Yes, the System is Broken

     On June 14, the Institute of Medicine (IOM) released the results of three years of study into our nation's emergency care system.

     According to the IOM, our nation's medical system is overburdened, underfunded and highly fragmented. Stretched to breaking point, the system is compromised in its ability to handle disasters. No kidding! As we reported in the May issue of EMS Magazine, ambulance diversions continue to be problematic in EMS, impacting the day-to-day delivery of emergency care. Hospitals are overwhelmed dealing with both an aging population and an increasing number of uninsured patients using the ED as their primary healthcare provider. Who knows what would happen in the event of a major disaster? (Well, we do know what would happen - Katrina showed us that.) But it's little wonder the emergency medical system is struggling. As the IOM report confirms, EMS received only 4% of the $3 billion distributed by the Homeland Security Department for emergency preparedness in 2002 and 2003. How are our systems supposed to address the challenges of this new world we live in with barely a buck in the bank?

     As part of the report process, the IOM looked at hospital-based emergency care, prehospital care and emergency care for children. In the EMS section of the report, the IOM committee is advocating that Congress establish a lead agency - located within the Department of Health and Human Services - for emergency and trauma care within two years of the publication of the report. This agency would be responsible for the full spectrum of prehospital care and be charged with increasing the profile of emergency care. In recent years, the question of which federal agency is best suited to lead EMS into the future has produced heated debate. Hopefully, this report will generate not only argument, but also change, as well as educate our nation's policy makers as to what needs to be done to repair emergency care in this nation.

     The August issue will feature a comprehensive summary of the IOM report and its implications for the future of prehospital and emergency care. We welcome your thoughts on this topic. E-mail nancy.perry@cygnusb2b.com.