tadao is right with the emergency room jazz. it'd be fine like that if people didn't abuse it so badly and treat the emergency room as their own personal primary care physician and go in for stupid small stuff knowing they can't be denied treatment and that they could get away without paying a dime. kitsa could probably confirm this!
also, the health reform bill/s are no doubt going to affect this - but it'll only make it worse if it hasn't already. things are going to get really bad before they get better, and they wont be better until at least 2015.