ER Confronts New Emergency: Too Many Patients ; Healthcare Experts Seek a Solution as Ambulances Are Turned Away at Overcrowded US Emergency Rooms

By Alexandra Marks writer of The Christian Science Monitor | The Christian Science Monitor, January 23, 2001 | Go to article overview

ER Confronts New Emergency: Too Many Patients ; Healthcare Experts Seek a Solution as Ambulances Are Turned Away at Overcrowded US Emergency Rooms


Alexandra Marks writer of The Christian Science Monitor, The Christian Science Monitor


Dial 911 and you may discover the nation's economically ailing healthcare system is caught in an emergency of its own.

Across the country, from Boston to Seattle, an increasing number of overcrowded, understaffed hospital emergency rooms are turning ambulances away and diverting them to other hospitals, except in the most extreme cases.

Healthcare experts contend the record number of ambulance diversions is the latest symptom of the healthcare system's economic crisis.

"It has become a nationwide issue," says Dr. Robert McNamara, head of the American Academy of Emergency Medicine. "The trouble is that there are patients who the emergency physicians know need to be admitted to the hospital, but there are no inpatient beds available."

While lawmakers in Washington focus on the battle over coverage for prescription drugs for the elderly, some healthcare experts say the emergency-room crisis is even more pressing. One way to alleviate the overcrowding, they contend, would be to find coverage for the more than 42 million uninsured Americans, whose first stop is often the emergency room.

The situation has reached such crisis proportions that some of the sharpest antagonists in the healthcare debate - from the insurance industry to the hospital associations to the advocates for universal coverage - have decided to work together, hoping to transcend their differences to find a workable solution to present to Congress this year.

Each group now says it's willing to give up some of its top priorities to forge a compromise. "We're looking for the opportunity to come together on a 'second favorite' choice," says Ron Pollack, executive director of Families USA, a leading reform advocate. "If we can do that, we could eliminate the contentiousness that has existed each and every time health reform has been on the table."

President George W. Bush's campaign pledge to spend $132 billion over 10 years to help deal with the problem of the uninsured is adding to the optimism a solution can be found this year.

The emergency-room crisis was caused by a combination of factors. For the past decade, the advent of managed care intensified the pressure on hospitals to cut costs. More than a thousand have closed nationwide, and those that remained open have cut back the number of available inpatient beds in order to save money. Add to that a nationwide nursing shortage.

At the same time, the number of uninsured Americans, who often use ERs for primary care, has continued to grow. With the exception of last year, more than 1 million people joined the ranks of the uninsured every year since 1993, when overall healthcare reform foundered in Congress. …

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