title: Should the Emergency Department be society's health safety net?
abstract: In the US health care system, a core safety net provider has two defining characteristics: (1) either by legal mandate or explicitly adopted mission, they maintain an "open door," offering patients services regardless of their ability to pay; and (2) a substantial portion of their patients are uninsured, on Medicaid, and/or otherwise vulnerable. The hospital Emergency Department (ED), by all accounts, falls within the definition of a core safety net provider. Yet many would argue that this is a primary health care role for which the ED was not originally intended or equipped. Should the ED be society's health-care safety net? Should it be the main provider of care for the indigent? Is this placing an unbearable strain on the ED? Should it be providing primary health-care? If not, what are the alternatives?
authors.affiliation: Department of Emergency Medicine, Virginia Commonwealth University Medical Center, Richmond, VA 23298-8597, USA. mftjong@yahoo.com
authors.forename: Marcus
authors.initials: M
authors.lastname: Ong Eng Hock
authors.forename: Joseph P
authors.initials: JP
authors.lastname: Ornato
authors.forename: Courtney
authors.initials: C
authors.lastname: Cosby
authors.forename: Thomas
authors.initials: T
authors.lastname: Franck
mesh_terms: D003695:Delivery of Health Care; D004636:Emergency Service, Hospital / Q000331:legislation & jurisprudence*; D006297:Health Services Accessibility; D008484:Medicaid; D011634:Public Health; D014481:United States