The authors argue that it is ethical to triage or place some VIP patients differently based on privacy concerns (assuming no harm to other patients), but it is unethical and usually harmful to actually provide different care based on VIP status.
Sepsis bundles like the CMS SEP-1 guidelines are too restrictive, requiring an all-or-nothing approach to achieve compliance. These bundles fail to prioritize the most important bundle components while penalizing providers for meaningless omissions that have no impact on mortality.
Failure of private hospitals to care for the uninsured resulted in informal ED to ED referrals, which meant up to 20% increased volume in public EDs for certain diagnoses, particularly orthopedic issues. This led to duplicate testing, increased cost, complications, delays in care, and poor treatment of the most vulnerable patients.