Americans assume they will receive lifesaving emergency care when and where they need it, but increasingly that isn't the case.

Many hospital emergency departments in this country are operating at, or over current capacity. We as a nation, have poured millions of dollars into preparedness, but virtually none of that has gone to the one place that is the true first response to something like a flu epidemic, or a hurricane, or a terrorist attack -- the nation's emergency departments.

There is no cop on the beat. In Washington, it is easy to get away with denying and delaying until a request dies.

At a time when emergency department visits are going through the roof, the number of emergency departments has declined because hospitals have found it more economically attractive to close the emergency department than keep it open and lose money.

Public engagement in helping fight terrorism or addressing public health risks is the biggest single advantage American society has.