The fact that this is even a point of investigation is very frustrating. Wait times at local restaurants in my area are basically constant and will remain so, because if there is an observable queue, someone opens a new restaurant or an existing one puts on more staff and finds space for more tables.

If people were permitted pay directly for emergency visits, and new hospitals allowed to open then it would be ridiculous for there to be a general problem with trending wait times. Someone would add more emergency capacity somehow. That isn't even in conflict with keeping a public system either, there can still be a public system. Just let people who can afford their own emergency care fund their won care.

The problem here is precisely that deliberative bodies trying to work out how much emergency care is required instead of creating an easily-joinable class of people who benefit financially from providing care and leaving decisions up to them. That works well for almost literally every service out there and there is no reason to think it would fail for emergency healthcare. These people attending clearly have hours to shop around.

The article is hazy on this point, but the monopoly agreement set an slo of 220 minutes (3 hours 40 minutes), and it was fairly stable, but worsening by tens of minutes per year.

Since then, the hospital in question increased to 10 hours 45 minutes.

Worse, the federal government stopped tracking this metric, and now, among hospitals that elected to share the number, the median is over 5 hours.

So, if you live in the US, you’re probably screwed, regardless of whether you live in appalachia.

In addition, depending on how you model ER admissions using queueing theory - the wait times very quickly goes exponential with even relatively small changes.

I imagine all the signs about don’t abuse the staff and incidents of abuse against hospital workers went up at the same rate as the wait times. Abusing the staff is wrong but you have people that have come there because they think they are about to die without attention, they really don’t have a choice