Delays in the Emergency Room

  If you have health insurance and were inclined to consider yourself protected from the problems facing the increasing proportion of uninsured Americans, consider this.  A recent study undertaken through Harvard Medical School documented that the delay in obtaining treatment through an Emergency Room has increased substantially from 1997 to 2004.  Regardless of insurance status, the average wait for all patients increased from 22 minutes in 1997 to 30 minutes in 2004.  The interim for the sickest heart patients increased from 8 minutes in '97 to 20 minutes, on average.  One-quarter of those patients waited 50 minutes or more, at a time when their triage diagnosis indicated that every minute of delay could be fatal or cause permanent harm.

   The authors of the study attributed this increased delay in treatment to the closure of ERs in many locations and to the clogging of existing ERs by uninsured patients who  have no choice but to use the Emergency Room for primary care when "routine" conditions deteriorate.  They also documented the fact that many urban hospitals have closed their Emergency Rooms after uninsured care essentially bankrupted the facility, while other hospitals  have allocated beds to well-paid elective procedures and then create a log-jam in the ER system, causing an inability to process patients out of the ER and "clear the decks" for incoming patients.

   In any event, the Institute of Medicine, a unit of the National Academy of Science, has offered the opinion that the American Emergency Room system is at the breaking point, a casualty of our diminishing medical coverage.  It suggests that the system cannot continue to provide medical care to all Americans on an emergent basis, if no provision is made for more widespread treatment of general health problems.  The system as it exists today simply does not work--for insured or uninsured Americans--and the problem will be exacerbated until we devise some form of more meaningful and inclusive coverage.