Air ambulance, and the bill afterwards

The wife recently had a minor, outpatient surgery at an outpatient surgery center. A fluid monitoring machine started giving readings indicating internal bleeding and then the lab tech apparently drew blood from the arm with the IV so the hemoglobin test came back crazy low(5.2). They literally ambulanced her across the street to the hospital. The ambulance bill came in at $1630 :ooh:. They billed $42 for mileage for the less than a tenth of a mile they drove. The surgical staff didn't laugh when I offered to transport her myself in the bed of my one ton truck.
 
Roger Roger said:
See, that I'm on board with. Extending the life of an 89 year old in constant pain by a week? Maybe not the best use of our resources. And what we spend on treating diabetes and obesity in people who live on junk food and soda....
Click to expand...

50% of all health care dollars in the US are spent on the last 2 years of a persons life, 25% are spent on the last 2 months.
 
USMCmech said:
50% of all health care dollars in the US are spent on the last 2 years of a persons life, 25% are spent on the last 2 months.
Click to expand...
Exactly. I'm not suggesting that one person is somehow more deserving than another, simply that if we changed the way we think about life on earth we might make better decisions with our limited resources.
 
USMCmech said:
50% of all health care dollars in the US are spent on the last 2 years of a persons life, 25% are spent on the last 2 months.
Click to expand...

Is that just an observation of fact, or do you think that reality should change (ala "Soylent Green," or some variation)?

There are certainly some individuals who are tired and ready to let go; there are many others who "rage against the dying of the light."

At this moment in time, I'd look into your eyes and ask you to forego the BMW (or whatever) and drive a used Chevy so that I could see just one more sunrise.

In a lifetime of sharing death with several hundreds of people, I've never known anyone who wanted the dark unknown to replace the light of human touch, conversation, love, life ...

Theory is very different from the final reality.
 
Back when I lived out in the sticks (80 miles from the nearest small hospital, 150 from a trauma center) we actually purchased specific independent insurance strictly for air ambulance as we had seen the costs ruin another rancher who had been airlifted. Think it was about $100 pp/year and covered up to $20k in air ambulance costs...but that was 10 years ago.
 
I spent 9 years working EMS in the PHX area. The system is so corrupt it's not even funny. There are several cities that have a partnership with PHI to put firefighter medics on a helicopter. Most areas are at most 30 minutes by ground to a trauma centre or pediatric hospital yet so many patients were flown unnecessarily. They say it was all in the name of "patient care" but it was truly all about budget justification. It took longer for the helo to launch,get an LZ established,let the helo guys do their assessment than it did to just load up in the ambulance and give diesel therapy to the hospital. Sadly most of the times patients weren't even told they had a choice to deny the helicopter ride.


Sent from my iPhone using Tapatalk
 
USMCmech said:
That's the basic premise of all insurance, particularly Obamacare.

You and 100 other people are overcharged for basic medical care, and one 28 week premie gets to live a full and productive life.
Click to expand...

The foundational premise of insurance is that parties pool funds to address rare and unexpected expenses.

Somewhere along the line this has been forgotten. It's not the premies that are creating financial problems, it's the healthy babies that are the problem.

If the average cost of maternity is $8000, then parents should be prepared to pay an $8000 bill, relying upon insurance to cover exceptional overages. That's not happening. Insurance has turned into a cost-sharing model.
 
azmedic said:
I spent 9 years working EMS in the PHX area. The system is so corrupt it's not even funny. There are several cities that have a partnership with PHI to put firefighter medics on a helicopter. Most areas are at most 30 minutes by ground to a trauma centre or pediatric hospital yet so many patients were flown unnecessarily. They say it was all in the name of "patient care" but it was truly all about budget justification. It took longer for the helo to launch,get an LZ established,let the helo guys do their assessment than it did to just load up in the ambulance and give diesel therapy to the hospital. Sadly most of the times patients weren't even told they had a choice to deny the helicopter ride.
Click to expand...

So now, in addition to Phoenix Childrens, there are 3 Level 1 trauma centers: Scottsdale-Osborn, Maricopa County, and now Chandler Regional. Yet just as you say, there are helos all over the place here that do transports even from very urban locations for MVAs etc, where there are already ground ambo's on scene, and which can get to a hospital ER, even if not Level 1, quicker than the helo can for just the reasons you describe. It's indeed crazy, and under the veil of "patient care", just as you describe....it hasn't changed, just seemingly gotten worse.
 
Pretty much. Actually counting,there are 6 level 1 trauma centers. West Valley,Good Sam,St Joes,JCL North,County,Chandler and Osborn. Obviously this is just one example and the one I am familiar with, but it really is a "dash for cash" out there


Sent from my iPhone using Tapatalk
 
azmedic said:
Pretty much. Actually counting,there are 6 level 1 trauma centers. West Valley,Good Sam,St Joes,JCL North,County,Chandler and Osborn. Obviously this is just one example and the one I am familiar with, but it really is a "dash for cash" out there
Click to expand...

Forgot about Good Sam and JCL-North, and they've been Level 1 for a while. Getting old and forgetting!
 
+1 to what Pilot Fighter said.

Since several people brought it up, as a practicing physician, let me put my 2 cents in about the general state of healthcare in 'Merica:
1. There is no such thing as health "insurance", everyone in the USA pays for healthcare coverage. Insurance is all about managing statistical risk. Since everyone, at some point, will get very ill or die, there is a 100% statistical chance that health "insurance" companies will pay out a claim for a policy holder. A health "insurance" company can, therefore, never make money in a traditional insurance model sense. This is the reason why they fought so hard to prevent the pre-exisiting condition clause in the ACA. It's also why they will fight to maintain the "everyone must buy" insurance clause in the ACA. Anyone under about 50 is paying premiums for the healthcare payout/benefits of everyone over 50.
2. In our country we STILL haven't made the decision as to whether or not healthcare is a right or a privilege. With the rapid rise of HSA/high deductible plans, healthcare is quickly, once again, becoming a privilege; unless you are very old, very poor, or very rich. I am seeing patients, once again, that are having to decide between getting care or getting groceries. When your co-pay/deductible is so high that you have to make this decision, healthcare is a privilege, not a right. We need citizens and politicians to have some balls and finally decide which model we want. FWIW, by leaving healthcare a privilege, as has been documented in many places, we end up paying a premium on many durable goods. I have seen figures like $3000 is the extra cost added to every US-made car to cover the healthcare of the auto workers. This is a "tax" that other automakers (BMW, toyota, peugeot) don't pay. This makes our vehicles less competitive on the world market.
3. I only have data from 2 states (RI and MN), but i have been told by highly placed people in both states that the real cost of medicaid in each state is approaching 30-40% of the annual budget. Imagine that: 30-40 cents of every dollar of your sales/property/income tax going to just medicaid; not schools, not police, not firefighters, not roads. The real cost of our balkanized, inefficient, disorganized system is probably far higher than the reported 20% of GDP. Compare this to Holland, where their system is a 80:20 "medicare for all" system, and people can buy supplemental plans that cover the 20%. Their system is the 2nd most expensive in the world: 14% of their GDP. I think we (America) are "doing it wrong"
 
Big medicine can, indeed, work wonders when necessary, but once the system is in place, it gets used more often. Why? Because it's there. And the bean-counters want to cover the overhead.

I forget why I knew this, but some 20 years ago, the State of New Jersey had three times the number of CAT scanners as all of Canada. I'm willing to accept that Canada's socialized medicine system might have been under-equipped, but those NJ radiologists were more than taking up the slack!

The Hippocratic Oath has replaced "First, do no harm." with "Do no good" in ordering more & more tests and procedures. I've started asking my doctors, "If this test hadn't been invented, what would you do instead?" Makes 'em think.
 
exneophyte said:
The wife recently had a minor, outpatient surgery at an outpatient surgery center. A fluid monitoring machine started giving readings indicating internal bleeding and then the lab tech apparently drew blood from the arm with the IV so the hemoglobin test came back crazy low(5.2). They literally ambulanced her across the street to the hospital. The ambulance bill came in at $1630 :ooh:. They billed $42 for mileage for the less than a tenth of a mile they drove. The surgical staff didn't laugh when I offered to transport her myself in the bed of my one ton truck.
Click to expand...
Where we landed was literally 500' from the entrance to the emergency room. We landed ON hospital property but had to cross a street to get the patient to the ER. This street was really a small two-lane road that was used exclusively for access to the hospital parking lots and garage so there wasn't enough traffic to worry about.

However, the city has a law that requires an ambulance any time a patient is transported ON a city owned street. So we had to call dispatch every time for an ambulance and the patient got a $1,200+ bill. Once, I had a MVA critical patient on board and we had to wait 15 minutes for the ambulance because they were stuck in traffic (because everyone knows one can't run lights and siren for a patient "transport"). The ER doc and small crew had to come to the aircraft and work on the patient there......ridiculous!!!
 
Pilot Fighter said:
The foundational premise of insurance is that parties pool funds to address rare and unexpected expenses.

Somewhere along the line this has been forgotten. It's not the premies that are creating financial problems, it's the healthy babies that are the problem.

If the average cost of maternity is $8000, then parents should be prepared to pay an $8000 bill, relying upon insurance to cover exceptional overages. That's not happening. Insurance has turned into a cost-sharing model.
Click to expand...


You miss the point that if something goes wrong with the pregnancy it can become a lot more than an $8000.00 bill.

Insurance paying helps assure medical care is sought to prevent problem down the road.
 
MikeD said:
So now, in addition to Phoenix Childrens, there are 3 Level 1 trauma centers: Scottsdale-Osborn, Maricopa County, and now Chandler Regional. Yet just as you say, there are helos all over the place here that do transports even from very urban locations for MVAs etc, where there are already ground ambo's on scene, and which can get to a hospital ER, even if not Level 1, quicker than the helo can for just the reasons you describe. It's indeed crazy, and under the veil of "patient care", just as you describe....it hasn't changed, just seemingly gotten worse.
Click to expand...

I think we've had this discussion a few times before. Seems like every year or two HEMS...HAA...whatever...makes the news. I think the last two times it was focused on AMC, but as the story explained, AMC is everywhere.

We've been down this road before:
http://forums.jetcareers.com/threads/deregulation-and-the-ems-industry.218456/
 
Air Methods recently acquired a helo operator in AZ. The employees of that company were initially told they would get a raise to bring them up to legacy Air Methods wages,however when they went to AMC orientation in DEN they were basically laughed at and told "we bought you guys to make a profit,it would make no sense to give you guys a raise. You can transfer to an AMC base if you want a higher wage". At the end of the day HEMS is still private EMS,where profits come before patient care.


Sent from my iPhone using Tapatalk
 
azmedic said:
Air Methods recently acquired a helo operator in AZ. The employees of that company were initially told they would get a raise to bring them up to legacy Air Methods wages,however when they went to AMC orientation in DEN they were basically laughed at and told "we bought you guys to make a profit,it would make no sense to give you guys a raise. You can transfer to an AMC base if you want a higher wage". At the end of the day HEMS is still private EMS,where profits come before patient care.


Sent from my iPhone using Tapatalk
Click to expand...


I heard it was the other way at TSCF. They were afraid that they'd get their pay cut to AMC levels. I think 4 r/w bases got closed out of that deal.
 
You must log in or register to reply here.
Back
Top