Wednesday, October 1, 2008

Why are emergency rooms disappearing across America?

The number of emergency rooms has fallen by more than one quarter over the past 20 years, yet visits have steadily risen over the same period, causing backlogs in remaining ER's that leave patients waiting sometimes for hours.

According to a first-of-its-kind study by the American Medical Association, from 1990 through 2009, the number of urban ER's fell from 2,446 to 1,779, a drop of 27 percent. The biggest reasons for the decline, the study's authors found, were market forces; most of the emergency rooms that were closed were being operated by for-profit hospitals. As healthcare became more expensive - and as the economy grew progressively worse in the past few years - profit margins fell. Closing ER's seemed like the easiest way for hospitals to save money.

And yet, over the same period, emergency room visits climbed by 35 percent, Dr. Renee Hsia, an emergency physician at the University of California, San Francisco, who worked on the study.

"This shows that the market forces very much are at play in our healthcare system," she told Reuters. "My opinion is that when we rely on a market-based approach, we can't expect resources to be distributed in an equitable fashion."

Hsia says other studies show that ER overcrowding affects how well patients do. She also said when things are left up to market forces, "these are the effects that we see."

Hsia herself may be a victim of the very market forces she decries, for truth be told, part of the problem with access to emergency rooms is the health care system itself. Without better education of, and access to, more natural treatments and less reliance on traditional medicine - when tends to worsen the overall health care system - then perhaps ER visits would decrease to the point where overcrowding would become a thing of the past.

In one New York study of women emergency room patients, 56 percent had tried alternative medical treatments, and an astounding 87 percent of them said such treatments were effective. They included chiropractic care, massage therapy, herbs, meditation, and acupuncture. Yet, the effort continues to criminalize alternative medical treatments and practitioners.

The phrase "home remedies" should not carry negative connotations. The fact of the matter is, natural health care provides a wealth of safe, viable options for medical consumers. Sticking to the current system, as evidenced by ER overcrowding, is just another sign the old system is failing.