The real result of overloading the ER is the wait time, which though bad for customer service (10 patients vs 100 will increase the wait time from minutes to hours), it doesn’t mean the ER is costing the hospital 10x.The real issue facing hospitals isn’t the rising cost, but lack of income from the their elective surgeries, due to staffing shortage. Pre Covid there may have been 10 ORs running from 7AM till 10PM every day, but if there aren’t enough doctors, nurses and other support staff, the hospital may be running at a fraction of that capacity, which then may not over the overhead for that department, let alone fund other departments, like the ER, which is a cost as a social service.