Those who survived Hurricanes Katrina and Rita faced homelessness and physical and mental health problems that created ethical dilemmas for physicians.
Medical stewardship is a way of describing a relatively new obligation to maximize health care resources. A professionwide conversation about its meaning and value is needed.
The current Medicare operation—reimbursing medical goods and services to a growing number of people without basing the reimbursement benefit on the actual cost of the services—is unsustainable, but there are some possible remedies.
Increased use of emergency departments for primary care puts undue burden on EDs; however, EMTALA obligates EDs to provide care to patients regardless of their ability to pay.