Hospitals in nearly every state have violated a federal law prohibiting them from dumping patients, Public Citizen reported. The watchdog group found that 527 hospitals violated the 1986 Emergency Medical Treatment and Active Labor Act (EMTALA). More than one in five hospitals throughout the country have violated the law since it was passed.
Most of the violations cited in the current report were confirmed in 1997, 1998 and 1999, although a few were confirmed in 1996 and 2000. Of the hospitals that had confirmed violations in 1997, 1998 and 1999 and were eligible to be fined, only 17% had been fined as of April 2001.
Public Citizen found that hospitals in 46 states as well as the District of Columbia and Puerto Rico were cited for violations. States with no confirmed violations were Delaware, Hawaii, New Mexico and Wyoming. Consumers wishing to find out which hospitals in their state violated the law can visit www.citizen.org, go to "Questionable Hospitals," click on a map of the United States and select their state.
Among the report's key findings:
* For-profit hospitals had a significantly higher rate of violation (1.7 times higher) than not-for-profit hospitals.
* Up to a third of surveyed emergency room registration staff recently told the US Department of Health and Human Services Office of Inspector General that patients might be asked for insurance information before a screening is provided or while it is taking place, and 35% said they contact health plans for authorization of screening exams at some point. These actions violate the law if they delay treatment.
* Hospitals are being fined more than in previous years. Civil money penalties increased from $130,000 in fiscal 1988 to more than $1 million in each of 1998, 1999 and 2000. However, the amounts paid are still paltry compared to a hospital's overall budget and do nothing to discourage hospitals from turning needy patients into the streets. Worse, most hospitals with confirmed violations are not fined.
One example of patient dumping:
A patient went to the emergency room of Houston Medical Center in Warner Robbins, Ga., vomiting blood and complaining of a loss of appetite and a swollen and painful stomach. The patient's symptoms indicated blood loss. He was treated with an IV solution, given prescriptions and discharged. An ambulance returned him to the ER about five hours later, at which point he was in full cardiac arrest and died six minutes later. As of April 2001, the hospital had not been fined.
While the records reviewed by Public Citizen generally don't reflect the reason a patient was dumped, often it is because the patient was uninsured, said Dr. Sidney Wolfe, director of Public Citizen's Health Research Group. The law prohibits emergency room personnel from delaying screening or treatment to ask whether a patient has insurance, but personnel still do. Further, some HMOs require pre-authorization for exams or treatment, and some HMOs refuse to pay for emergency room treatment later if the patient is found not to have a condition that constitutes an emergency. This often means the hospital gets stuck with the bill, giving them an incentive to dump uninsured or poor patients.
Federal legislation or new federal regulations could help, Wolfe said. The EMTALA could be amended to create liability for insurers that require pre-authorization or that refuse to reimburse hospitals for emergency screening and treatment.
O'NEILL AGAIN QUESTIONS SOCIAL SECURITY. Responding to criticism by Democrats, Treasury Secretary Paul O'Neill on July 10 repeated that Social Security is a pay-as-you-go program with no real assets to pay future retirees. His comments, reported by Associated Press but otherwise little-noticed, were similar to a June 19 speech to Wall Street and corporate executives in New York that promoted President Bush's plan to add private investment accounts to Social Security. In that speech, O'Neill said "we have no assets" presently in the Social Security trust fund. Rep. Charles Rangel of New York, senior Democrat on the tax-writing House Ways and Means Committee, and Robert Matsui of California, the top Democrat on the committee's Social Security subcommittee, said the trust fund has billions of assets invested in the form of Treasury bonds. O'Neill acknowledged that Treasury securities are issued to the trust fund. However, "because the Social Security trust fund does not consist of real economic assets, we are left to rely on the federal government's future decisions to either raise taxes, reduce spending or increase borrowing from the public to finance fully Social Security's promised benefits," O'Neill said.
FAST TRACK FOES STEP UP. With unions, environmentalists, consumer advocates, family farmers and students drumming up opposition, US House Majority Leader Dick Armey admitted on July 10 the outlook appeared "grim'' for legislation giving President Bush "fast track" authority to forge broad new trade deals. Republican leaders want Congress give up its right to amend trade agreements negotiated by the White House but Democrats are demanding protections for workers and the environment in any trade agreements. Independent farm groups are complaining that local farm economies already have been devastated by commodities from Canada and Mexico being dumped onto the US market under the North American Free Trade Agreement. A preliminary count showed 180 "firm'' votes for the "fast track" legislation as introduced by Rep. Phil Crane, R-Ill., AP reported, citing a Republican leadership source. Bush needs 218 votes for House passage. The AFL-CIO has set up a toll-free telephone number (1-800-393-1082) to help opponents contact their representatives to oppose Fast Track. If the toll-free number doesn't work, the regular Capitol switchboard number is 202-224-3121. For more information see www.tradewatch.org or www.aflcio.org/globaleconomy/index.htm.
CHI TRIBUNE NOTES NAFTA POWER GRAB. The Chicago Tribune is one of the few major daily newspapers in the US willing to report on the North American Free Trade Agreement's impact on local labor and environmental laws. R.C. Longworth wrote in the July 5 Tribune that at least 20 US, Canadian and Mexican corporations have seized on the chance to collect multimillion-dollar settlements from governments that were enforcing their own laws that might be accused of limiting trade. Governments that try to ban chemicals suspected of causing cancer have been sued by the companies that make the chemicals. A chain of funeral homes that lost a jury trial in Mississippi sued the US government for damages. UPS is alleging that the state-owned postal service in Canada is unfair competition. They are suing under NAFTA's Chapter 11, which was supposed to be an innocuous clause inserted into the treaty to make sure foreign investors are treated "fairly and equitably" by host governments. Instead, Lydia Lazar of the Chicago-Kent College of Law and an expert on NAFTA law told the Tribune, "the balance of power between sovereign nations and corporations has shifted against governments, providing significant economic and legal strategic leverage to corporations." But you probably won't hear that discussed in the New York Times, the Washington Post or other leading newspapers, much less TV news operations -- at least not until after the Free Trade Agreement for the Americas is finalized sometime next year.
Some text of the controversial trade agreement was made public July 3, but the version that was released lacks vital information and represents only a fraction of the entire pact, Public Citizen said. The FTAA text made available after seven years of negotiations is only 434 pages, even though it is a "bracketed text," which means that it contains several versions or options for many clauses. Yet public documents reveal that FTAA is slated to cover the same vast array of issues as NAFTA. Since the NAFTA text is more than 700 pages long, observers believe the FTAA text released today is only a fraction of the whole agreement. "Even with a sizeable chunk of the negotiating text remaining concealed from the public, it is clear that FTAA is all about cramming NAFTA-on-steroids down the throats of people from Toronto to Tierra del Fuego," said Lori Wallach, director of Public Citizen's Global Trade Watch.
SENATE MOVES TOWARD MEXICAN TRUCK INSPECTIONS. The Senate Appropriations Committee on July 12 approved a measure that would require inspections and audits of Mexican truck companies before they are certified to enter the United States. The inspections are necessary because Mexico -- unlike the US and Canada -- does not have mandatory safety standards for large trucks. The committee action would require a full safety audit of Mexican trucking firms before granting them a conditional operating certificate and a follow-up safety audit before a permanent operating certificate is granted. It also calls for Mexican truckers to comply with US hours-of-service rules, provides funding for 80 additional border inspectors and prohibits opening the border until crossings have weigh scales and an accessible database to monitor the safety performance of Mexican firms operating in the US. The House earlier voted to prohibit operating certificates for Mexican trucks, but Joan Claybrook, president of Public Citizen, a critic of NAFTA's provisions to open US highways to Mexican truckers, said the Senate action calls for affirmative efforts to improve the safety of these vehicles.
ANTI-DRUG AID ABUSED. US anti-drug money spent on Latin America has been funneled through corrupt military, paramilitary and intelligence organizations and ends up violating basic human rights, the Center for Public Integrity reported.
CPI"s International Consortium of Investigative Journalists found that in three Latin American countries examined, US aid was implicated in civilian human rights abuses. Other findings:
* The $1.3 billion Plan Colombia aid package represents the largest American commitment in a guerrilla war since Vietnam. With the drug war's focus on leftist guerrillas, successive US administrations have tolerated the Colombian military's ties to right-wing forces, even though they, too, are steeped in drugs.
* In Peru, the CIA paid at least $10 million to spymaster Vladimiro Montesinos, who also diverted US high-tech surveillance equipment to spy on political opponents. Montesinos betrayed his American benefactors by arming Colombia's FARC guerrillas.
* Human rights abuses were revealed by members of the elite Mexican special forces unit known as GAFE, many of whose troops are trained by the United States. As in South America, US aid to Mexican military ends up as dual use -- to counter drugs and to deal with internal security matters. The complete report can be found on www.public-i.org or call CPI at 202-466-1300.
D'S MOVE BANKRUPTCY BILL. Senate Democrats are preparing to move toward final approval of a bankruptcy overhaul bill, the Financial Times reported July 11. The bankruptcy bill, which would make it more difficult for middle class people to discharge debts, was stalled by partisan conflicts over the setup of a conference committee, after different versions of the bill passed the House and Senate earlier this year. But Tom Daschle, the Democratic Senate leader whose state includes a large Citigroup credit card operation, has signalled his determination to see the legislation proceed toward a compromise. According to the Financial Times' Deborah McGregor, Daschle has sided with the the banking, credit card and retail credit companies -- and the Republicans -- against liberals such as Paul Wellstone, D-Minn., who oppose the bankruptcy bill on the grounds that it was unduly harsh on debtors, particularly those saddled with disastrous medical debts.
CUT AND RUN? Robert Parry's Consortiumnews.com, notes that Bush has begun telling his followers that he is ready to "go back to Crawford," the site of his Texas ranchette, if he doesn't get his way on his conservative policies. The threat, first reported by conservative columnist Robert Novak, came as Bush was losing control of Washington's political agenda in the wake of the Democratic takeover of the US Senate, while his poll numbers sagged and the Senate passed a patients' bill of rights that was more populist than the version he supports. Los Angeles Times political writer Ronald Brownstein also picked up word of Bush issuing a "back to Crawford" threat, this one recounted by a GOP lobbyist close to the administration. "Bush is telling his supporters that it's either his way or the highway," Parry writes. "In this case, however, Bush says if he doesn't get his way, he's ready to take the highway back to Crawford."
GREENS TO FILE PARTY. Delegates of the Association of State Green Parties (ASGP) meeting in Santa Barbara, Calif., July 27-29 are expected to finally vote to file papers to establish a new national party: the Green Party of the United States. Said national organizer Dean Myerson of Colorado, "A strong grassroots foundation will prevent the top-heavy hierarchies and resulting power struggles and schisms that have destroyed other third parties." ASGP, founded in November 1996, organized the national convention that nominated Ralph Nader for president. Some 89 Greens currently hold office in 21 states. Greens won 38 races nationally in 2000; Green candidates have already won 14 victories in 2001. See www.greenparties.org.
FOX FAIR TO REPUBLICANS. Rupert Murdoch in March laid down a challenge "to show me an example of bias in Fox News Channel." Network officials bristle at the slightest suggestion of a conservative tilt and instead tout slogans like "Fair and balanced" and "We report, you decide," but Fairness and Accuracy In Reporting (FAIR) took the trouble to get the conservative goods on the cable network, which debuted in 1996 under the leadership of Roger Ailes, a veteran of the Nixon and Reagan campaigns, and reportedly has carefully screened its on-air personalities for their Republican tilts. See the report at www.fair.org.
UNION: WORKER CUT FOR REPORTING RAT. A worker at a Minute Maid packaging plant in Auburndale, Fla., was fired for telling a US Department of Agriculture inspector about a dead rat in the facility, union officials said July 10. The Associated Press reported Eric Meissner, a 30-year veteran at Cutrale Citrus Juices USA's Minute Maid plant near Tampa, said he found the dead rat in late May under a capping station, an area where juice containers are sealed, but couldn't find a company supervisor to report the rodent sighting, so he told a USDA inspector. He was suspended without pay the following day while company officials conducted an investigation, and he was fired June 19, the International Brotherhood of Teamsters said. Cutrale was contracted by Coca-Cola in 1996 to run the plant. Minute Maid is a subsidiary of Coca-Cola. A Cutrale official said he believes union workers planted the rat there because the Teamsters are unhappy with a settlement reached after a recent strike and want the company to look bad.