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Insurance-based inequities in emergency interhospital transfers: an argument for the prioritisation of patient care
  1. Jacob Riegler
  1. College of Medicine, University of Central Florida, Orlando, Florida, USA
  1. Correspondence to Jacob Riegler, College of Medicine, University of Central Florida, Orlando, FL 32827, USA; Jriegler{at}


Currently there is an inequity in transfer rates of uninsured patients versus their insured counterparts. While this may vary by hospital system, studies indicate that this is a national trend, especially in emergency situations, and represents a prioritisation of profits over ethical obligations. This creates a variety of ethical issues for patients and society that generates a concordance between deontological and utilitarian viewpoints, two generally opposed schools of thought. The prioritisation of profit maximisation in order to provide better care for a select population is insufficient to justify deleterious health outcomes, stress and financial burden on patients. Current policy regarding patient transfers in the emergency department is insufficient to protect the uninsured and must be reevaluated.

  • ethics
  • business
  • population policy
  • public law
  • distributive justice

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  • Contributors Jacob Riegler was the sole author of this work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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