The effects of the Great Recession and associated budget cuts are playing out in emergency rooms across the country, according to a Reuters report that spanned from Seattle to Boston with stops in Chicago and smaller areas like Grand Rapids, Winston-Salem in between.

It reveals what poor cost-shifting decisions look like in real time, and the picture isn’t pretty. ER’s are serving awkwardly as holding areas (10% of hospitals noted that they have “boarded” patients for a week or more), ineffective (but less expensive) medications are replacing effective ones, and first-responders are attempting work previously handled by mental health practitioners. Beyond what the system is experiencing lies the toll on the people enmeshed in what is taking place.

The best that U.S. medicine has to offer is very difficult to deliver in such circumstances. Successful treatments and accomplished professionals have been derailed while the people they would serve receive inadequate patchwork services in inappropriate settings.

Not long ago we had to dispell the persistent fallacy that illegal immigrants clogged emergency departments and drove both long wait times and increasing health care costs. Today, we need to disabuse ourselves of the idea that cost-shifting of this type is anything but an oxymoron. Costs that are shifted inappropriately they don’t shift at all, they grow – in terms of the system, and in terms of human lives.