U.S. hospitals are ill-prepared to handle emergencies stemming from terrorist attacks and natural disasters, a congressional committee concluded on May 7.

The House Oversight and Government Reform Committee held a two-day hearing into hospitals' lack of emergency surge capacity.

The hearing was specifically related to the Department of Health and Human Services issuing Medicaid regulations that will reduce federal funds to public hospitals.

Committee chairman Rep. Henry Waxman, D-CA, presented results from a committee survey of 34 Level I trauma centers – hospitals equipped with a full range of specialists and equipment available 24/7 – in seven major cities. The survey examined hospital operations on March 25 in order to determine real-time capacity of the trauma centers' emergency rooms and found that none had the capacity to respond to an attack on the scale of the March 11, 2004, commuter train bombings in Madrid that killed 177 and injured more than 2,000.

Some cases were worse than others. For instance, in three of the trauma centers surveyed in Los Angeles, overcrowding would be such an issue that the hospitals would have to turn away new patients. In Washington, D.C., there were no available treatment spaces due to severe overcrowding.

"If a terrorist attack had occurred in Washington, D.C. or Los Angeles on March 25 when we did our survey, the consequences would have been catastrophic," Waxman said in a statement.

The hearings included testimony from doctors and experts in the medical field. "To those of us who work in the front lines of the medical care system, it is irrational to believe that an emergency care system that is already overwhelmed by the day-to-day volume of acutely ill patients would be able to expand its capacity on short notice in response to a terrorist attack or natural disaster," said Roger Lewis, M.D., Ph.D., of Harbor-UCLA Medical Center in Torrance, CA, in a statement.

Homeland Security Secretary Michael Chertoff and Health and Human Services Secretary Mike Leavitt also testified at the hearing. Leavitt said in a statement that his department is "working diligently to improve our nation's emergency preparedness and medical surge capacity, and we have made extensive funding available to hospitals through the states specifically toward this end."