SACRAMENTO - (Health Care Topic) CA ER Rooms Stained to Breaking Point : LUSENET : Grassroots Information Coordination Center (GICC) : One Thread

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Title: ER crisis threatens California

Shutdowns, rising use and overworked staff put patients' health at risk, doctors tell Senate.


(Published March 23, 2000)

SACRAMENTO -- California's emergency rooms are strained to the breaking point, with patient care in jeopardy, bills routinely going unpaid and doctors increasingly worried about the future, emergency physicians declared Wednesday at a special state Senate hearing on the issue.

"We feel that emergency care in California is overwhelmed, it's under-funded and at times, frankly, it is out-and-out dangerous," testified Dr. Dan Abbott, a veteran emergency physician at St. Jude Hospital in Orange County.

While emergency room overcrowding and related problems have been in the news nationwide, legislators nonetheless voiced dismay at the grim testimony from Abbott and other emergency physicians on the front lines in California. They said the reality of many emergency rooms appears to be sharply different from the fictional scenes in popular television shows.

"'ER' on TV is heaven; ER in California is hell," said Sen. Jackie Speier, a Daly City Democrat and chairwoman of the Senate Insurance Committee.

Speier said statewide, 19 emergency rooms have closed since 1997 despite increasing patient loads.

"California now has 375 licensed emergency rooms that are overworked and overcrowded, forcing patients to wait longer for required treatment. Tragically, negative outcomes increase as delays in care increase," she said.

Legislators quickly called for further action on the issue, including possible creation of a "strike force" panel to attack the problem, support of additional emergency room dollars in the state budget, and a review of health maintenance organization policies on paying or denying emergency room bills. One measure already under consideration, SB 1177 by Sen. Don Perata, D-Alameda, would penalize HMOs for not paying legitimate emergency room medical bills on time.

"If the legislative and executive branches of state government fail to alleviate the ER emergency room crisis, I fear we will have blood on our hands," Speier added.

Abbott said two hospitals in Orange County alone have closed their emergency departments in the last 12 months.

"The emergency care system in California in many places right now is literally on the brink of collapse. Patients are suffering undue consequences and even dying due to the fact that the system is simply overwhelmed," Abbott testified.

Testifying physicians and legislators said problems hitting emergency rooms include the failure of many health maintenance organizations and government programs to make adequate payments for emergency patient care, and a large number of emergency room patients that walk in with no insurance at all. In addition, they said some HMO patients become so frustrated with waiting for an appointment to see a regular doctor that they feel forced to turn to emergency rooms.

The financial squeeze in turn has led to a host of other problems, including total shutdown of some emergency rooms, temporary diversion of ambulances from emergency rooms that are full, and the increasing reluctance of some specialty doctors to take on emergency room cases, the doctors and lawmakers said.

While HMOs were the target of repeated criticism during the hearing, a spokesman for many of the organizations said HMOs are often misbilled by emergency rooms, and that many emergency treatment claims justifiably face more scrutiny because they come from emergency rooms that are not under contract with the HMO.

"Nobody is volunteering to pay higher health insurance premiums," said William Wehrle of the California Association of Health Plans.,1724,146133,00.html


-- (, March 23, 2000


correction: typo in title...should be 'strained'


-- (, March 23, 2000.

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