Is the Healthcare System Really Collapsing?

Wei Yee Chong in the Emergency Room (Author’s photograph)

Wei Yee Chong is currently working on her PhD at the University of Adelaide, AU. She graduated from the University of Malaya (Malaysia), and previously lectured at various institutions of higher education in Malaysia for fifteen years before immigrating to Australia. She also published a companion piece to this article, “The ‘Messy’ Reality of the Doctor Shortage,” in Against Professional Philosophy last year (Chong, 2024).

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Is the Healthcare System Really Collapsing?

Act in such a way that you treat humanity, whether in your own person or in the person of any other, never merely as a means to an end, but always at the same time as an end. (Kant, 1785/1996: p. 83, Ak 433)

1. Introduction: Do Not Get Sick. Has the Healthcare System Failed Us?

More than 10,000km across the globe from Adelaide, the tragic death of the Greek heiress (Marissa Laimou) in the United Kingdom due to fatal insect bites and inadequate healthcare resonates with my own prolonged wait experience in the emergency department in Adelaide, Australia. The grieving mother of the Greek heiress claimed, “Everybody says in all the countries the system is getting worse and worse in the UK, everybody knows it” (Daily Mail, 2025). Here is my real-life experience at the Emergency Department at the Metropolitan Hospital in Adelaide, Australia).

2. My Encounter with the Emergency Department

I was stuck in the Emergency Department from 11:45 pm, 5 May 2025, to 4:44 pm, 6 May 2025.

It started on 5 May 2025 at about 11.30am, when I woke up with a heavy head and tight neck in the morning. Trying hard to relax my body, I submerged my head down on three huge pillows and waited for a while. When I looked up again, the room was spinning rapidly like a merry-go-round horses (carousel horses) at the funfair. I lay down again and closed my eyes, then opened them again. It was still spinning. It didn’t stop, and I was a little afraid. I thought that if I gave my body a break and continued sleeping, I would be alright when I woke up again. After a while, I opened my eyes, but my world was still spinning. However, I could not walk more than one metre, so I slumped back into my bed and lay there for a few hours.

Then I texted my friend, and he told me he could come after work to take me to the hospital. I live on the second floor in an apartment without a lift, and I was not sure how to go down. We were discussing the possibility of home doctors, telehealth, and hospitals. At that point, I was reluctant to go anywhere because I couldn’t even stand up without being so dizzy I would fall down.

So, I continued sleeping till 11 pm. When I woke up, my room was still spinning, and I was afraid. I texted my neighbour, but he was away in the country. He suggested I knock on the door of other neighbours to accompany me to the Emergency Department. At that point, I was worried I might faint on the way, and thank God, a very kind neighbour from my university went with me. I stumbled along the way because I could not walk properly. I held on to her hands, and we reached the entrance of the hospital, but it was locked, and later we found out that the Emergency Department is on a floor below outside the hospital. It took quite an effort for us to reach the Emergency Department in view of my situation. We reached the emergency department before midnight and I urged my neighbour to go home because it was late, and I saw some suspicious characters along the way.

The Emergency Department was like a war zone. When I walked in, there were lots of patients lying on couches, and some were sitting on chairs. All of them looked ill and weak. There were too many patients at the registration counter. I was too weak to stand and told them I had to sit down because I was feeling dizzy. One of the triage nurses came to ask about my condition but had to leave for other patients. I couldn’t sit on the couch but had to lie down because of the dizziness. More people kept coming in, and after a few hours, my condition worsened. I was freezing, shivering, and my head was spinning with headache. A male patient went to the counter and told the staff about my condition after looking at me. (I thanked the patient.) The nurse told me I had to wait a few hours to see a doctor.

At about 2:11 am, a male triage nurse came to measure my blood pressure, and I burst into tears and told him I had pain and was cold. I was breathing heavily under the intense pressure and pain. I asked for a blanket, and he told me he had to move me to a chair away from the couch in front of the counter. I told him I could not walk because I felt dizzy and needed a wheelchair. Later, he used the wheelchair to move me across the room, but no couch was available as it was full of sick people. He then moved me to a plastic chair and used the wheelchair to support my legs. I was still shivering with cold and covered myself with a white blanket. The night was long, sad, and scary. I was with a group of ill and desolate people in a cold room, which might have been worse than the situation in the developing country I came from.

At about 3 am, our peace was interrupted by a very noisy male patient. He was talking non-stop, yelling, and saying he needed help for his mental insanity and wanted to see a doctor, but he was in the queue, just like anyone of us. He rumbled through the night, mentioning a few times that he had been having a troubled mind for 31 years and needed help. Occasionally, I heard him mention 911 and abuse. Even though I was weak and dizzy, my mind was still clear, and I could absorb what was happening around me.

At one point, it crossed my mind whether this mentally troubled man would attack us, as it seemed his mind was not clear. The hospital guard came out of the room to calm down this poor man. There were also a few rowdy men in the room, but not as loud as the man with mental problems. I heard in the background the mentally unsound man saying he would give up his slot for “this poor lady,” perhaps referring to me.

The night was long and freezing, and when the first sunlight appeared, I was hoping to see a doctor. I asked a triage nurse who passed by me when I could see a doctor, and she told me soon. But I waited for another hour and asked another nurse, and she told me soon, as the doctors’ shift change was at 8 am. I was still waiting, and the nurse told me I was third on the list, so I continued waiting in hope. Finally, one doctor came out to call a patient’s name, and it was not mine. Another male doctor came out, and I was hoping he would call my name, but instead he called a male Caucasian’s name; however, that patient had left, and the doctor then called my name. (At this point, I wondered whether someone had given up their slot for me.)

The doctor was kind and let me hold his hands while walking because I was feeling dizzy, and my body was not balanced. He brought me into a room and started checking me. The nurse gave me medication through drips. For a few hours, I was put through many tests, including CT scan, two ECGs, and blood tests. In between, I asked the doctor why the long wait. Was it a lack of doctors? He told me it was not a lack of doctors, but the system. I asked him whether it was a lack of beds, and he told me vaguely that some patients would be moved somewhere, and I didn’t ask further.

I left the Emergency Department at 4:44 pm on 6 May 2025, which was a total of 17 hours. The eight-hour waiting period and the rigorous checks, including a CT scan, two ECGs, and blood tests, had taken out the energy of me, and if they had found anything wrong with my brain or heart, I think that would have been my breaking point.

I decided to write about my Emergency Department experience for the following five reasons:

(1) My PhD research is on healthcare, and this experience as a patient in an emergency department was first-hand, hands-on experience.

(2) The healthcare system needs a shake-up. While there are good health practitioners, such as the doctor who treated me, the long wait period to see a doctor (eight hours in my case) worsened my situation. By the time I had gone through all the tests, it was 17 hours, and I was exhausted; my body was completely drained, and if they had found anything worse, I would have had a total breakdown physically, mentally, and emotionally.

(3) Healthcare is a part of human rights, and the Emergency Department at the hospital was like ground zero when I was there, with more than 10 patients (including myself) lying in the lobby waiting for treatment. There was also a mentally disturbed man crying for help to be cured. Why was he not sent to a mental hospital? This is Australia, a developed country, not a war-torn country! We should do better than this.

(4) I want to thank the emergency doctors, nurses, and hospital staff for their unrelenting dedication. I also want to thank my friend, neighbours and other patients who helped me.

(5) Most importantly, I want to give voice to the vulnerable, such as the mentally disturbed man and other patients. For example, why was not this man given the appropriate help at a mental hospital instead of being in the Emergency department? Has the system failed us?

3. The Case of Australia: A State of Emergency

In Australian hospitals, emergency departments employ a triage system to prioritize patients based on the urgency of their condition. Maximum recommended wait times vary by triage category. Immediate (Resuscitation) patients should be seen immediately, while Emergency patients within 10 minutes, Urgent patients within 30 minutes, Semi-urgent patients within an hour, and non-urgent patients within two hours. (SA Health, n.d.)

After departing the Emergency Department after a 17-hour ordeal, I was not only overwhelmed by my unpleasant experience but concerned about the welfare of patients subjected to the incessant waiting time and the surreptitious deterioration of our healthcare system, which resembles a walking zombie. When I felt better, I started researching on the Australian healthcare system particularly, the emergency waits time and related matters.

True enough, there is substantial evidence supporting my concern about the deteriorating Australian healthcare system. According to Dr John Williams, President of Australian Medical Association (South Australia):

South Australia’s emergency departments continue to perform well below the national average. The latest figures reflect the stubborn challenges our members confront on a daily basis—the overwhelming patient demand, the staffing shortages, the stretched resources. (Australian Medical Association, 2025).

Dr Williams further noted that:

South Australia’s emergency department performance went from bad to worse in 2023–24. Last year’s Public Hospital Report Card showed South Australia’s emergency departments were performing at the lowest levels in recent memory, with this year’s reporting period showing even further declines. Just 38 per cent of ED patients triaged as “urgent” were seen on time, down from 65 per cent 10 years prior. Meanwhile, only 50 per cent of ED presentations were completed in four hours or less, a near worst-in-class performance which represents a 12 per cent decline in the past five years. (Australian Medical Association, 2025)

The hospital crisis is not only confined to South Australia but also impacts each state and territory. As reported by SBS news,

[d]octors are demanding urgent action as surgery wait times blow out, leaving patients waiting longer than ever for common procedures. (Amy Hall, 2024)

According to Australian Medical Association President Professor Stephen Robson, “Australia’s public hospitals “are at breaking point” and

Australians are now waiting almost twice as long on average for planned surgery than they were 20 years ago, which is unacceptable. (Amy Hall, 2024)

4. The Case of the USA

The failure to respond to acute emergency cases is not restricted to Australia and the United Kingdom but in fact is widespread, like a viral disease in rich Western countries; and the USA is no exception to this medical catastrophe.

One clear case was the tragic death of Edith Isabel Rodriguez in the ED waiting room at Martin Luther King Jr.-Harbor Hospital in Los Angeles. It was later learned that her parents made two emergency call to 911 while she was deteriorating in the ED waiting room (Clinician.com, 2007; see also Orenstein, 2007). The Los Angeles Times reported that

Rodriguez had been seen in the ED several times over a three-day period before she died, but each time the medical staff found nothing seriously wrong. Rodriguez received pain medication before being released, and she returned later when the pain intensified but was told to wait in the lobby. She died of a perforated bowel. A security videotape shows the woman writhing for 45 minutes on the floor of the ED lobby; a janitor could be seen cleaning around her. (Clinician.com, 2007; see also Orenstein, 2007)

According to Ramon Johnson, MD, director of paediatric emergency medicine at Mission Hospital Regional Medical Center in Mission Viejo, CA, it is “too common in emergency departments across the country” (Clinician.com, 2007; see also Orenstein, 2007). Michael Frank, MD, JD, general counsel of Emergency Medicine Physicians (EMP) in Canton, OH states that, “EMP has been involved in three cases recently that arose from patient deaths involving ED waiting rooms.” (Clinician.com, 2007; see also Orenstein, 2007). Frank further elaborated that

the third, which never got to litigation, had a fellow waiting three hours and being diagnosed with a dissecting aortic aneurism when he crumpled during initial assessment in the ED.

He died the next day after being resuscitated, Frank says. Even with positive results, the defense of such cases can cost tens of thousands of dollars, he noted (Clinician.com, 2007; see also Orenstein, 2007). Frank stressed that it “requires a ‘philosophic shift’ within the hospital” where

there have to be procedures for recognizing those issues or problems for which patients must be seen right now. (Clinician.com, 2007; see also Orenstein, 2007)

Tom Syzek, MD, FACEP, director of risk management at Premier Health Care Services in Cincinnati added that overcoming biases when treating patients is important because “if we fail to overcome our own biases, not only will we get burned, but our ability to provide care gets compromised” (Clinician.com, 2007; see also Orenstein, 2007). Lastly, we should heed Frank’s final warning:

You’re really playing with fire if you have any policy that indicates these patients should be coerced not to return—or worse yet, simply turned away. (Clinician.com, 2007; see also Orenstein, 2007)

5. Healthcare Catastrophe

At the current time, worldwide systemic failure in healthcare continues, without borders, even in rich developed countries like the United States, the United Kingdom, and Australia. As reported by Newsweek, a new study found that,

after U.S. hospitals were acquired by private equity firms, mortality among Medicare beneficiaries in the emergency departments increased by 13 percent on average (seven additional deaths per 10,000 emergency department (ED) visits, from a baseline of 52 deaths per 10,000), as compared with non-private equity, control hospitals. (Millington, 2025; see also Kannan et al, 2025)

According to the study,

private equity hospitals have also been found to experience large cuts in staffing and salaries, which may be among common strategies to generate financial returns for firms and investors. (Millington, 2025; see also Kannan et al, 2025)

Similarly in Scotland, over 800 deaths were linked to long emergency department waits in 2024. The analysis by the Royal College of Emergency Medicine (RCEM) shows “excess deaths that were linked to delays in emergency department admission increased by a third” (Bowie, 2025). Fiona Hunter, vice president of RCEM Scotland states that the deaths is a national tragedy and a system in crisis (Bowie, 2025). Hunter further stresses that patients are

forced to endure extreme wait times for an inpatient bed to become available for them. Often, they will be experiencing this, counting the hours they have been in emergency departments, on a trolley in a corridor, cupboard, or simply any available floor space. (Bowie, 2025)

Back now to the case of the Greek heiress (Marissa Laimou) who died tragically in the University College London Hospital (UCLH). Her death was due to improper examination and the failure to admit her for further treatment. Despite of her being sent to UCLH from the Leaders in Oncology Care (LOC) by ambulance due to the seriousness of her condition, no doctors examined her (Parashar, 2025). Laimou was a cancer patient, previously treated at LOC for chemotherapy. While waiting at the emergency department, she sent some concerning messages to her friend saying:

Nobody is checking up on me, nobody is coming, I don’t know where they are, I’m still itching, I feel dizzy, I don’t feel well. (Parashar, 2025)

Laimou was discharged later the same day and died on 11 September 2025. Her family has confirmed that they are going to take legal action against UCLH on the ground of medical negligence. Laimou’s mother and tycoon father Diamantis have hired lawyers to sue UCLH for medical negligence (Parashar, 2025).

Because Laimou belonged to a prominent Greek shipping clan, her affluent family has the means to fight for postmortem justice. But what about underprivileged and under-represented victims? Are they only statistics to be reported in the news? Is the concept of human dignity still relevant for the poor, less educated and voiceless?

6. Human Rights to Health

The idea that human health is not merely a fundamental human right, but also, it will be argued, the core right. For without health, all other aspects of life are devalued and impoverished, and other values become of little point. No health; no life. Health it will thus be shown, is a transcendental value, essential to human identity and flourishing and continuity of life.

The natural law jurisprudential position, according to John Finnis in “Natural Law and Legal Reasoning,” is concerned with practical rather than pure theoretical reasoning, giving reasons for human action, and showing what constitutes good reasons for choice. (Finnis, 1990). Law itself, as a social practice, is a means and mechanism for supplying to communities reasons for actions, be it common law, legislation, or even custom. The obligatory force of law, according to Finnis’s position on natural law, discussed and developed in this thesis, arises from its aim of promoting the common good for the community. Likewise, the very point of morality is to produce the same aim.

Therefore, law and morality are intrinsically linked. Natural law as viewed here, along the lines of Finnis’s position, is based upon there being a set of fundamental values arising from being human in the physical world, such as life, health, knowledge, and philosophy (giving significance to human existence). In the case of life and health, these goods are prerequisites for valuable human existence, and thus have an intrinsic value that trumps utilitarian and merely economic considerations. Both morality and law are aspects of a social system that enable humans to pursue these basic goods, and more complex goods derived from them, for a flourishing life, or even life at all. Law then can be viewed from a natural law position, as Finnis says:

[T]he term “law” has been used with a focal meaning so as to refer primarily to rules made, in accordance with regulative legal rules, by a determinate and effective authority (itself identified and, standardly, constituted as an institution by legal rules) for a ‘complete’ community, and buttressed by sanctions in accordance with the rule-guided stipulations of adjudicative institutions, this ensemble of rules and institutions being directed to reasonably resolving any of the community’s co-ordination problems (and to ratifying, tolerating, regulating, or overriding co-ordination solutions from any other institutions or sources of norms) for the common good of that community. (Finnis, 2011)

The International Covenant of Economic, Social and Cultural Rights (ICESR) recognises healthcare as a fundamental human right. On 12 May 2000, the UN added General Comment 14 to ICESCR, that primary healthcare in one of the most fundamental obligations that a state which is a party to the Covenant can have. Building upon this proposition, namely that there is already recognition of the fundamentality of the right to healthcare, argues that the fundamentality of health care is based upon the basic primal fact of the human condition, that people are physically vulnerable, that injury potential and diseases are ubiquitous, and that without health care, human life itself become impoverished, or may cease to exist. Such a right, grounded upon the bottom line of continued existence, arguably trumps other human rights, such as free speech, as important as that right is. Thus, the argument is that the right to healthcare follows-from the natural law position as will be presented.

Unfortunately, with the spread of capitalism and commercialization in the name of progress, the healthcare sector is not spared from the ill-effects arising from the lack of medical resources, as seen in the shortage of doctors. In this brutal process, very often fundamental human rights and natural law are compromised. For example, the rich can seek medical treatment from private hospitals because they can afford to pay a premium price, but the poor will have to “rot in hell” without the availability of dollars and cents in their pockets. So, in this ever-materialised world, there are two sets of principles; “laws,” which is one for the wealthy and the “inhuman” one for the poor. However, there is the third way of life which is moving back to ethics that focuses on “mercy” as an alternative to reduce human suffering.

There is an urgent need for research to establish a human rights framework for health, and also to develop a concrete, humane policy focussing on poor people and other under-represented groups.

7. Final Thoughts

Apart from the Emergency Department crisis, and the doctors’ shortage as discussed in my earlier article (Chong, 2024), ambulance ramping and violence at the hospital are major problems too. In recent years, there were many media reports “about the ramping of ambulances at hospital emergency departments (EDs) around Australia” (Karnon and Partington, 2024). Violence in emergency departments is also a “national crisis,” as reported by ABC news. It was reported that, the abuse had pushed healthcare workers to their “breaking point” and was a key factor behind a “mass exodus” from the healthcare industry, which was putting patient care and safety at risk (Cockburn, 2025). Peter Allely, the director of emergency at Sir Charles Gairdner Hospital in Perth and the president-elect of ACEM said that “[t]he violence didn’t only affect staff, but also other sick patients” (Cockburn, 2025). Finally, according to David Shearman (Emeritus Professor of Medicine) in his discussion paper for the submission to the Australian Universities Accord,

health services had been deteriorating in most Western countries for at least 2 decades and they have not been prioritised in the growth economy of the richest countries. (Shearman, 2023)

Therefore, there is not only an urgent need for Emergency Departments to be revamped, but also for the entire Australian healthcare system to undergo radical reform, because inaction itself constitutes a violation of human rights, echoing Edmund Burke’s assertion that the only thing necessary for the triumph of evil is for good men to do nothing.

REFERENCES

(Australian Medical Association, 2005). Australian Medical Association. “Public Hospital Report Card: Clear the Hospital Logjam.” Available online at URL = <https://www.ama.com.au/clear-the-hospital-logjam/phrc-sa>.

(Bowie, 2025). Bowie. K. “Over 800 Deaths Were Linked to Long Emergency Department Waits in Scotland Last Year, Analysis Finds.” British Medical Journal 390: r2019. Available at URL = <https://www.bmj.com/content/390/bmj.r2019>.

(Chong, 2024). Chong, W. Y. “The ‘Messy’ Reality of the Doctor Shortage.” Against Professional Philosophy. 22 September. Available online at URL = <https://againstprofphil.org/2024/09/22/the-messy-reality-of-the-doctor-shortage/>.

(Clinician, 2007) “Woman Dies in ED Waiting Room; Experts Say This Happens Too Often. Clinician. 1 August, Available online at URL = <https://www.clinician.com/articles/105643-woman-dies-in-ed-waiting-room-experts-say-this-happens-too-often>.

(Cockburn, 2025). Cockburn, P. “Violence in Emergency Departments a National Crisis.” ABC News. 24 February. Available online at URL = <https://www.abc.net.au/news/2025-02-24/violence-in-hospital-emergency-departments-national-crisis/104964278>.

(Finnis, 1990). Finnis, J. “Natural Law and Legal Reasoning.” Univ. of Notre Dame Law School. Available online at URL = <https://scholarship.law.nd.edu/cgi/viewcontent.cgi?article=1078&context=law_faculty_scholarship>.

(Finnis, 2011). Finnis, J. Natural Law and Natural Rights. 2^nd edn., Oxford: Clarendon/Oxford Univ. Press.

(Hall, 2024). Hall, A. “Breaking Point: How Australia’s Hospital Crisis is Impacting Each State and Territory.” SBS News. 19 April. Available online HERE.

(Kannan et al., 2025). Kannan, S., Bruch, J. D., Zubizarreta, J. R., Stevens, J., and Song, Z. “Hospital Staffing and Patient Outcomes after Private Equity Acquisition.” Annals of Internal Medicine 178, 11. Available online at URL = <https://doi.org/10.7326/ANNALS-24-03471>.

(Kant, 1785/1996). Kant, I. Groundwork of the Metaphysics of Morals. Trans. M. Gregor. In I. Kant, Practical Philosophy. Cambridge: Cambridge Univ. Press. Pp. 43-108 (Ak 4: 387-463).

(Karnon, 2024). Karnon, J. and Partington, A. “Ambulance Ramping is Getting Worse in Australia. Here’s Why—And What We Can Do About It.” The Conversation. 24 July. Available online at URL = <https://theconversation.com/ambulance-ramping-is-getting-worse-in-australia-heres-why-and-what-we-can-do-about-it-232720>.

(Millington, 2025). Millington, H. “ER Deaths Surged in US Hospitals Taken Over by Private Equity, Study Finds.” Newsweek. 22 September. Available online at URL = <https://www.newsweek.com/er-patient-deaths-us-hospitals-private-equity-2133777>.

(Orenstein, 2007). Orenstein, C. “How a Hospital Death Became a Cause Celebre.” Los Angeles Times. 15 June. Available online at URL = <https://www.latimes.com/local/la-me-king15jun15-story.html>.

(Parashar, 2025). Parashar, A. “Family of Greek Heiress Who Died from Toxic Insect Bite Accuse Authorities of Playing with Grief.” Daily Mail. 19 September. Available online at URL = <https://www.dailymail.co.uk/news/article-15129817/Family-Greek-heiress-died-toxic-insect-bite-accuse-authorities-playing-grief.html>.

(SA Health, n.d.). SA Health. “About the Emergency Department Dashboard.” Available online HERE.

(Shearman, 2023). Shearman, D. “A Centre of Learning to Ensure the Sustainability of the Planet and the Human Race.” Unpublished MS. Available online HERE.

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