3. It used to be that emergency rooms got too busy just during winter flu outbreaks, or just in inner-city neighborhoods on
Saturday nights. But now emergency departments are overwhelmed year-round. They're maxed out in world-class institutions
that consistently land on U.S. News and World Report's honor roll of Best Hospitals-including Johns Hopkins Hospital, the
University of California-San Francisco Medical Center and the Cleveland Clinic, which last year turned away ambulance
patients almost half of the time. And they're struggling in wealthy suburbs like Fairfax County, a high-technology center with a
median household income of more than $90,000. "When there's not enough room," says Thom Mayer, chairman of the Inova
Fairfax Hospital emergency department, "there's not enough room."

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