NACHMAN: The Hidden Driver Of America’s Overcrowded Hospitals


Paul Nachman Contributor
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Emergency rooms nationwide are dangerously overcrowded, and scores of hospitals are struggling to cope with a surge of patients. ER staff in one Seattle-area hospital recently called 911 due to the flood of patients, telling dispatchers that they were “drowning” and “in dire straits.”

In Massachusetts, ERs are not only facing unprecedented numbers of patients — they’re also having a devil of a time discharging them. Post-acute care facilities simply can’t accommodate all the patients who need longer-term rehabilitative care, which shifts the burden back onto overworked ER staff.

An unusually bad cold and flu season deserve some blame for the sorry state of emergency departments — but the crisis has been brewing for years, even decades. Simply put, America isn’t adding nearly enough hospital beds generally, and emergency room capacity specifically, to keep up with its growing population. And the ongoing border crisis is exacerbating the problem, since illegal immigrants disproportionately rely on emergency rooms for routine — and effectively free — care. 

America’s population has soared in the past half century, rising from 205 million in 1970 to over 334 million today. And it’s continuing to surge — even though fertility rates have been sliding for years — because of migration from other countries. In 2021, the net population increase attributable to immigration outweighed the increase attributable to births for the first time ever.

These trends will accelerate in the coming decades. America’s population will hit 404 million by 2060, according to Census Bureau projections. By that year, immigration will account for more than two-thirds of the annual population increase, with births making up less than a third. If one also factors in the babies born to immigrant parents, immigration will account for 88% of all U.S. population growth over the next four decades, according to Pew Research.

Hospital capacity hasn’t remotely kept pace with America’s population boom. According to World Bank data, the number of U.S. hospital beds per 1,000 people has shrunk dramatically — from 7.9 in 1970 to just 2.9 in 2017.

So it’s no wonder that nearly 90% of emergency departments report overcrowding to be a problem, with over 40% reporting it as a daily occurrence.

The unprecedented 2.8 million border crossings in fiscal 2022 — over 1 million more than fiscal 2021’s record of 1.7 million — are putting even more pressure on already-beleaguered hospitals.  

Of course, any population surge of that magnitude would burden the healthcare system. But the huge influx is especially problematic. While only 8% of citizens are uninsured, 46% of illegal immigrants don’t have health insurance, which means that emergency rooms — which provide treatment regardless of people’s ability to pay — are often the only source of medical care they use. These further strain emergency-care personnel, who are forced to tend to situations that aren’t actually emergencies.

America’s healthcare system is simply not equipped to cope with this influx. A booming population coupled with overworked, burnt-out nurses and doctors is a recipe for disaster. If politicians want to safeguard public health and relieve overwhelmed hospital workers, they’ll need to get the border under control. 

Paul Nachman, a retired physicist, is a volunteer in a research group at Montana State University in Bozeman and a founding member of Montanans for Immigration Law Enforcement.

The views and opinions expressed in this commentary are those of the author and do not reflect the official position of the Daily Caller.