In the past decades, emergency room care has been quickly commercialized, governed often not by patient needs but by finances. Many states—notably Texas and Colorado—have permitted the opening of freestanding ERs often owned by entrepreneurial physicians. If a patient arrives via ambulance and is seriously injured or really sick or has had a heart attack, a doctor checks him out and sends him to the nearest real emergency department connected to a hospital with facilities like operating rooms and a cardiac laboratory. Aside from the risk of delays in treatment, the sequence results in bills
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