Emergency department closures will be disastrous, says ACEP

Nation's Emergency Physicians Laud President Obama's Efforts to Revive Health Care Reform, but Urge the President and Congress to Address the Critical Problems facing Emergency Patients

As members of Congress and President Obama meet this week about health care reform, the American College of Emergency Physicians (ACEP) today raised alarm over the recent closure of an emergency department in Cincinnati and reports of more ERs on the brink of closure in New York and Washington, D.C.  

Saying these closures are especially troubling because health care reform has stalled and President Obama's new proposal does not address any of the critical problems facing emergency patients, Dr. Angela Gardner, president of ACEP, urged national policymakers to recognize the need to preserve America's emergency departments, which care for people when seconds count.  She issued the following statement:

"As President Obama releases a health care reform proposal, America's emergency physicians are reminding national policymakers that the dangerous problems facing emergency patients are not going away.  In fact, things are getting worse, and a recent GAO report said emergency patients who need care in 1 to 14 minutes are being seen in more than twice that timeframe [37 minutes].  

"The President's proposal calls for investing in community health centers, but we also need to invest in community emergency departments.  Most people seeking emergency care have the symptoms of a medical emergency and need to be there.  Emergency visits are increasing at rapid rates, and as our population ages, even more people will need these vital services.

"However, Deaconess Hospital in Cincinnati is closing its emergency department because millions of dollars in losses have made sustaining it impossible. The venerable St. Vincent's Hospital in New York City, an icon of emergency care for years that treated many victims of the terrorist attacks of 9/11, announced it too may close the emergency department.  Right in the shadow of the U.S. Capitol, United Medical Center in Washington, D.C., is also on the brink of failure.

"Closing these emergency departments will have a disastrous effect — not just on the people who rely on them for emergency care — but also on the neighboring hospitals that will have to absorb more emergency patients.  

"If you think your ER is crowded now, wait until one in your community closes and then see how bad crowding can get.  As people lose jobs or continue to be unemployed, they lose health insurance.  Where do they turn for medical help when all other doors are closed to them?  Consider the 25,000 people in 2009 who reached their lifetime caps on private health insurance.  Where do they turn for medical help?  

"The answer to all these questions is the emergency department.  It is the one place people have always been able to rely on to get care when they need it, but every time an ER closes that care becomes a little harder to get.  We are all only one step away from a medical emergency, and where will you turn for help when the emergency department closes?  

"The crises at Deaconess, St. Vincent's and United Medical Center are grim reminders of what can happen when nothing is done to provide universal health insurance.  These hospitals provided a disproportionate amount of medical care to the uninsured and are now suffering the economic consequences of that burden.  Deaconess lost more than $13 million in 2008 alone.  Only 10 percent of United Medical Center's patients have private insurance, making it nearly impossible for that hospital to operate without a deficit.  St. Vincent's, which has been a beacon of hope to some of New York City's poorest residents, loses millions of dollars every month.  

"This problem affects everyone, not just the poor and the uninsured.  Emergency departments provide a safety net for everyone in a community, rich and poor, insured and uninsured.  The closure of an ER doesn't stop the flow of patients – they simply turn to other ERs for care.  Every hospital has its breaking point, including those in affluent areas.

"The nation's emergency care system is in critical condition.  The political will for health care reform may be fading, but the need to shore up our nation's emergency departments is as urgent as ever."  

SOURCE American College of Emergency Physicians