The emergency department: rethinking the safety net for the safety net.

America's emergency departments (EDs) are in crisis. The dwindling numbers of EDs are increasingly overcrowded as they cope with rising demand. In a Health Affairs Web Exclusive, Glenn Melnick and his colleagues find that despite these trends, overall ED capacity is actually increasing in California. While this may appear to make financial sense for some hospitals, it is a costly response that does little to fix the complex problems that drive ED overcrowding. Given a convergence of factors, it may now be time to radically alter and broaden our historical expectations of the role of the ED.