The Washington Post cited three reports issued by the institute after an extensive two-year study of the problem.

The study's experts said the US emergency care system lacks stability and the capacity to respond to large disasters or epidemics. They say it would cost billions to resolve the problems and require the leadership of a new federal agency, which must be set up in the next two years.

Declining Number of ERs

Dr. Rick Blum, president of the American College of Emergency Physicians, said reports show only a tiny fraction of federal funding for emergency preparedness since Sept. 11, 2001, has been spent on medical preparedness, and the situation is exacerbated by a declining number of emergency rooms.

"Congress must convene a hearing on the state of emergency medicine in this country and dedicate funding to the emergency care system to support disaster preparedness," said Blum. "Hospitals must be reimbursed for the significant amounts of uncompensated emergency and trauma care they provide."

Ambulances Wait Hours to Unload

However, Blum also said hospitals must end the practice of boarding patients in emergency departments.

The situation is so serious overcrowded ERs often are unable to provide the expertise needed to treat seriously ill people in a safe and efficient manner.

The analysis found ambulances in some instances wait for hours to unload patients and once in, some patients have to wait two days for a hospital bed.