don't hav...

Health Insurance and the ER

A hospital's emergency room is sometimes a scary place, especially when patients with critical conditions don't have the proper health insurance coverage.

There are a number of questions that arise when uninsured patients arrive at the ER in need of costly medical attention.

In order to help answer those questions, here are just a few ways hospitals handle patients who don't have health insurance coverage:

No One is Turned Away

For uninsured patients in need of medical attention that requires an emergency room visit, ERs by law cannot turn away those in need of care.

In 1986, the government passed the Emergency Medical Treatment and Labor Act, which requires all emergency rooms in the United States to treat anyone who walks in.

In other words, if a patient is truly in a life or death medical situation, the ER is the best place to seek treatment, whether the patient is insured or not. Financial repercussions will follow, but money should never come before health and uninsured patients should never avoid the ER due to cost.

Charity Care

Another option for ERs handling uninsured patients is to recommend they apply for charity care. Also known as uncompensated health care, uninsured patients can apply to have their medical bills reduced or completely covered through participating hospitals.

Many hospitals nationwide participate in charity care programs, but the availability of charity care does depend on the patient's situation.

When it comes to how life changes impact health insurance, everything from job loss to divorce can create financial setbacks, but uninsured patients with low incomes can still get the care they need when hospitals participate in charity care programs.  

Negotiated Rates and Regular Payments

Hospitals don't like turning patient accounts over to collection agencies in order to receive payment for their services.

Because of this, hospitals suggest that financially unprepared patients negotiate their ER costs with the hospital's billing department before letting their account go delinquent. Most hospitals are willing to reduce patients' medical bills as opposed to turning them over to collections.

Likewise, many hospitals also offer payment plans for those uninsured patients who are unable to cover their medical costs upfront.

Depending on the costs involved, hospitals are more than willing to work with patients by setting up monthly payment plans as long as patients make regular payments until the balance is paid off.

Urgent Care Clinics

In some cases, patients rush to the ER under the impression they need immediate attention when they actually don't.

If the emergency room staff and technicians decide a patient isn't in need of immediate medical attention, they can redirect them to the nearest walk-in clinic.

Although the ER can't turn away the patient, they can suggest that the patient seek attention at a walk-in clinic to avoid the high hospital fees, which is extremely beneficial advice for the uninsured.

Walk-in clinics and urgent care clinics can handle a wide range of medical issues like lacerations that require stitches, sprains and strains, minor allergic reactions, and minor burns.

But if the patient is experiencing signs of a heart attack, stroke, severe shortness of breath, poisoning, gunshot or stab wounds, or head trauma, the ER is definitely necessary.

When it comes to health insurance and the ER, there are plenty of options for the uninsured when visiting the emergency room.


About the Author

Adam Groff is a freelance writer and creator of content. He writes on a variety of topics including social media and personal health.

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Jun 19, 2021

Driving sustainability in medical device production

George I’ons
5 min
George I’ons, Head of Product Strategy and Insights at Owen Mumford Pharmaceutical Services on how technology is driving sustainability 

Environmental protection and stewardship are rapidly rising to the top of the corporate agenda and medical device businesses are no exception. The healthcare sectors of the United States, Australia, Canada, and England combined emit an estimated 748 million metric tons of greenhouse gases each year, an output greater than the carbon emissions of all but six nations worldwide. In order to curb this situation various European standards have been introduced. 

The Waste Electrical and Electronic Equipment (WEEE); Restriction on Hazardous Substances (RoHS); Registration, Evaluation, and Authorisation of Chemicals (REACH) and the Energy Using Products (EuP) regulations have all significantly altered manufacturing processes, specific labelling, compliance with disposal restrictions, and creation of instructions for end-of-life management and recycling.

At the moment many medical devices are currently exempt from these regulations but several directives, including RoHS and WEEE, are in the process of being reviewed and could be applicable in future. This is especially relevant for devices that are ‘connected’ and have a digital monitoring component which then brings them under the regulatory purview of authorities that govern devices with electronic components.

Safety, Usability and Sustainability

While medical device manufacturers have been working to respond to increasing demand for environmental sustainability from the market, they also have to contend with a key element of their mission: to ensure safety and usability to healthcare workers and patients. Parenteral and other invasive devices are strictly regulated to help reduce the risk of Healthcare Acquired Infection which typically runs as high as 5% and 8% in most developed countries, according to the European Centre for Disease Prevention and Control. As a result, they typically contain disposable single-use plastic elements.

At the same time, many hospitals and purchasing organisations have started to recognise that sustainable purchasing practices play a pivotal role in reducing costs over time. Many GPOs have appointed and empowered Senior Directors of Environmentally Preferred Sourcing who are successfully implementing the sustainable purchasing business case. In addition global pharmaceutical companies are increasingly creating senior positions with sustainability objectives as key to the role.

Medical device disposal is a particularly burning issue; generally carried out through incineration in the EU, it typically releases nitrous oxide, as well as known carcinogens including polychlorinated biphenyls, furans and dioxins. Some of the strategies trialled by manufacturers to reduce waste matter destined to incineration include sterilisation and reprocessing.

Sterilisation, however, falls short on the environmental front, and may consume more energy and produce more emissions than incineration itself. In the United States for example, 50% of all sterile medical devices are sterilised with ethylene oxide but since this method releases harmful emissions, the US Food and Drug Administration is now encouraging the development of new methods or technologies. Many other established sterilisation methods use glutaraldehyde that is not only harmful to the environment but also tends to be regulated by strict usage and disposal rules such as COSSH guidelines.

Focus on Recycling

The outlook on recycling is changing significantly thanks to new research and technologies enabling, for example, monomer extraction. Recycled polymers can be broken down to their constituent monomers promoting an almost limitless recyclability of some polymers. In addition to this, Polyvinyl chloride (PVC), renewable polyethylene and polyethylene terephthalate (PET) can be recycled several times without losing critical properties.

Reducing the impact of packaging can also significantly reduce the materials that need to be dealt with through either waste or recycling. Packaging manufacturers are decreasing packaging volume by favouring sealed trays instead of pouches, laser-etching instructions directly on to the tray where regulation permits it, or reducing the number of components required overall. In addition to this, for recycling plans to be successful it important to have a full understanding of the practices surrounding device use and to establish, where possible,  closed loop recycling systems that recover the waste materials from hospitals or patients and bring them back into the recycling process.

Sustainable Manufacturing: Technology and Research

Greater employment of fast degrading plastics or material from other sources is a key strategy to reduce harmful pollutants both at production and disposal stage. Bio-based materials can in fact offset the carbon emitted during processing as the monomer source grows, and a growing range of sources for bio based monomers -such as wood pulp or sugar cane- is available. However, when assessing the most suitable material for a part, the entire lifecycle of the product needs to be considered. For example: bio-degradable polymers can contaminate a recycling stream and emit methane when incinerated.

The use of environmentally friendly materials should also be supported by an increase in clean renewable energy sources. Lower energy consumption means fewer carbon emissions but also financial savings, making this an appealing measure for manufacturers. New technologies are proving a major gamechanger on this front, helping manufacturers marry their environmental stewardship with cost savings and efficiency.  3D printing, for example, can help develop optimum product moulds more quickly, refining production parameters to minimise raw materials volumes and maximising output productivity.

Similarly, ‘digital twin’ production software uses inline sensors to create a virtual, real-time mirror of the production environment to enable inline refinements. The objective is to achieve “zero defect”, waste-free manufacturing. In addition to this, LEAN manufacturing methodologies are already helping to optimise inventory management and reduce overproduction. 

Sustainability by Design

It is increasingly clear that effective environmental sustainability in the medical device sector cannot exist without a full view of the product life cycle from concept development, material selection, design and engineering to manufacturing, packaging, transportation, sales, use, and end-of-life disposal. These evaluations are typically made for factors such as manufacturing efficiency, time to market, or safety and regulatory compliance, packaging and transportation costs, but should be extended to energy efficiency and environmental impact by means such as life cycle analysis.  

In addition to this, with devices rapidly becoming more digitally connected, developers need to be aware that the costs of disposable electronics would simply not be viable, or indeed acceptable in the light of electronics disposal regulations. Design therefore should focus on creating a simple, repeatable interface between the two component sections so as not to impair the functionality or efficacy. As reducing waste and harmful emissions continues to exert businesses and governments globally, the medical devices industry cannot stand by. The environmental but also commercial implications of inaction are too serious and the array of solutions now available is exciting and diverse.

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