Anytime I have a debate about healthcare with someone who doesn’t support the idea of socialized medicine, s/he invariably asserts that America has the best healthcare system in the world, and hey, if it ain’t broke, don’t fix it.

First of all, we don’t have the best healthcare system in the world, even if we (some of us) have access to (arguably) the best and most cutting-edge health care services, but I’ll leave that for another time. At the moment, I’d prefer to address the claim that “it ain’t broke.” Because, guess what? It is.

Half a million times a year — about once every minute — an ambulance carrying a sick patient is turned away from a full emergency room and sent to another one farther away. It's a sobering symptom of how the nation's emergency-care system is overcrowded and overwhelmed, "at its breaking point," concludes a major investigation by the influential Institute of Medicine.

That crisis comes from just day-to-day emergencies. Emergency rooms are far from ready to handle the mass casualties that a bird flu epidemic or terrorist strike would bring, the institute warned Wednesday in a three-volume report.

…At the root of the problem: Demand for emergency care is surging, even as the capacity for hospitals, ambulance services and other emergency workers to provide it is dropping.
There’s more at the link—and it doesn’t get any better. Their finding that “only 6 percent of emergency departments had all the supplies needed, such as child-size equipment, to treat” children, for example, makes me so angry that I could spit—and I’m not even a parent.

So why is demand for emergency care surging, anyway? Are we suddenly becoming a nation of accident-prone klutzes? Well, no. It more likely has something to do with the fact that since 1993, America has lost 703 hospitals and 425 ERs—and that, according to the US Census Bureau, as of August 2005, nearly 46 million Americans (1 out of every 7) are uninsured. Six million have been added to the rolls of the uninsured just since Bush took office. When people don’t have insurance, they tend to use the emergency room to seek treatment for many health issues for which insured people go to primary care providers, which puts an undue strain on emergency rooms, “which by law must treat every patient who shows up.”

The system is broken. We’re plied into complacency with scare stories about Canadians desperately crawling over the border for medical care or Britain’s horrific NHS, but most of the stories fall somewhere in between “exception to the rule” and “utter bunk.” No system is perfect, but ours is a lot less perfect than many others, and, most importantly, a lot less perfect than it could be, given half a chance.

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