A recent surge in emergency room wait times across the United States has left many patients in distressing situations. Stories from patients highlight the severity of the problem. A woman in Colorado bled on the floor while waiting 12 hours for care. In New York, a man feared he had appendicitis and endured eight hours of vomiting and fainting. In San Francisco, a cancer survivor waited a staggering 28 hours for a doctor, only to find herself paralyzed by the time she was seen.
Wait times in emergency rooms have been rising steadily since 2012, and the COVID-19 pandemic made things worse. Currently, the average wait time in emergency departments exceeds four hours, with 5% of patients waiting more than 24 hours for assistance. This data comes from a study published in the journal Health Affairs, which analyzed 46 million emergency visits across the country since 2017.
One of the contributing factors to these long wait times is staffing shortages, but experts say that’s not the whole story. Niklas Kleinworth, a policy analyst at the Paragon Health Institute, points to a lack of financial incentives in the U.S. healthcare system as a primary issue. He argues that when the Affordable Care Act was enacted, it was promised that more healthcare coverage would lead to fewer emergency room visits. Instead, many people are using emergency rooms for routine care, which adds to the congestion.
Kleinworth suggests that expanding telehealth services could help alleviate some of the pressure on emergency rooms. In Montana, for instance, after a law was passed to enhance telehealth access, emergency visits decreased among Medicaid enrollees. This change also made mental health services more accessible, particularly in rural areas.
Another factor exacerbating the situation is the closure of rural hospitals. With fewer facilities available, patients are forced to travel farther to reach urban hospitals, which are already overwhelmed. Kleinworth also notes that federal programs, like the 340B Drug Pricing Program, can unintentionally encourage larger hospitals to buy smaller rural ones, limiting access to care in those communities.
Kleinworth advocates for basic reforms to ensure that government programs truly support rural hospitals. He also believes that allowing non-physicians, like pharmacists, to provide primary care could improve access to healthcare.
Recently, some officials have attributed rising ER wait times and costs to illegal immigration. However, Kleinworth is skeptical of this claim. He points to California, which has offered healthcare benefits to undocumented immigrants for years, yet still experiences some of the longest ER wait times in the nation.
Ultimately, Kleinworth argues for a significant overhaul of Medicaid, suggesting that the program should prioritize the most vulnerable populations, such as pregnant women, the disabled, the elderly, and children, rather than focusing primarily on able-bodied adults. He believes that these changes could help reduce emergency room wait times and improve overall access to healthcare.
