December 28, 2007 | Executive Summary on Health Care
America's emergency rooms are in crisis.
Emergency medicine encompasses the care of patients with traumatic injuries or serious signs and symptoms of disease. Quick evaluation and rapid treatment of these patients obviously cannot be done on an "elective" basis. These services are invariably provided under the auspices of a hospital and are available to patients 24 hours a day, seven days a week.
Moreover, hospital emergency departments (EDs) are the only part of the health care system that is required by federal law to provide care to all patients, regardless of ability to pay. Yet a sizable number of patients who visit the ED do not require the level of care that an emergency room provides. In Maryland, for example, patients with non-urgent medical problems account for over 40 percent of ED visits.
Jammed with increasing numbers of uninsured Americans and enrollees in public programs, emergency rooms find their overcrowding further aggravated by outdated federal and state policies. Worse, while many emergency rooms are already operating at peak capacity on a day-to-day basis, the emergency medical system is incapable of absorbing the massive surge in demand for emergency medical assistance that would follow a natural disaster or terrorist attack.
Recent trends highlight the challenge:
A Better Policy. Beyond correcting federal and state laws and regulations, policymakers need to help hospital officials realign the economic incentives for emergency care, clarify the roles of hospitals and emergency departments, and restore a federalist approach to the provision of emergency care that clearly distinguishes between what is a public responsibility and what is a private responsibility and between what is the proper role of the federal government and what priorities should remain with the states. The states should have the primary role in setting rules for first responders.
Specifically, policymakers should:
Conclusion. America's emergency room crisis is complex. Simply throwing more taxpayer money at the problem will not solve this crisis. Reform of the emergency medical system will require fundamentally rethinking the role of the emergency department and its relation to the acute care hospital.
Generally, the failure to address the problem of emergency medical care degrades the quality of care for all Americans. Specifically, it jeopardizes critically ill citizens' access to timely, efficient, and highly competent emergency medical services while compromising the ability of the health care system to respond to disasters.
John S. O'Shea, M.D., is Health Policy Fellow in the Center for Health Policy Studies at The Heritage Foundation.