As shown in this chart tens of thousands are using ER services who do not have emergency needs. Combine the two top bars and you have about 20,000 who had emergency needs while the remaining over 70,000 could have been served by a physician or a clinic. The data is from a study of ERs in a few representative states.

The study of ERs found that the time patients wait for services has increased with the increase in numbers. For patients with heart attack symptoms the increased wait time could mean death or further disability. Even the 8 minutes wait time in 1997 is too long.

Chief author of the study was Dr. Andrew Wilper of Harvard Medical School in the January 15, 2008, online issue of Health Affairs. He describes the situation in ERs as a "perfect storm" of increasing demand while 12% closed during the period of the study in that set of ERs.

See Andy Grove's view of the emergency in emergency rooms in Wired magazine.