Great weather and sandy beaches may make Californians seem like a healthy, outdoorsy bunch, but if you fall off your surfboard in California, gear up for a long wait in the emergency room. California ranks dead last among all states when it comes to access to emergency care, according to the 2009 Report Card on the State of Emergency Medicine. In fact, the situation’s so bad that emergency room doctors are suing the state.

Why is emergency care so lacking in California? A big part of the problem seems to be underfunding of Medi-Cal, the state-run medical program in California. The Medi-Cal budget keeps getting cut — leaving emergency rooms to subsidize the cost of emergency care for people who can’t pay for it. That financial burden’s caused many emergency rooms to close – so many, in fact, that the Los Angeles Times put together a web app called “California’s dwindling emergency rooms” that informs you which hospitals and emergency rooms have closed in the past decade in or near your zip code.

Yet, the financial burden seems to be getting worse for the emergency rooms that are still open. According to the Los Angeles Times, “In 2007 alone, emergency room doctors statewide say they have subsidized more than $100 million in services provided to Medi-Cal patients because the reimbursement rate often barely covers half the cost of treatment.”

Hopefully, some relief will come from Obama’s economic recovery plan, which the House of Representatives passed on Jan. 28. That plan would give an extra $87 billion over two years in additional federal matching funds to help states maintain their Medicaid programs. As of now, we’re waiting for the Senate to start discussing their version of the plan.

Curious to see how good emergency care is in your neighborhood? Check the 2009 Report Card on the State of Emergency Medicine to see what grade your state received.