Emergency Physicians Press Congress on Health Reform

John Commins, for HealthLeaders Media , June 8, 2009

The American College of Emergency Physicians, still stinging over its exclusion from the high-level healthcare reform debate, has launched a letter-writing campaign among its 27,000 members, urging Congress to address emergency patients' needs as they take up the issue this month.

"Nearly 120 million people are treated in our nation's emergency departments annually, and we expect that number to climb with each passing year," says ACEP President Nicholas Jouriles, MD. "People age 65 and older represent the fastest-growing segment of the population and the group whose visits to the emergency department are increasing the fastest. These are also the patients who require the most acute care and are admitted to the hospital from the emergency department most often. This could lead to catastrophic crowding in just a few years."

ACEP has not hidden its disappointment and resentment after emergency physicians were not invited to attend a White House summit on healthcare reform this spring, while other groups, such American Medical Association, the American Hospital Association, and America's Health Insurance Plans, were given front-row seats. In the face of an indifferent White House, ACEP is making an appeal to Congress.

Jouriles says Congress must bolster the nation's safety net system to meet current needs, even as lawmakers consider reforms to the healthcare system that will not play out for many years. He says workforce issues persist across all of medicine, including emergency care, and will likely grow more acute as physicians in the Baby Boomer generation retire. Jouriles points to a Government Accountability Office report released in April that found that patients who need to be seen in less than one minute in the emergency department are now waiting an average of 28 minutes for care.

ACEP has maintained that widespread claims by some members of Congress and in the news media that universal health coverage will ease emergency department crowding are not supported by data. CDC reports that 83% of emergency patients have some type of insurance, and Jouriles says emergency department use in Massachusetts increased following the 2006 enactment of mandatory health insurance for all state residents.

 "Even if everyone had primary and preventive care tomorrow, emergencies will continue to be a fact of life," Jouriles says. "Considering how many patients emergency departments treat every year and how many resources they can draw upon in one place, it is remarkably cost-effective," he says. "Emergency care accounts for less than 3% of the nation's $2.1 trillion in healthcare expenditures, but is a priceless public resource."

John Commins is a senior editor with HealthLeaders Media.

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