ABC Nightline for Friday -- E.R.'s, healthcare of last resort?

[Bozita]

Nightline Daily E-Mail
October 24, 2003


TONIGHT'S SUBJECT: The final program in our week-long look at the national health care crisis. Tonight we look at emergency rooms, the country's health care safety net. E.R.'s are required by law to treat all patients, but as they find themselves overcrowded, overwhelmed and hemorrhaging money, some are saying a drastic change has to be made. Is the safety net about to break?

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Emergency rooms are pretty self descriptive. They are for emergencies. As anyone who has spent any time watching Dr. John Carter or Nurse Abby Lockhart on a rival network can tell you, emergency rooms are for traumas and life threatening conditions. E.R.'s are not health clinics. They do not treat complaints such as persistent coughs or minor skin rashes. Right?

Well, not surprisingly, truth is stranger than fiction. E.R.'s today have become the safety net for a health care system that leaves 43 million Americans without insurance. E.R.'s are seeing uninsured patients who have nowhere else to go. In fact, a recent study found that 55 percent of all emergency services go uncompensated. But E.R.'s are also being flooded by patients with insurance that is woefully inadequate. These patients are trying to make appointments with their primary care doctors but simply are not able to get in to see the doctor in a reasonable timeframe. Sick and desperate, they turn to the E.R.

The E.R. is the healthcare of last resort. Or is it?

Nightline producers Daniel Green and Brooke Runnette traveled to several emergency rooms and discovered that many E.R.'s are overwhelmed and overcrowded and losing money. In fact, for some E.R.'s, the crisis has become so acute that the hospitals are considering what was once unthinkable: turning patients away who cannot pay. In fact, that's what is happening in one of the E.R.'s we visit. If you don't have a true emergency, and you don't have insurance, or can't otherwise demonstrate your ability to pay the bill, you are going to be shown the door.

The crisis in emergency rooms in many ways illustrates the problem in the health care system overall. Financial decisions are competing with ethical decisions — and sick people are caught in the middle.

We hope you'll join us.

Sara Just and the Nightline Staff
Nightline Offices
Washington DC