Andrew Jay McClurg, Your Money or Your Life: Interpreting the Federal Act Against Patient Dumping, 24 Wake Forest Law Review 173-237 (1989).
“Patient dumping” is the world of medical non-practice: hospitals, usually private hospitals, refusing to treat patients in need of emergency care because of their inability to pay. Instead of receiving treatment, the indigent, uninsured patient is turned away or shuffled across town to the nearest public hospital. The latter practice is euphemistically referred to as an “economic transfer.”
In 1986, Congress gave victims of patient-dumping a weapon with which to fight back: a provision of the Consolidated Omnibus Budget Reconciliation Act of 1986 (COBRA) creating a private right of action to patients who have been refused emergency care. Your Money of Your Life, which has been widely cited by courts as well as legal commentators, was one of the first law review articles seeking to interpret the Act. The article examines numerous sources of interpretation, including the statutory language, the legislative history both before and after enactment, federal regulations proposed to implement portions of the Act, analogies drawn from general tort principles and other remedial statutory schemes, and the policies sought to be furthered by the anti-dumping legislation.
The article begins by reviewing the scope of the patient-dumping problem, the reasons for the problem, and state law remedies available to victimized patients.