Guest guest Posted September 12, 2004 Report Share Posted September 12, 2004 Pt Barnum once said I hear people say they cant afford to advertise, but I say they cant afford not to advertise. ====================================================== Re: Re: EMS Pay > > >In nursing you see all these 'Dare to care' commercials and magazine ads, but you don't see this in EMS. WHY IS THIS? > Simply put, because so many of those who receive care don't pay for it, and the owners of the ambulance services are trying to get all the profit they can, so after paying the medics they already have, and taking care of the rest of the bills (maintenance, restock, insurance, tax's, etc.) advertising is pretty low on the list of priorities so it would be surprising to see more than a want ad. Anything more dips into the (some say much too thin) profits. Just a thought. Meredith Vetterick wrote: > Well, here is one reason people don't pay their ambulance bill, and it is the same reason they don't pay any medical bills...the public feels ENTITLED to health care. Of course, most of the one's who don't pay are the biggest users of the system. Yes, this is America and everyone should have access to the healthcare system, but is is not free. If someone's electricity goes out and there goes the airconditioning, this is an EMERGENCY to most people. They know they get no relief until they pay someone to fix it. They have a medical emergency, they call EMS to pick them up, take them to the hospital where (hopefully) they get fixed. Emergency is now over. They got what they needed. They don't want to fork over the money so they tell themselves they are owed medical care. And paid or not, we do come out the next time. Personally, I am all for garnishing wages of those who make no effort to pay their bills, insurance or no insurance. ! Even if these people paid $10 dollars ! > a month for the rest of their lives it would help. > As for the higher education for EMS, I am all for it. As we all know, image is almost everything. And people tend to hold people with degrees in higher regard than those without. This may not be fair, and there are plenty non-degreed EMS personel who should be teaching the people going for degrees, but it is the way it is seen. And more will be asked of EMS in the future, probably to the point where some sort of degree will be required. If all nurses did was pass out pills and give bed baths, they certainly wouldn't need a degree. > And as I have mentioned before, EMS hasn't done a lot to promote itself to the public. A lot of people don't know it's more than ambulance driving. Most don't know there is a shortage of EMT's. They don't know about the 24/7, or that is some cases a crew may really be up the whole 24. They certainly didn't like it when they found out their hospital residents are up that long. In nursing you see all these 'Dare to care' commercials and magazine ads, but you don't see this in EMS. WHY IS THIS? Seriously folks, can anyone think of any such promotion? Not even a bulletin board. At least now the public knows there is a shortage and nurses should be paid a respectable wage. But they would be shocked to know that lots of EMS workers are trying to make a living off $8 an hour. The thing is, who has the resources to do all this? >Meredith > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2004 Report Share Posted September 13, 2004 I hear you, but the fact is that as long as enough new EMT's show up who are willing to work for low wages or to do their thing as a volunteer wages will be low and owners will not feel the need to advertise or feel any compunction to pay a higher wage. So far, it seems to be working in favor of the suits. Silsbee EMS wrote: > Pt Barnum once said I hear people say they cant afford to advertise, but I say they cant afford not to advertise. > > ====================================================== > Re: Re: EMS Pay > > > > > > > >In nursing you see all these 'Dare to care' commercials and magazine ads, but you don't see this in EMS. WHY IS THIS? > > > Simply put, because so many of those who receive care don't pay for > it, and the owners of the ambulance services are trying to get all the > profit they can, so after paying the medics they already have, and > taking care of the rest of the bills (maintenance, restock, insurance, > tax's, etc.) advertising is pretty low on the list of priorities so it > would be surprising to see more than a want ad. Anything more dips into > the (some say much too thin) profits. > > Just a thought. > > > Meredith Vetterick wrote: > > > Well, here is one reason people don't pay their ambulance bill, and it is the same reason they don't pay any medical bills...the public feels ENTITLED to health care. Of course, most of the one's who don't pay are the biggest users of the system. Yes, this is America and everyone should have access to the healthcare system, but is is not free. If someone's electricity goes out and there goes the airconditioning, this is an EMERGENCY to most people. They know they get no relief until they pay someone to fix it. They have a medical emergency, they call EMS to pick them up, take them to the hospital where (hopefully) they get fixed. Emergency is now over. They got what they needed. They don't want to fork over the money so they tell themselves they are owed medical care. And paid or not, we do come out the next time. Personally, I am all for garnishing wages of those who make no effort to pay their bills, insurance or no insurance. ! Even if these people paid $10 doll! > ars ! > > a month for the rest of their lives it would help. > > As for the higher education for EMS, I am all for it. As we all know, image is almost everything. And people tend to hold people with degrees in higher regard than those without. This may not be fair, and there are plenty non-degreed EMS personel who should be teaching the people going for degrees, but it is the way it is seen. And more will be asked of EMS in the future, probably to the point where some sort of degree will be required. If all nurses did was pass out pills and give bed baths, they certainly wouldn't need a degree. > > And as I have mentioned before, EMS hasn't done a lot to promote itself to the public. A lot of people don't know it's more than ambulance driving. Most don't know there is a shortage of EMT's. They don't know about the 24/7, or that is some cases a crew may really be up the whole 24. They certainly didn't like it when they found out their hospital residents are up that long. In nursing you see all these 'Dare to care' commercials and magazine ads, but you don't see this in EMS. WHY IS THIS? Seriously folks, can anyone think of any such promotion? Not even a bulletin board. At least now the public knows there is a shortage and nurses should be paid a respectable wage. But they would be shocked to know that lots of EMS workers are trying to make a living off $8 an hour. The thing is, who has the resources to do all this? > >Meredith > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2004 Report Share Posted September 13, 2004 I hear you, but the fact is that as long as enough new EMT's show up who are willing to work for low wages or to do their thing as a volunteer wages will be low and owners will not feel the need to advertise or feel any compunction to pay a higher wage. So far, it seems to be working in favor of the suits. Silsbee EMS wrote: > Pt Barnum once said I hear people say they cant afford to advertise, but I say they cant afford not to advertise. > > ====================================================== > Re: Re: EMS Pay > > > > > > > >In nursing you see all these 'Dare to care' commercials and magazine ads, but you don't see this in EMS. WHY IS THIS? > > > Simply put, because so many of those who receive care don't pay for > it, and the owners of the ambulance services are trying to get all the > profit they can, so after paying the medics they already have, and > taking care of the rest of the bills (maintenance, restock, insurance, > tax's, etc.) advertising is pretty low on the list of priorities so it > would be surprising to see more than a want ad. Anything more dips into > the (some say much too thin) profits. > > Just a thought. > > > Meredith Vetterick wrote: > > > Well, here is one reason people don't pay their ambulance bill, and it is the same reason they don't pay any medical bills...the public feels ENTITLED to health care. Of course, most of the one's who don't pay are the biggest users of the system. Yes, this is America and everyone should have access to the healthcare system, but is is not free. If someone's electricity goes out and there goes the airconditioning, this is an EMERGENCY to most people. They know they get no relief until they pay someone to fix it. They have a medical emergency, they call EMS to pick them up, take them to the hospital where (hopefully) they get fixed. Emergency is now over. They got what they needed. They don't want to fork over the money so they tell themselves they are owed medical care. And paid or not, we do come out the next time. Personally, I am all for garnishing wages of those who make no effort to pay their bills, insurance or no insurance. ! Even if these people paid $10 doll! > ars ! > > a month for the rest of their lives it would help. > > As for the higher education for EMS, I am all for it. As we all know, image is almost everything. And people tend to hold people with degrees in higher regard than those without. This may not be fair, and there are plenty non-degreed EMS personel who should be teaching the people going for degrees, but it is the way it is seen. And more will be asked of EMS in the future, probably to the point where some sort of degree will be required. If all nurses did was pass out pills and give bed baths, they certainly wouldn't need a degree. > > And as I have mentioned before, EMS hasn't done a lot to promote itself to the public. A lot of people don't know it's more than ambulance driving. Most don't know there is a shortage of EMT's. They don't know about the 24/7, or that is some cases a crew may really be up the whole 24. They certainly didn't like it when they found out their hospital residents are up that long. In nursing you see all these 'Dare to care' commercials and magazine ads, but you don't see this in EMS. WHY IS THIS? Seriously folks, can anyone think of any such promotion? Not even a bulletin board. At least now the public knows there is a shortage and nurses should be paid a respectable wage. But they would be shocked to know that lots of EMS workers are trying to make a living off $8 an hour. The thing is, who has the resources to do all this? > >Meredith > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2004 Report Share Posted September 13, 2004 Dudley; OK then lets open this can. How do you get the government to up what they will pay? Where do you go to get the ball rolling? Surely the hospitals are having the same problem but how have they overcome it? I do agree with the don't ride if you don't pay routine. I think for those that are " frequent fliers " there needs to be some type of set up for on going payment. I also hear that the subscription plan works with some agencies. I am curious to know how the new legislation on putting liens on those that owe EMS bills is doing. I think maybe more work needs to be done on our legislature. If people are expecting Health Care then EMS needs to be as highly funded as Hospital funding. Danny L. Owner/NREMT-P Panhandle Emergency Training Services And Response (PETSAR) Office FAX Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2004 Report Share Posted September 13, 2004 Dudley; OK then lets open this can. How do you get the government to up what they will pay? Where do you go to get the ball rolling? Surely the hospitals are having the same problem but how have they overcome it? I do agree with the don't ride if you don't pay routine. I think for those that are " frequent fliers " there needs to be some type of set up for on going payment. I also hear that the subscription plan works with some agencies. I am curious to know how the new legislation on putting liens on those that owe EMS bills is doing. I think maybe more work needs to be done on our legislature. If people are expecting Health Care then EMS needs to be as highly funded as Hospital funding. Danny L. Owner/NREMT-P Panhandle Emergency Training Services And Response (PETSAR) Office FAX Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2004 Report Share Posted September 13, 2004 Dudley; OK then lets open this can. How do you get the government to up what they will pay? Where do you go to get the ball rolling? Surely the hospitals are having the same problem but how have they overcome it? I do agree with the don't ride if you don't pay routine. I think for those that are " frequent fliers " there needs to be some type of set up for on going payment. I also hear that the subscription plan works with some agencies. I am curious to know how the new legislation on putting liens on those that owe EMS bills is doing. I think maybe more work needs to be done on our legislature. If people are expecting Health Care then EMS needs to be as highly funded as Hospital funding. Danny L. Owner/NREMT-P Panhandle Emergency Training Services And Response (PETSAR) Office FAX Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2004 Report Share Posted September 13, 2004 > Good, Now we have some numbers to work with. > > $18 per hour on a 24/48 hour schedule > Number of calls needed to run annually by this ONE unit to JUST pay for personnel: 2,696 or 7.39 per day (this doesn't include cost of vehicle, supplies, fuel, station, uniforms, holidays, maintenance, equipment, dispatching, supervision/control, billing processing, computer support, etc) > > $18 per hour on a 40 hour per week schedule > Number of calls needed to run annually by this ONE unit to JUST pay for personnel: 2,358 or 6.46 per day > > $24 per hour on a 24/48 hour schedule > Number of calls needed to run annually by this ONE unit to JUST pay for personnel: 3,594 or 9.85 per day > > $24 per hour on a 40 hour per week schedule > Number of calls needed to run annually by this ONE unit to JUST pay for personnel: 3,145 or 8.62 per day So how many fire calls does each fire engine have to make, staffed at 3 (or 4) to recoup the costs for providing fire protection and EMS first response? Mike Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2004 Report Share Posted September 13, 2004 > Good, Now we have some numbers to work with. > > $18 per hour on a 24/48 hour schedule > Number of calls needed to run annually by this ONE unit to JUST pay for personnel: 2,696 or 7.39 per day (this doesn't include cost of vehicle, supplies, fuel, station, uniforms, holidays, maintenance, equipment, dispatching, supervision/control, billing processing, computer support, etc) > > $18 per hour on a 40 hour per week schedule > Number of calls needed to run annually by this ONE unit to JUST pay for personnel: 2,358 or 6.46 per day > > $24 per hour on a 24/48 hour schedule > Number of calls needed to run annually by this ONE unit to JUST pay for personnel: 3,594 or 9.85 per day > > $24 per hour on a 40 hour per week schedule > Number of calls needed to run annually by this ONE unit to JUST pay for personnel: 3,145 or 8.62 per day So how many fire calls does each fire engine have to make, staffed at 3 (or 4) to recoup the costs for providing fire protection and EMS first response? Mike Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2004 Report Share Posted September 13, 2004 > Good, Now we have some numbers to work with. > > $18 per hour on a 24/48 hour schedule > Number of calls needed to run annually by this ONE unit to JUST pay for personnel: 2,696 or 7.39 per day (this doesn't include cost of vehicle, supplies, fuel, station, uniforms, holidays, maintenance, equipment, dispatching, supervision/control, billing processing, computer support, etc) > > $18 per hour on a 40 hour per week schedule > Number of calls needed to run annually by this ONE unit to JUST pay for personnel: 2,358 or 6.46 per day > > $24 per hour on a 24/48 hour schedule > Number of calls needed to run annually by this ONE unit to JUST pay for personnel: 3,594 or 9.85 per day > > $24 per hour on a 40 hour per week schedule > Number of calls needed to run annually by this ONE unit to JUST pay for personnel: 3,145 or 8.62 per day So how many fire calls does each fire engine have to make, staffed at 3 (or 4) to recoup the costs for providing fire protection and EMS first response? Mike Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2004 Report Share Posted September 13, 2004 Danny, Not a bad can of worms to open...as our rates (on average-fully loaded) are higher than $600. This is another factor in my argument. If we could get everyone to pay the $600 (or even $450 in a lot of locations) we would be much better off...but M'care, M'caid, Tricare (notice the theme: All gov't provided healthcare) won't pay even close to the real cost so we shift the cost to all others. Some insurance will pay but it continues to be the non-insured and the ones with private insurance that only pays a portion that then subsidize our payments. Others have hit the nail on the head too...we pay for plumbers, AC repair, and electricians because if we don't...they don't provide the service. " EMS can't do this " is so very often quoted...BUT (To really open a can of worms)...I ask WHY NOT? Wait a second...let me finish. In the " Mother, Jugs, and Speed " days everyone paid or they didn't ride...that swung to the totally opposite end of the scale after that where we don't even talk about the payment end (let alone get a signature or insurance information) because " money shouldn't be a factor in it " . Neither of these extremes are appropriate...but like so many other issues in EMS, instead of having the pendulum at one extreme or the other...how about stopping it somewhere near the middle??? I know...I am speaking blasphemy here...but hear me out. We respond to all requests from 911 just like we do today. We evaluate and begin treatment of the patient. We recognize it as a medical emergency, we treat them, load'em up, and transport, gathering billing information when we can....BUT IF, after the evaluation, it truly appears as if the patient does not need EMERGENCY medical treatment, we then determine from them the method of payment. We should also have other means of transport (such as med-assist vans, wheelchair transport, taxi, etc) and we transport them according to their means of payment...again, only after we have determined that ambulance transport is not needed (by any stretch of the imagination)...We then, through credit card, check, cash, etc take payment for the trip from the patient (at a lower cost than having to bill it) and perform the transport. AAAAARRRRRRGGGGHHHHHH!!!!! blasphemy, burn him at the stake, ridicule him and his mother.....healthcare is a RIGHT!!!!! Give it to us...give it to us..... Now, we have that out of our system. Those who know me will think I have somehow suffered a head injury because this is not something I advocate right now...but as we move forward, the issue will continue to be how we get paid for it...not for the " suit's " profit margins....but so that you, joe & jane paramedic, can buy your house in the suburbs, 3 cars, boat, 2.3 kids, 1.2 cats, etc..... Speak up...why not? What would it entail to make it happen (better trained medics again??? Seems that keeps coming up)...better oversight? More physician involvement? Just sharing on a blah Monday!!! Dudley Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2004 Report Share Posted September 13, 2004 Danny, Not a bad can of worms to open...as our rates (on average-fully loaded) are higher than $600. This is another factor in my argument. If we could get everyone to pay the $600 (or even $450 in a lot of locations) we would be much better off...but M'care, M'caid, Tricare (notice the theme: All gov't provided healthcare) won't pay even close to the real cost so we shift the cost to all others. Some insurance will pay but it continues to be the non-insured and the ones with private insurance that only pays a portion that then subsidize our payments. Others have hit the nail on the head too...we pay for plumbers, AC repair, and electricians because if we don't...they don't provide the service. " EMS can't do this " is so very often quoted...BUT (To really open a can of worms)...I ask WHY NOT? Wait a second...let me finish. In the " Mother, Jugs, and Speed " days everyone paid or they didn't ride...that swung to the totally opposite end of the scale after that where we don't even talk about the payment end (let alone get a signature or insurance information) because " money shouldn't be a factor in it " . Neither of these extremes are appropriate...but like so many other issues in EMS, instead of having the pendulum at one extreme or the other...how about stopping it somewhere near the middle??? I know...I am speaking blasphemy here...but hear me out. We respond to all requests from 911 just like we do today. We evaluate and begin treatment of the patient. We recognize it as a medical emergency, we treat them, load'em up, and transport, gathering billing information when we can....BUT IF, after the evaluation, it truly appears as if the patient does not need EMERGENCY medical treatment, we then determine from them the method of payment. We should also have other means of transport (such as med-assist vans, wheelchair transport, taxi, etc) and we transport them according to their means of payment...again, only after we have determined that ambulance transport is not needed (by any stretch of the imagination)...We then, through credit card, check, cash, etc take payment for the trip from the patient (at a lower cost than having to bill it) and perform the transport. AAAAARRRRRRGGGGHHHHHH!!!!! blasphemy, burn him at the stake, ridicule him and his mother.....healthcare is a RIGHT!!!!! Give it to us...give it to us..... Now, we have that out of our system. Those who know me will think I have somehow suffered a head injury because this is not something I advocate right now...but as we move forward, the issue will continue to be how we get paid for it...not for the " suit's " profit margins....but so that you, joe & jane paramedic, can buy your house in the suburbs, 3 cars, boat, 2.3 kids, 1.2 cats, etc..... Speak up...why not? What would it entail to make it happen (better trained medics again??? Seems that keeps coming up)...better oversight? More physician involvement? Just sharing on a blah Monday!!! Dudley Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2004 Report Share Posted September 13, 2004 Danny, Not a bad can of worms to open...as our rates (on average-fully loaded) are higher than $600. This is another factor in my argument. If we could get everyone to pay the $600 (or even $450 in a lot of locations) we would be much better off...but M'care, M'caid, Tricare (notice the theme: All gov't provided healthcare) won't pay even close to the real cost so we shift the cost to all others. Some insurance will pay but it continues to be the non-insured and the ones with private insurance that only pays a portion that then subsidize our payments. Others have hit the nail on the head too...we pay for plumbers, AC repair, and electricians because if we don't...they don't provide the service. " EMS can't do this " is so very often quoted...BUT (To really open a can of worms)...I ask WHY NOT? Wait a second...let me finish. In the " Mother, Jugs, and Speed " days everyone paid or they didn't ride...that swung to the totally opposite end of the scale after that where we don't even talk about the payment end (let alone get a signature or insurance information) because " money shouldn't be a factor in it " . Neither of these extremes are appropriate...but like so many other issues in EMS, instead of having the pendulum at one extreme or the other...how about stopping it somewhere near the middle??? I know...I am speaking blasphemy here...but hear me out. We respond to all requests from 911 just like we do today. We evaluate and begin treatment of the patient. We recognize it as a medical emergency, we treat them, load'em up, and transport, gathering billing information when we can....BUT IF, after the evaluation, it truly appears as if the patient does not need EMERGENCY medical treatment, we then determine from them the method of payment. We should also have other means of transport (such as med-assist vans, wheelchair transport, taxi, etc) and we transport them according to their means of payment...again, only after we have determined that ambulance transport is not needed (by any stretch of the imagination)...We then, through credit card, check, cash, etc take payment for the trip from the patient (at a lower cost than having to bill it) and perform the transport. AAAAARRRRRRGGGGHHHHHH!!!!! blasphemy, burn him at the stake, ridicule him and his mother.....healthcare is a RIGHT!!!!! Give it to us...give it to us..... Now, we have that out of our system. Those who know me will think I have somehow suffered a head injury because this is not something I advocate right now...but as we move forward, the issue will continue to be how we get paid for it...not for the " suit's " profit margins....but so that you, joe & jane paramedic, can buy your house in the suburbs, 3 cars, boat, 2.3 kids, 1.2 cats, etc..... Speak up...why not? What would it entail to make it happen (better trained medics again??? Seems that keeps coming up)...better oversight? More physician involvement? Just sharing on a blah Monday!!! Dudley Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2004 Report Share Posted September 13, 2004 Dudley, Let me see if I can toss some kerosine on the fire... In the " Mother, Jugs and Speed " example, it was a private service that was called on rotation or by geographic or someother means with other private services. Similar to what happens when you need a wrecker. It was a service, not an entitlement. To improve the quality of care, professionalism, whatever the reason, EMS (9-1-1 responses) became a core government function with many being provided by departments of city or county government. Or they became an extension of the hospital's emergency department, which is mandated to treat all who enter. Either way, the shift was on towards being a " service " to something that my taxes pay for, my insurance pays for, or someone else pays for. The examples of electrician, plummer, etc., are usually paid out of the users pockets and then filed on the insurance if applicable. To many times, we think that because someone else pays for it, then it's something we shouldn't have to fund out of our own pockets. Even if the departments are actally " enterprise " budgets that have to fund themselves, by being part of the institutions of the community, they are viewed as being something the community pays for as opposed to being a private enterprise like the electrician, plummer, etc. It's the worst of both worlds. The members of the community believe that it's something the government/insurance/anyonebutthem pays for. The leaders of the community's institutions believe that it's something the users should pay for and thusly underfund it. And they are both right, so no one pays. Just my $.02. Barry Re: EMS Pay Danny, Not a bad can of worms to open...as our rates (on average-fully loaded) are higher than $600. This is another factor in my argument. If we could get everyone to pay the $600 (or even $450 in a lot of locations) we would be much better off...but M'care, M'caid, Tricare (notice the theme: All gov't provided healthcare) won't pay even close to the real cost so we shift the cost to all others. Some insurance will pay but it continues to be the non-insured and the ones with private insurance that only pays a portion that then subsidize our payments. Others have hit the nail on the head too...we pay for plumbers, AC repair, and electricians because if we don't...they don't provide the service. " EMS can't do this " is so very often quoted...BUT (To really open a can of worms)...I ask WHY NOT? Wait a second...let me finish. In the " Mother, Jugs, and Speed " days everyone paid or they didn't ride...that swung to the totally opposite end of the scale after that where we don't even talk about the payment end (let alone get a signature or insurance information) because " money shouldn't be a factor in it " . Neither of these extremes are appropriate...but like so many other issues in EMS, instead of having the pendulum at one extreme or the other...how about stopping it somewhere near the middle??? I know...I am speaking blasphemy here...but hear me out. We respond to all requests from 911 just like we do today. We evaluate and begin treatment of the patient. We recognize it as a medical emergency, we treat them, load'em up, and transport, gathering billing information when we can....BUT IF, after the evaluation, it truly appears as if the patient does not need EMERGENCY medical treatment, we then determine from them the method of payment. We should also have other means of transport (such as med-assist vans, wheelchair transport, taxi, etc) and we transport them according to their means of payment...again, only after we have determined that ambulance transport is not needed (by any stretch of the imagination)...We then, through credit card, check, cash, etc take payment for the trip from the patient (at a lower cost than having to bill it) and perform the transport. AAAAARRRRRRGGGGHHHHHH!!!!! blasphemy, burn him at the stake, ridicule him and his mother.....healthcare is a RIGHT!!!!! Give it to us...give it to us..... Now, we have that out of our system. Those who know me will think I have somehow suffered a head injury because this is not something I advocate right now...but as we move forward, the issue will continue to be how we get paid for it...not for the " suit's " profit margins....but so that you, joe & jane paramedic, can buy your house in the suburbs, 3 cars, boat, 2.3 kids, 1.2 cats, etc..... Speak up...why not? What would it entail to make it happen (better trained medics again??? Seems that keeps coming up)...better oversight? More physician involvement? Just sharing on a blah Monday!!! Dudley Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2004 Report Share Posted September 13, 2004 Dudley, Let me see if I can toss some kerosine on the fire... In the " Mother, Jugs and Speed " example, it was a private service that was called on rotation or by geographic or someother means with other private services. Similar to what happens when you need a wrecker. It was a service, not an entitlement. To improve the quality of care, professionalism, whatever the reason, EMS (9-1-1 responses) became a core government function with many being provided by departments of city or county government. Or they became an extension of the hospital's emergency department, which is mandated to treat all who enter. Either way, the shift was on towards being a " service " to something that my taxes pay for, my insurance pays for, or someone else pays for. The examples of electrician, plummer, etc., are usually paid out of the users pockets and then filed on the insurance if applicable. To many times, we think that because someone else pays for it, then it's something we shouldn't have to fund out of our own pockets. Even if the departments are actally " enterprise " budgets that have to fund themselves, by being part of the institutions of the community, they are viewed as being something the community pays for as opposed to being a private enterprise like the electrician, plummer, etc. It's the worst of both worlds. The members of the community believe that it's something the government/insurance/anyonebutthem pays for. The leaders of the community's institutions believe that it's something the users should pay for and thusly underfund it. And they are both right, so no one pays. Just my $.02. Barry Re: EMS Pay Danny, Not a bad can of worms to open...as our rates (on average-fully loaded) are higher than $600. This is another factor in my argument. If we could get everyone to pay the $600 (or even $450 in a lot of locations) we would be much better off...but M'care, M'caid, Tricare (notice the theme: All gov't provided healthcare) won't pay even close to the real cost so we shift the cost to all others. Some insurance will pay but it continues to be the non-insured and the ones with private insurance that only pays a portion that then subsidize our payments. Others have hit the nail on the head too...we pay for plumbers, AC repair, and electricians because if we don't...they don't provide the service. " EMS can't do this " is so very often quoted...BUT (To really open a can of worms)...I ask WHY NOT? Wait a second...let me finish. In the " Mother, Jugs, and Speed " days everyone paid or they didn't ride...that swung to the totally opposite end of the scale after that where we don't even talk about the payment end (let alone get a signature or insurance information) because " money shouldn't be a factor in it " . Neither of these extremes are appropriate...but like so many other issues in EMS, instead of having the pendulum at one extreme or the other...how about stopping it somewhere near the middle??? I know...I am speaking blasphemy here...but hear me out. We respond to all requests from 911 just like we do today. We evaluate and begin treatment of the patient. We recognize it as a medical emergency, we treat them, load'em up, and transport, gathering billing information when we can....BUT IF, after the evaluation, it truly appears as if the patient does not need EMERGENCY medical treatment, we then determine from them the method of payment. We should also have other means of transport (such as med-assist vans, wheelchair transport, taxi, etc) and we transport them according to their means of payment...again, only after we have determined that ambulance transport is not needed (by any stretch of the imagination)...We then, through credit card, check, cash, etc take payment for the trip from the patient (at a lower cost than having to bill it) and perform the transport. AAAAARRRRRRGGGGHHHHHH!!!!! blasphemy, burn him at the stake, ridicule him and his mother.....healthcare is a RIGHT!!!!! Give it to us...give it to us..... Now, we have that out of our system. Those who know me will think I have somehow suffered a head injury because this is not something I advocate right now...but as we move forward, the issue will continue to be how we get paid for it...not for the " suit's " profit margins....but so that you, joe & jane paramedic, can buy your house in the suburbs, 3 cars, boat, 2.3 kids, 1.2 cats, etc..... Speak up...why not? What would it entail to make it happen (better trained medics again??? Seems that keeps coming up)...better oversight? More physician involvement? Just sharing on a blah Monday!!! Dudley Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2004 Report Share Posted September 13, 2004 <<<As for the higher education for EMS, I am all for it. As we all know, image is almost everything. And people tend to hold people with degrees in higher regard than those without. This may not be fair, and there are plenty non-degreed EMS personel who should be teaching the people going for degrees, but it is the way it is seen. And more will be asked of EMS in the future, probably to the point where some sort of degree will be required. If all nurses did was pass out pills and give bed baths, they certainly wouldn't need a degree.>>> I see this all the time and have even fell victim to it once or twice myself...but I can't stand by and agree with it any longer. If other avenues in healthcare felt this way then we wouldn't have Medical Schools, Dentistry Schools, Vetrinary Medicine Schools, Nursing Schools, etc. " Dr. Jimmy just got out of his Medical Doctor class down at the local Doctor Office, and he passed his state boards after three tries...luckily he didn't have to take a national test like those paramedics do...I am on my way over to congratulate him and see about him removing this nasty brain tumor... " (removing tongue from cheek now) This doesn't happen...because as a profession, many years ago, they determined that it was necessary to make everybody go for more education. IT wasn't so they would be held in a higher regard, it was because the expectations were so great, that the only way to prepare people was to give them a solid educational foundation and then drowned them with information over 4 additional years hoping they would be able to retain and recall it when necessary... Doctors today do not care about how many years you have been doctoring, how good you appear to your peers, or " what a great clinician " or " excellent skills " you have....you want to practice you gotta have that medical school degree and board certifications (dependant) then...they might care about the other stuff. We need to stop making excuses, figure out how we are going to get paid for it, and then develop the right educational system (regardless of what I did 20 years ago...) to develop paramedics capable of performing to the level required by those willing to pay the bill. Come on all you dinosaurs, lets head off to the tar-pits and let this profession move forward appropriately. Dudley Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2004 Report Share Posted September 13, 2004 <<<As for the higher education for EMS, I am all for it. As we all know, image is almost everything. And people tend to hold people with degrees in higher regard than those without. This may not be fair, and there are plenty non-degreed EMS personel who should be teaching the people going for degrees, but it is the way it is seen. And more will be asked of EMS in the future, probably to the point where some sort of degree will be required. If all nurses did was pass out pills and give bed baths, they certainly wouldn't need a degree.>>> I see this all the time and have even fell victim to it once or twice myself...but I can't stand by and agree with it any longer. If other avenues in healthcare felt this way then we wouldn't have Medical Schools, Dentistry Schools, Vetrinary Medicine Schools, Nursing Schools, etc. " Dr. Jimmy just got out of his Medical Doctor class down at the local Doctor Office, and he passed his state boards after three tries...luckily he didn't have to take a national test like those paramedics do...I am on my way over to congratulate him and see about him removing this nasty brain tumor... " (removing tongue from cheek now) This doesn't happen...because as a profession, many years ago, they determined that it was necessary to make everybody go for more education. IT wasn't so they would be held in a higher regard, it was because the expectations were so great, that the only way to prepare people was to give them a solid educational foundation and then drowned them with information over 4 additional years hoping they would be able to retain and recall it when necessary... Doctors today do not care about how many years you have been doctoring, how good you appear to your peers, or " what a great clinician " or " excellent skills " you have....you want to practice you gotta have that medical school degree and board certifications (dependant) then...they might care about the other stuff. We need to stop making excuses, figure out how we are going to get paid for it, and then develop the right educational system (regardless of what I did 20 years ago...) to develop paramedics capable of performing to the level required by those willing to pay the bill. Come on all you dinosaurs, lets head off to the tar-pits and let this profession move forward appropriately. Dudley Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2004 Report Share Posted September 13, 2004 That's an excellent question Mike...and if the general public ever saw past the front put up by this industry (self-imposed regulations, antiquated approaches, etc) and could figure out what they were getting for their money...they might truly demand a reform in this idustry too. Just because we continue to pour tax-payer dollars into an industry...doesn't mean it is the right thing to do. Besides, many FD's have seen the change in the wind coming and are now billing themselves.... Lets carry this a step further. Why do I have to pay for my hospital visit? Why doesn't this get covered by tax dollars? When I go to get a building permit, why do I have to pay for that...can't tax subsidy pay for it? Why do I have to pay for groceries at HEB? Seems that eating is a much more important right than healthcare...why don't I just browse the aisles at HEB and take what I need....I mean, I pay taxes don't I? How about gasoline? I pay enough gasoline taxes to support everything from highway stripes to school chalkboards...how come I have to pay for gasoline? As a matter of fact, why do I even have a bank account....let Uncle Sam take the remaining 75% of my paycheck because we know they can spend it much better than I can. Sorry, but inappropriate things of the past do not constitute appropriate things in the future. Dudley Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2004 Report Share Posted September 13, 2004 That's an excellent question Mike...and if the general public ever saw past the front put up by this industry (self-imposed regulations, antiquated approaches, etc) and could figure out what they were getting for their money...they might truly demand a reform in this idustry too. Just because we continue to pour tax-payer dollars into an industry...doesn't mean it is the right thing to do. Besides, many FD's have seen the change in the wind coming and are now billing themselves.... Lets carry this a step further. Why do I have to pay for my hospital visit? Why doesn't this get covered by tax dollars? When I go to get a building permit, why do I have to pay for that...can't tax subsidy pay for it? Why do I have to pay for groceries at HEB? Seems that eating is a much more important right than healthcare...why don't I just browse the aisles at HEB and take what I need....I mean, I pay taxes don't I? How about gasoline? I pay enough gasoline taxes to support everything from highway stripes to school chalkboards...how come I have to pay for gasoline? As a matter of fact, why do I even have a bank account....let Uncle Sam take the remaining 75% of my paycheck because we know they can spend it much better than I can. Sorry, but inappropriate things of the past do not constitute appropriate things in the future. Dudley Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2004 Report Share Posted September 13, 2004 our service runs about 500 calls per year, are hospital based, and do our own billing and our billing folks says filing liens is " well worth the trouble " i dont know a collection % tho.. it has become a routine procedure. ht Hatfield wrote: > I > am curious to know how the new legislation on putting liens on those that owe > EMS bills is doing. The liens for EMS are in use in a few places that I am aware of, my service is one of them. Remember that the liens are only in place for third party type injuries/illnesses and only apply to prospective or expected settlements. We file the lien, and if they get a settlement, we get a check first before anyone else does. The cost to place a lien for us is 11.00, and to remove it is the same. It is without a doubt the best 22.00 one could spend. Jane Hill and her staff took a lien form that we had, updated it and made corrections to it, and if I recall, it is posted to this groups files section, you might wnat to download it and take a look at it. Mike Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2004 Report Share Posted September 13, 2004 > It would help too if the movies > wouldn't portray us as Ambulance drivers. That's not likely to happen so long as we continue to portray ourselves as " ambulance drivers. " No matter how much education and knowledge we aquire, most systems are still dressing their medics up like Mexican traffic cops (MedStar) or Quik Lube grease monkeys (ETMS). Not to mention the fire service medics in their wrinkled t-shirts. Image is everything, and is a sorely overlooked part of the equation. It is true that if you want to be important, you had best look important. If you wouldn't go to a job interview dressed as any of the above, then you shouldn't be working while dressed as any of the above either. EMS needs a queer-eye makeover. Rob Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2004 Report Share Posted September 13, 2004 > It would help too if the movies > wouldn't portray us as Ambulance drivers. That's not likely to happen so long as we continue to portray ourselves as " ambulance drivers. " No matter how much education and knowledge we aquire, most systems are still dressing their medics up like Mexican traffic cops (MedStar) or Quik Lube grease monkeys (ETMS). Not to mention the fire service medics in their wrinkled t-shirts. Image is everything, and is a sorely overlooked part of the equation. It is true that if you want to be important, you had best look important. If you wouldn't go to a job interview dressed as any of the above, then you shouldn't be working while dressed as any of the above either. EMS needs a queer-eye makeover. Rob Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2004 Report Share Posted September 13, 2004 > It would help too if the movies > wouldn't portray us as Ambulance drivers. That's not likely to happen so long as we continue to portray ourselves as " ambulance drivers. " No matter how much education and knowledge we aquire, most systems are still dressing their medics up like Mexican traffic cops (MedStar) or Quik Lube grease monkeys (ETMS). Not to mention the fire service medics in their wrinkled t-shirts. Image is everything, and is a sorely overlooked part of the equation. It is true that if you want to be important, you had best look important. If you wouldn't go to a job interview dressed as any of the above, then you shouldn't be working while dressed as any of the above either. EMS needs a queer-eye makeover. Rob Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2004 Report Share Posted September 13, 2004 Excellent point Barry. One way I heard it described before (potentially on this list) is that our taxes should provide for its availability...but the end user's should provide for its use. Such as a water department. The city taxes pay for the water mains, wells, treatment plants, etc. But if I water my yard once a month and you re-fill your 10,000 gallon swimming pool twice a week, why should I have to pay for your usage? The same really holds in this entitlement vs. service argument. Dudley Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2004 Report Share Posted September 13, 2004 Excellent point Barry. One way I heard it described before (potentially on this list) is that our taxes should provide for its availability...but the end user's should provide for its use. Such as a water department. The city taxes pay for the water mains, wells, treatment plants, etc. But if I water my yard once a month and you re-fill your 10,000 gallon swimming pool twice a week, why should I have to pay for your usage? The same really holds in this entitlement vs. service argument. Dudley Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2004 Report Share Posted September 13, 2004 Way to stir the pot Dudley..... Just kidding. This thread takes a turn to Paramedic Initiated Refusals, a thread that has in the past brought up many good points, not the least of which is the need for training on the paramedics part. Many studies have shown that Paramedics are not the best in the world at defining what necessitates emergency room treatment, or hospital admission. That said, the training would have to improve to the point where field technicians could effectively evaluate which patients require the ER and which ones require their doctors office, and transport them accordingly. We spend a lot of time trying to figure out how to increase our reenue, which I will agree is imperative. But another thing to look at, is reduction of expenses. One of the ways to do this, is to reduce the number of unnecassary transports by MICU buses. Alternative transportation could be a med-assist van, or even a taxi. The expense is less on the service, and if the patient only needs trasnport to thier physicians office, it aides in reducing strain on the ER. We shouldn't have to do more with less, but we should have the opportunity to do more with what we have right now. Same revenue, lower expenses. Just my humble opinion, Mike > Danny, > > Not a bad can of worms to open...as our rates (on average-fully loaded) are higher than $600. This is another factor in my argument. If we could get everyone to pay the $600 (or even $450 in a lot of locations) we would be much better off...but M'care, M'caid, Tricare (notice the theme: All gov't provided healthcare) won't pay even close to the real cost so we shift the cost to all others. Some insurance will pay but it continues to be the non-insured and the ones with private insurance that only pays a portion that then subsidize our payments. > > Others have hit the nail on the head too...we pay for plumbers, AC repair, and electricians because if we don't...they don't provide the service. " EMS can't do this " is so very often quoted...BUT (To really open a can of worms)...I ask WHY NOT? > > Wait a second...let me finish. In the " Mother, Jugs, and Speed " days everyone paid or they didn't ride...that swung to the totally opposite end of the scale after that where we don't even talk about the payment end (let alone get a signature or insurance information) because " money shouldn't be a factor in it " . Neither of these extremes are appropriate...but like so many other issues in EMS, instead of having the pendulum at one extreme or the other...how about stopping it somewhere near the middle??? I know...I am speaking blasphemy here...but hear me out. > > We respond to all requests from 911 just like we do today. We evaluate and begin treatment of the patient. We recognize it as a medical emergency, we treat them, load'em up, and transport, gathering billing information when we can....BUT IF, after the evaluation, it truly appears as if the patient does not need EMERGENCY medical treatment, we then determine from them the method of payment. We should also have other means of transport (such as med-assist vans, wheelchair transport, taxi, etc) and we transport them according to their means of payment...again, only after we have determined that ambulance transport is not needed (by any stretch of the imagination)...We then, through credit card, check, cash, etc take payment for the trip from the patient (at a lower cost than having to bill it) and perform the transport. > > AAAAARRRRRRGGGGHHHHHH!!!!! blasphemy, burn him at the stake, ridicule him and his mother.....healthcare is a RIGHT!!!!! Give it to us...give it to us..... > > Now, we have that out of our system. Those who know me will think I have somehow suffered a head injury because this is not something I advocate right now...but as we move forward, the issue will continue to be how we get paid for it...not for the " suit's " profit margins....but so that you, joe & jane paramedic, can buy your house in the suburbs, 3 cars, boat, 2.3 kids, 1.2 cats, etc..... > > Speak up...why not? What would it entail to make it happen (better trained medics again??? Seems that keeps coming up)...better oversight? More physician involvement? > > Just sharing on a blah Monday!!! > > Dudley > > > > > > Quote Link to comment Share on other sites More sharing options...
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