HEALTH-CARE REFORM AND EMERGENCY-MEDICINE

The twin goals of health care reform-providing universal coverage and limiting health care costs-will require increased primary care access and reductions in the overuse of inappropriate sub-specialty intervent ions. The emergency department provides acute care access for all pati ents and nonemergency care for those patients unable to find other sou rces of care. Implementation of marketplace reforms may direct patient s away from EDs to other primary care sites and reallocate residency p ositions now available for training of emergency physicians to other p rimary care specialties. These two effects may endanger the viability of the ED as the safety net of the health care system. The impact of h ealth care reform on the emergency care system of the nation requires careful analysis to protect the important role of the ED in providing acute care and in guaranteeing access to care.