Hospital emergency rooms are under siege. Some inner city hospitals are losing on-call specialists to treat severely injured patients or must pay high prices to keep them. In some parts of the country, ambulance diversions are continuing. So are wallet biopsies which telegraph to hospitals who can pay and who cannot. Changes to Medicaid mandated by the Deficit Reduction Act could affect the care those on Medicaid will receive. Technology and emergency room care will become more expensive, raising the question: “Who will fund this place of last resort as the move to market-driven health care rushes ahead? “