EMERGENCY ROOMS: Near ‘Breaking Point,’ Doctors Tell Lawmakers
California's emergency rooms have reached their "breaking point," according to physicians who testified Wednesday at a state Senate hearing on the issue. Overcrowding and limited resources have left "patient care in jeopardy, bills routinely ... unpaid and doctors increasingly worried about the future." While "'ER' on TV is heaven, ER in California is hell," state Sen. Jackie Speier (D-San Mateo) said. Dr. Dan Abbott of St. Jude Hospital in Orange County agreed, testifying, "We feel that emergency care in California is overwhelmed, it's underfunded and at times ... out-and-out dangerous." He added, "Patients are suffering ... and even dying due to the fact that the system is simply overwhelmed." Since 1997, 19 ERs have closed across the state, leaving only 375 licensed facilities to care for an increasing patient load. Among the primary problems plaguing ERs, physicians and legislators said, are declining reimbursement rates from both HMOs and the government and the large number of uninsured. The "financial squeeze" has forced some hospitals to divert ambulances and has prompted some specialty doctors to refuse ER cases. Legislators discussed several possible courses of action during Wednesday's hearing, including the creation of a "strike force" to deal with the issue, additional state funding for ERs and a review of HMOs' ER payment policies. One measure already under consideration in the state Senate, SB 1177, would penalize HMOs for tardy payment of legitimate ER claims. Speier concluded, "If the legislative and executive branches of state government fail to alleviate the ER crisis, I fear we will have blood on our hands" (Matthews, Sacramento Bee, 3/23).
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