Emergency rooms have been inundated by basic primary care problems since mid 1970’s. They have had to care for more and more uninsured patients by default with little support or recognition of the growing burden. By the way, there aren’t enough nurses, physical therapists and a lot of other ancillary but important services for proper medical treatment and health maintenance. No one has come up with a solution in the last thirty years. There are probably some other cultural and market factors that effect this. The point is the problem is not new nor has it been entirely ignored. It is however very chronic and symptomatic of our self centered fragmented health care system.

Free market factors have not solved the problem. The solution needs to be multi-factorial and coordinated, encompassing the best of what we have while adopting best practices from other health care delivery systems around the world. We can no longer afford to rely on antiquainted, ideological arguments or continue to behave as if doesn’t affect us. Indeed it has an effect on everyone directly or indirectly for cost and accessibility of quality health care. One can only hope that the new administration can make some headway in improving things while fighting the headwinds of special interests who are deeply vested in the status quo. Ironically, the chances for repair and substantial improvement of these issues are as good as ever in spite of a past history of little positive action. As in many areas right now, it’s time for a change.

Every year we delay the inevitable, we make it harder and harder to fix.