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Oregon’s emergency care system is reaching a breaking point.
Frontline workers are not failing. The system around them is.
Fire departments and ambulance agencies struggle to retain paramedics. Emergency rooms remain crowded. Quality of care complaints are rising. These are not isolated problems, but the signs of a system stretched thin. This strain is the result of years of decisions, many of which have been made quietly — in local meetings few residents attend.
In Lane County, the Ambulance Service Area plan is a county-level system that decides which ambulance agencies serve which areas, and sets standards for response and quality of care. Last June, the Lane County Board of Commissioners approved a task force to reevaluate how emergency medical services are funded, acknowledging the burden these services have been facing.
While commissioners debate the funding process, some communities are already living with the limits of a strained system.
The Upper McKenzie Rural Fire Protection District, about an hour east of Springfield, is an all-volunteer ambulance provider, where fire chief Joel Zeni says response times can average more than 45 minutes due to the size of the district.
The distance between calls is a struggle, Zeni said late last year. Discussions about authorizing the ambulance have centered around system structure and liability concerns within the county’s Ambulance Service Area framework, which has stalled the process for nearly a year, he said.
This delayed process is keeping a needed ambulance off the road in one of the county’s more remote areas. Rural Oregonians are not asking for a luxury, they are simply asking for a better chance at surviving a medical emergency.
Volunteer-based systems will continue to feel strain if they do not receive sustainable funding and prioritized approval processes. The Lane Fire Authority, another rural fire district, cut an ambulance unit out of its service in January due to lack of funding. This will further delay wait times.
Urban systems face their own crises.
In Springfield, the PeaceHealth Sacred Heart Medical Center at RiverBend emergency department continues to struggle after the 2023 closure of the University District emergency room. Data from the Oregon Health Authority shows average ER wait times increased from about five hours to more than seven hours from 2024 to 2025.
Additionally, a 2024 survey conducted by Pacific Northwest Hospital Medicine Association found that 97% of patients seen in the RiverBend emergency department had a negative experience.
Recently, PeaceHealth ended it’s 35-year contract with Eugene Emergency Physicians and is transitioning to a Georgia-based medical group. But leadership changes will not fix a system that is stretched beyond its limits. The RiverBend emergency room has become a safety net for far too many residents compared to what it is equipped to handle.
Insurance coverage is another looming issue. In 2024, roughly 30% of Oregonians were enrolled in Medicaid. Following the federal approval of H.R.1 last year, up to 200,000 Oregon residents could lose coverage, with thousands more facing reductions in benefits.
Lane County health officials are warning that the loss of coverage could be devastating for low-income families. When people lose coverage, they delay preventative care. Conditions worsen. By the time they seek care, they are sicker and require more intensive — and expensive — treatment. Emergency rooms become overcrowded because they are the only door left open for these patients.
The issue is statewide. In the Portland metro area, American Medical Response, a private ambulance company, recently reported improved ambulance response rates but an increase in quality-of-care complaints.
Members of Teamsters Local 223, a labor union in Oregon, testified in Multnomah County last September that a lack of training for new EMT recruits and difficult work conditions make their already difficult jobs harder. Burnout remains widespread.
Blaming the staff who show up to help misses the point. These professionals routinely work 10 to 12 hour shifts. They treat patients in hallways when beds are unavailable. They deal with the frustration of a scared, annoyed, sick public.
Emergencies do not warn us. Car crashes, broken bones and strokes can happen to anyone at any time. The strength of our emergency care system is everyone’s responsibility.
Lane County residents should attend county public health meetings or Eugene City Council sessions when emergency services funding is discussed. They should take CPR and AED classes through Eugene-Springfield fire. They should learn when to call 911, or when to visit urgent care instead of the emergency room. They should support ballot measures that invest in public health.
When residents are engaged, they can influence crucial decisions such as whether a volunteer district receives more funding or not. When residents are silent, it allows for budget cuts and service reductions to pass with little to no resistance.
If residents demand faster response times, better staffing ratios and sustainable funding, elected officials will be forced to respond. If residents disengage, emergency services remain an afterthought until they are stuck in the waiting room for seven hours.
Residents should pay attention. Most importantly, they should thank the emergency care staff that are still showing up.
The question is not if emergencies will happen. The question is whether Oregonians will demand a system strong enough to meet their needs.