I was talking to one of my closest buddies the other day when he told me a story that made me shudder. This guy, in his late 50s, recently developed a painful cyst at the bottom of his spine and, when the pain got pretty intense, his wife drove him to an emergency room in Chattanooga because he obviously needed some help.

The attending physicians took a look and agreed the problem needed to be immediately addressed. At the same time, somebody else presumably took a look at the poor guy’s insurance status and learned he only had Medicare health insurance. Guess what? It was then determined the patient would be “better treated” at our area’s Level One trauma center, Erlanger Hospital, and an ambulance was summoned.

Never mind the guy’s wife had a car, it was determined an additional $200 ambulance ride was a much safer mode of travel.

While I was happy that the struggling Erlanger crowd had a skilled surgeon standing by, and that a pain-relieving procedure went off without a hitch as the medical malady was solved, I had this nagging worry over what might happen if one day our emergency-room care is dictated by what type of insurance is presented rather than the acute patient’s symptoms and needs.

Everybody knows that Erlanger Hospital provides the overwhelming indigent care for our area, but I was startled to be told that many of those with just Medicare insurance are also being shuttled to Erlanger rather than being treated by hospitals where I know there is a quality medical staff available. Such a scenario makes me queasy because, in certain cases, I believe a chronically ill patient could foreseeably die en route.That’s what apparently has already happened in Nashville. Highly-regarded Vanderbilt Hospital and a doctor there were both fined by the Office of Inspector General recently in an effort to resolve a 2008 incident of alleged “patient dumping.” It seems an unstable patient was turned away after suffering critical injuries in an auto accident and died shortly after being transferred to another facility.

Vanderbilt vigorously denied the patient was turned away because of insufficient insurance. According to the 1988 Emergency Medical Treatment and Labor Act, the act of “patient dumping” is illegal and hospitals are penalized for it. Just the same, Vanderbilt settled the matter for a cool $45,000 and a hospital doctor paid another $35,000 for the incident that was unearthed by the Department of Human Services.

John Howser, a Vanderbilt Hospital official, told the Nashville Tennessean he couldn’t comment on the specifics due to federal privacy regulations but that the physician in question based the decision on his belief the hospital was near capacity and adequate care could be given elsewher. And he did indeed deny the transfer request.

“The physician’s decision, while carefully considered, was not consistent with our hospital policy,” Howser also told the Nashville newspaper.

While I wonder why on earth anybody would pay $80,000 in civil penalties if they weren’t guilty of such loathsome conduct, the OIG claimed they research only cases they believe are credible and recent penalties for “patient dumping” have been settled with the U.S. Department of Human Services in Florida, Alabama, Georgia, Michigan, Nebraska, Kentucky and now Tennessee.

There are a number of physicians who refuse to see Medicare patients for routine office visits, citing poor payments and burdensome paperwork, but an emergency room visit is altogether different and the Department of Human Services is eager to address “patient dumping” whenever it occurs in any emergency room.

As for my buddy, he claimed he has learned a lesson. “If I go anywhere other than Erlanger I am wasting my time.” Gee whiz, is this the way our nation should treat its lame and its sick?

royexum@aol.com