Insurance status appears to play a role in ED disposition (transfer versus admission) for many high-transfer conditions.

The Emergency Medical Treatment and Labor Act was enacted in 1986 to prevent hospitals from turning away patients with emergency medical conditions, often because they were uninsured--a practice commonly known as "patient dumping." Twenty-five years later, Denver Health--a large, urban, safety-net hospital--continues to experience instances in which people with emergency conditions, many of whom are uninsured, end up in the safety-net setting after having been denied care or receiving incomplete care elsewhere. We present five case studies and discuss potential limitations in the oversight and enforcement of the 1986 law. We advocate for a more effective system for reporting and acting on potential violations, as well as clearer standards governing compliance with the law.

How the law addresses major policy issues in genetic testing and treatment represents one of the most important issues in public health, science, and law. This installment of Law and the Public's Health examines the critical relationship between patent law and genetic testing, as well as the implications of the U.S. Supreme Court's decision on access to genetic tests that can improve health.

More than twenty-four million people in the United States are considered limited English proficient (LEP), and numerous studies have documented the consequences of communication barriers in healthcare. These consequences include: patients’ inability to become engaged and involved in their care; the absence of crucial information—including cultural information—essential to healthcare quality; risks to patient safety arising from the misunderstanding of physician instructions; and ethical and legal lapses stemming from the absence of informed consent. Addressing healthcare rights necessarily entails coming to grips with how to facilitate communication and the exchange of information between the healthcare system and an increasingly diverse patient population.The history of language access services in healthcare is grounded in two distinct bodies of law: the law of informed consent and civil rights law. Modern notions of informed consent law—which have their roots in the Nuremberg trials of the late 1940s—would recognize a cause of action in tort where a lack of adequate communication creates a barrier to an LEP patient's ability to consent to care. In modern healthcare law, the ability of patients to affirmatively give informed consent to treatment is considered a fundamental element of healthcare quality.

One of the most important challenges facing public health agencies is how best to regulate health-care industry practices that carry public health implications. A crucial question, however, is the extent to which the U.S. Constitution imposes limits on the regulatory powers of public health, when the industry conduct in question involves what the law considers speech. The following article discusses the implications of a recent U.S. Supreme Court decision for public health policy and practice.