The state of emergency care in America received low marks in a report released by an objective panel of emergency medical experts. The first-ever National Report Card on the State of Emergency Medicine finds an emergency care system characterized by overcrowding, declining access to care, soaring liability costs and a poor capacity to deal with public health or disasters.

The nation's emergency medical care system received an overall grade of C-, which represents the average of grades for all 50 states and the District of Columbia. A task force of experts assembled by the American College of Emergency Physicians used a range of available data to develop 50 measures for grading each state on a scale of A through F for its support in four areas: access to emergency care, quality and patient safety, public health and injury prevention, and medical liability environment.

A curved grading system was used, applying grades by comparing each state with the highest-ranked state in each category.