deadstick
Well-Known Member
There are consequences, but we usually want to have the cake and gobble it up.
http://abcnews.go.com/Entertainment/Movies/Story?id=7139585&page=1
Deregulation and the EMS industry
- Thread starter deadstick
- Start date
There are consequences, but we usually want to have the cake and gobble it up.
http://abcnews.go.com/Entertainment/Movies/Story?id=7139585&page=1
Boris Badenov
Fortis Leader
Politically, I loathe that this is the only sensible option at this point. But it is.
Seggy
Well-Known Member
You should be loathing the fact that corporate greed has pushed us to this system.
Then, every EMS operator will bitch/complain about the government taking their business in competition.
One of the reasons we don't transport patients to the hospital on our birds unless it's one of our own guys, or something so critical and couldn't transload or transload not available; apart from other reasons.
CoffeeIcePapers
Well-Hung Member
I have a problem with a system where you pay a large portion of your annual salary for insurance, and when you have a catastrophic injury, in which you are incapacitated, you are hit with a bill after the fact for your entire annual salary.
A good policy has a yearly out of pocket max.
Yup. But the way I read the post was that it was billed to insurance, but didn't cover all the costs.
CoffeeIcePapers
Well-Hung Member
Did you read the article? The insurance company refused to cover his air ambo ride, and Methods is suing him for over 40k.
Again, yes, I did read the article. Good insurance has a yearly out of pocket max that you'll pay. No questions asked. It costs more upfront, but saves you on the back end. It pays to read that packet they give you of things that will and won't be covered before you sign. It also helps that my mother pulled double duty at a Dr office as an RN/office manager for most of her professional life, and understands this stuff really well.
Edit to add: In a case like this, he needs to understand his policy, and possibly sue his insurance provider if they failed to hold up their end. If they did, then he has no leg to stand on. Do I agree with the system, no. But what other option does he have at this point?
SlumTodd_Millionaire
Most Hated Member
gotWXdagain said:
I was wondering how long it would take for someone to point out the obvious!
🦈💜
Well-Known Member
yesplz.
CoffeeIcePapers
Well-Hung Member
Sorry, I had crappy hotel internet and like quadruple posted.
The guy makes 40k a year. Where is he going to get the money to win a legal battle against a giant insurance agency? There shouldn't be anything to understand. I pay for medical insurance. I have a catastrophic event where I am given medical care without my consent to save my life. I should be covered. Period.
I agree. But the system is what's messed up. And he played the system and lost, or rather is loosing. He could also get an attorney that would work on a commission basis. You win, he wins. You loose, you get nothing, they get nothing. I've done it and won. Once.
deadstick
Well-Known Member
Exactly.
Oh, I know it won't happen.
Is single payer the answer? If it's anything like Canada, maybe @MikeD has some better info, this could result in a fraction of the coverage we have now (not necessarily a bad thing). Ornge is the (only?) operator in Ontario. They have 10 f/w and 10 r/w aircraft covering an area about the same as Texas, Oklahoma, and Kansas. According to EMSflightcrew.com there are 15 bases in OK and another 18 in KS. I can't even begin to count the mess in TX. Regardless of the total, that's done with 20 aircraft up north.
SpiraMirabilis
Possible Subversive
I have a problem with these stuations too. It is not as though the patient is an expert on what an insurance company will consider medically necessary, or really is in much of a position to be expected to say yay or nay to the transport. Your average person as soon as a doctor says: 'I'm going to get a helicopter / airplane for you' probably assumes they're dying even if they're not.
From the EMS perspective it is not legal for an air ambulance to decline to transport someone on the basis that 'there is 0% chance their insurance company will pay for this flight' but those as I understand don't actually occur frequently. You get the situation where we transport arguably waste of oxygen individuals who get a free ride because they're recovery proof so our billing/collections doesn't even bother doing extraordinary collection efforts (like a lawsuit) but your average middle class guy gets screwed because they think they can atleast get something. That sounded so jaded of me it almost sounded Republican-- ick.
Either insurance should not be able to decline a flight as medically unnecessary if it is signed off by a doctor or the EMS providers should just take a wash on such flights, instead of ruining someone's life (even more, because if you're being medevaced you probably already have a crap situation somehow.)
Our CEO does a meet and greet/QA with every new hire class of pilots each month. I remember in my class someone asked how much do we actually get versus how much we bill for. He said if a person is on private insurance we get approximately 70% of what we bill. If the person is on Medicare we get 50%, Medicaid 30% and if they are self-pay we consider ourselves fortunate to get 1%.
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