<p style="text-align: justify;">Has anyone visited the emergency department recently? I know I’m preaching to the choir here, but it seems to me that increasingly the emergency department (ED) is the “canary in the coalmine” of America’s health care. And because I’ve made my living in EDs during the past 25 years in a number of states, in a variety of hospitals, and in different types of jobs, I’ve had the privilege and misfortune of seeing some of the best, and the worst, of health care, human nature, and, I fear, our nation’s future. Full disclosure: some of my observations may be pessimistic.</p>