Last year, 49-year-old Beatrice Vance began experiencing some alarming symptoms, nausea, shortness of breath, and chest pains.  She called her daughter, Monique, and asked to be driven to the emergency room at Vista Medical Center in Lake County, Illinois.  Upon arrival, a nurse briefly met with her and asked her to wait until she could be seen by a doctor as patients are treated in order of severity.  Two hours later when her name was finally called, Beatrice didn't respond.  In fact, hospital officials found her slumped over in her chair unconscious and without a pulse.  According to ABCNews.com of September 17^th, 2007, Beatrice had already died from a heart attack while waiting to be seen by a doctor.  Sadly, Beatrice is not the only one who suffers from the hands of an irresponsible, inconsistent, and incompetent emergency room staff.  Hospitals across the country are wrought with discord.  According to Dr. Brent Eastman, Chief Medical Advisor at Scripps Health Hospital in San Diego, America 's emergency rooms are in a crisis that could jeopardize everyone in this room and all their loved ones.  Today we'll uncover the catastrophic conditions existing in America 's emergency rooms, discover what is causing these issues and finally how to restore our faith in a system that according to the June 21^st, 2006 New York Times has reached a breaking point.  There are three major problems with the United States Emergency Care System.  They include overcrowding, lack of specialization and training, and funding.  First, according to an Institute of Medicine report on June 21^st, 2006 the need for emergency rooms has increased by 26% since 1993.  However, the number of emergency departments has declined by 425 during this same time period.  These two numbers point to one critical issue, emergency rooms are overcrowded.  Good Morning America of September 17^th, 2006 tells us that the average emergency room wait is now up to four hours.  However, patients could be asked to wait up to 48 hours before they are allowed into an inpatient bed.  The second problem of the United States Emergency Care System is that it lacks specialization and is understaffed.  According to the previously cited New York Times, emergency rooms find it very difficult to get specialists to take emergency room and trauma center calls.  Furthermore, specialists such as neurosurgeons shy away from emergency room procedures because of the lack of compensation associated with treating so many uninsured patients, and the risk emergency room procedures cause them to gain malpractice premiums on their record.  But not only are emergency rooms understaffed, but those who are there are often unprepared.  According to the July 6^th, 2006 Columbus Dispatch, EMTs received only one hour of training for major disaster preparation.  What's even scarier is that according to the Fort Worth Star Telegram of June 15^th, 2006 with one major disaster our emergency care service could fall apart completely.  The third problem is not surprising.  There is simply not enough money to adequately fund our emergency rooms.  According to the June 15^th, 2006, New York Times emergency rooms are notorious money losers.  While most have operating budgets well in the millions, they receive only a fraction of that amount and are asked to operate securely and safely.  Additionally, the June 15^th, 2006 Pittsburgh Tribune Review tells us because of the lack of money, there are now 200,000 less hospital beds in the United States than there were in 1993.  However, the need has increased tremendously.  So, our emergency rooms are broke, overcrowded, and understaffed.  Don't you feel secure?  There are three specific causes of the emergency room crisis.  They include the highly fragmented emergency medical care system, the uninsured patients, and the lack of money.  First, fragmentation occurs on all levels because there is no standardized procedures and no clear chain of command.  On the regional level, emergency vehicles fail to communicate effectively with ER and Trauma Care centers, causing poorly managed patient flow.  On the national level, there is no standardized procedures for the training and certification of emergency room personnel.  To complicate matters even more, there is no lead agency to control emergency room and trauma care centers.  So, as you can see this lack of organization causes chaos and confusion in what should be a streamlined and secure service industry.  Uninsured patients cause about as much chaos in the emergency room as does fragmentation.  According to the July 6^th, 2006 Columbus Dispatch there are now 46 million uninsured in the United States today.  This of course leads to more unpaid ER bills, which leads to more financial problems for the emergency rooms.  But please understand, I am not blaming the patients who simply cannot afford or are not offered health insurance.  They are merely the effect of a larger cause, a society that doesn't place a premium on affordable health care.  This of course only perpetuates the cycle.  No affordable health care means no insurance.  No insurance means unpaid ER bills, which leads us to the third and final cause of the emergency room breakdown, which is the lack of money and inadequate financial backing.  According to the June 15^th, 2006 New York Times, money is a major cause of the shortage of capacity and the lack of stability in the emergency rooms.  Additionally, the June 15^th, 2006 Fort Worth Star Telegram tells us that emergency rooms received only 4% of the $3.38 billion that was allotted to them by the Homeland Security Department in 2002 and 2003 for emergency medical preparation.  As budgets continue to be slashed, the quality of our health care will continue to deteriorate.  So, how can we renovate a cycle that seems beyond control?  Well, we can look to solutions on a national and then on a personal level.  The first step to defeating the chaos in the emergency rooms is to create a coordinated, regionalized system with national standards and a lead agency.  Everyone from 911, to ambulances, to emergency care services need to coordinate their operations effectively and efficiently in order to ensure each patient a safe and secure emergency room visit.  Additionally, the Institute of Medicine also suggests that a lead agency be started in the Department of Health and Human Services in order to control emergency room and trauma care centers.  On a personal level, the National Association of Emergency Physicians asks us to be responsible before going to the emergency room.  Before going to the emergency room, you need to ask yourself, do I really need to go to the emergency room, or can my primary care physician take care of my needs?  This way, the precious face in the emergency room is saved for the true emergencies.  As for uninsured patients, I understand that affordable health insurance is another persuasion altogether, but steps can be taken in order to help those uninsured in our communities.  We can take our lead from the people of Columbus, Ohio.  The July 6^th, 2006 Columbus Dispatch tells us that primary care clinics were started in some of the poor neighborhoods.  This way those uninsured can get the primary care they so desperately need.  So, today we have uncovered some of the catastrophic conditions existing in America 's emergency rooms.  Armed with a greater understanding of what is causing these issues we can now look to the future and focus our energy on solving this national crisis.  Unfortunately, it is too late for Beatrice Vance.  However, her death was officially ruled a homicide which opens the door to criminal prosecution against the hospital.  Maybe this is the wake up call that the United States has needed in order to restore safety and stability in our emergency care system.