Congressional Quarterly: ERs are “Biggest Crisis in American Healthcare”

Congress hears from those who prepared last June’s IOM report on the impending ED disaster:

June 22, 2007 – 7:24 p.m.

Emergency Rooms Labeled ‘Biggest Crisis in American Health Care’

Physicians told a House hearing Friday that the nation’s emergency medical care departments are overwhelmed, understaffed, underfunded and unready to take on the type of patient surge that could come with a major natural disaster or terrorist attack.

Despite numerous reports highlighting conditions such as patients being boarded in ER departments waiting for rooms elsewhere in the hospital or ambulances diverted to other facilities — creating treatment delays that have led to patients’ deaths — federal agencies charged with overseeing the nation’s emergency health care system have done little to ease the burden, witnesses told the House Oversight and Government Reform Committee.

“While the demands on emergency and trauma care have grown dramatically, the capacity to handle such demands has not kept pace,” said C. William Schwab, who heads the University of Pennsylvania Medical Center’s Trauma and Surgical Division. Schwab, who helped compile the Institute of Medicine’s report released last June detailing key problems with ER departments and recommendations to fix them, noted that there has been little response from Washington.

Read the whole article to get the flavor. The good news? At least one congressman is ticked at HHS for not acting strongly enough:

Committee member

Elijah E. Cummings, D-Md., who chaired the hearing, said the Department of Health and Human Services (HHS) “appears to be ignoring the mounting emergency care crisis” despite the billions of dollars Congress has appropriated for biodefense and pandemic preparedness. Witnesses said the funding had not relieved any of the burdens in their emergency care departments, and Cummings said HHS has “not made a serious effort to identify the scope of the problem and which communities are most affected.” Cummings was clearly irritated that Leslie Norwalk, acting administrator for the Centers for Medicare and Medicaid Services, did not accept the committee’s June 14 invitation to testify at the hearing. Of the 115 million emergency room visits in 2005, more than 40 percent were covered by CMS programs such as Medicare, Medicaid or the State Children’s Health Insurance Program.

Read the rest for the denoument (Warning: mentions Rep. Henry Waxman). So, Congress is awakening to the idea that the ED’s are being over-run. Most likely that’s good news.


  1. Aerospace Genius says:

    Hi, I’m from the government and I’m here to help you.

  2. Michael Rack says:
  3. Why is everything in health care a “crisis”? There’s this “crisis” and that “crisis” and we should do this and that to alleviate all of these crises.

    I think this stuff is blown up by the single payer people who want medicine to look like it’s in a total meltdown, ready to collapse tomorrow, if their solution isn’t adopted.

    This is only good news for you, Grunt, if you’ve got someone up there advocating YOUR solution. Because if you don’t, they’ll either let the “crisis” pass, if it exists, or adopt another solution you don’t like.

  4. “Most likely that’s good news.”

    Are you sure you were in the military, GD? The solution that the government is likely to come up with is to put the onus on EDs to “fix” this problem, and probably with something like reducing all ED reimbursements, forcing the EDs to figure out how to cope.

    This is how the “solution” to Medicare costs works, it’s how the “75% rule” for rehab facilities works. Expect the same.

  5. I work for a locum tenens staffing firm called Linde Healthcare and a permanent recruitment firm called Kendall & Davis, and we also have been experiencing a lot of changes in our business due to the increased need for EM doctors…facilities are desperately seeking doctors to alleviate the stress in their EDs and it is also becoming increasingly difficult to find qualified EM physicians. It’s exciting to see that the government is finally taking an interest in this dilemma, which I do feel has gotten progressively worse over the past several years, but I’m interested to hear what kind of solution you propose, Grunt.

  6. If it causes Congress to reconsider cuts in reimbursement, or better yet to overhaul some of the Medicare payment schemes, it’d be worthwhile.

  7. Randy in Arizona says:

    Simple solution to cut down unpaid patronage:

    Park older obviously used Border Patrol / ICE pickups near the ER entrance area.
    DEA marked cars might also be useful if parked nearby.

    Yes, I am a heartless, cynical, grumpy old man!