One may argue that we send bills to these patients. This is true. I will concede that as a valid point when someone shows me a successful business model for a motel or restaurant that takes all comers (even those in their slippers and undershirt), does not charge up front, and sends bills in the mail. I’m standing by.

I’m not even asking for back pay. I figure that in 23 years I probably have given away over $2 million of free care. I don’t expect to see that any more than I ever expect to receive a check from Social Security. What I do expect is that our government should stop the slavery and formulate a plan to in some way recognize our unique status in the health care universe.

One might suggest that the government just pay us or allow us to write off the bad debt. Possibly if every politician resigned on the same day and only property owners elected new representatives this might happen. This is less likely than the winning Ohio Lottery ticket being delivered to me by flying pigs, so it is best not to dwell on such ideas.

Since we won’t get any financial break, at least the government could provide a break on the litigation side. This won’t cost a thing. Our malpractice premiums would decrease quickly along with litigation stress. As an added benefit, eventually physician behavior would change and the amount of unnecessary testing would fall. Emergency department and on-call coverage would improve as well. This would be good for patients and doctors. The only losers are the trial attorneys, which makes this très bien. H.R. 5, which recently passed in the House [see story on p. 1], would accomplish these goals. Write to your congressional representatives to encourage their support.

Emergency physicians tired long ago of extending a helping hand only to have it bitten by a patient who never intended to pay the bill and some shark from the back cover of the phone book.

The reach of the federal government has been too wide for too long. This will be a campaign issue this year, so it is a perfect time for us to point out that if the government shouldn’t force insurance companies to give something away for free, it shouldn’t be forcing us to provide a service for free either.

It is time for emergency physicians to stand up, stick their head out the window, and yell “STOP THE ECONOMIC SLAVERY!”