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American medical care is supposed to be among the best in the world.  But a new study shows a picture of an emergency health care system that is critically ill. 

Every 60 seconds, an ambulance carrying a sick or injured patient is turned away from a hospital somewhere in the United States because the medical staff is already overburdened caring for others. 

A two-year study by the National Academy of Sciences' Institute of Medicine does not answer the question of how many patients die after that ambulance is redirected to another hospital ... or how the patient's condition is affected by the delay. 

But it does say patients brought to emergency rooms often wait hours ... even days ... before being moved to a hospital room.  The quality and timeliness of medical care varies greatly. In some cities, half of heart attack victims are saved, while in other towns, the life-saving rate is as low as five percent.

These are just the routine crises.  How would American hospitals cope with another terrorist attack ... or a deadly virus, such as bird flu? 

The study's co-author, Dr. A. Brent Eastman, says the situation is at a breaking point. "This has evolved over the last several years and it has simply reached crisis proportions."

The demand for emergency medical care has grown by at least 25 million hospital visits a year, compared to a decade ago. 

Much of the pressure on these services comes from poor, uninsured patients who cannot legally be turned away or who wait until health problems reach the critical stage.  Adding to that: the number of emergency personnel has not kept up with demand. Some hospitals have shut down after losing money on emergency care.  And fewer hospital beds are available because of a trend toward more outpatient services.

The doctors who have written and support this study say this is a plea for help -- more money is needed from the U.S. Congress to save an ailing health system.