RE: Councilman Proposes Payment Up Front BeforeAmbulance Ride

[Guest guest]

Jane:

Thank you. You hit the nail on the head. At one time,in life I was a peace

officer. I felt I was sent to handle an insignifcant family beef or other

call where I thought psychologists like my two sisters were better

qualified to deal with. Unfortanately,they were not trained at a police

academy and sheriffs academy as I was. These calls constituted an emergency

to the caller concerned and me knowing how things can spiral out of control

with the wrong words,body language,or misperception.Yet, as peace officers

we thought many were a waste of our precious time. This attitude pervades

EMS and our government officials. Next,a walletectomy which I have seen

done by hospitals and private ambulances is not the solution either.We must

realize that we are an emergency services,and treat our patients as if they

are family,and deal with business,and the money later on.It is not our job

to be screeners or psychologists,and bill collectors.No matter what we

do,we must provide a service which all of ,large or small incomes do pay

for. It is time for our politicians to get a social conscience see that EMS

is a priority, and what we all need. Rabbiems,again I get off my soap box

> [Original Message]

>

> To: <texasems-l >

> Date: 5/21/2008 6:41:21 PM

> Subject: RE: Councilman Proposes Payment Up Front

BeforeAmbulance Ride

>

>

> I think Dr. Bledsoe's numbered points here hit it on the head. Those are

valid points all.

>

> This problem, use of emergency response for non-emergency situations, is

not unique nor does it have any simple resolution. Unfortunately, it will

continue to be " the nature of the beast. " Public education of the

community regarding the definition of an emergency and " when to call 911 "

sometimes helps, but it never entirely solves the problem. An emergency is

what the person who calls 911 PERCEIVES is an emergency, and you can't

change perception in many people no matter what you do. And passing an

edict that would " educate " the public that they will have a wallet biopsy

if the responders decide the situation is not an emergency will only do two

things:

>

> 1. It will breed discontent in the community and could increase violence

towards emergency responders who are forced to tell the caller that their

situation is NOT an emergency and they will have to pay the bill in advance

or guarantee payment. For whatever reason many people call 911, in most

situtations SOMEONE is upset before the responders ever even get there. If

violence doesn't occur, complaints to the powers that be up above will most

likely increase because again, the caller perceives the situation as an

emergency regardless of what the responders tell them.

>

> 2. It could lead to some folks NOT calling for REAL emergencies when

they should for fear of being dunned for money at the time of service. Why

call for help when you can throw them in the car and drive them for the

cost of gas??? It won't matter that the baby is not breathing. Again, it

is based in perception only now the perception is that if they don't have

the money, you won't treat them and transport them anyway.

>

> The only thing I have to say about the article iteself is that the Dallas

councilman who is proposing this has a valid point regarding the financial

impact on taxpayers of non-emergency non-paid ambulance transports. But HE

is not educated to the real issues obviously or the potential ramifications

of his plan. Someone needs to educate him a little better, in my opinion,

so that maybe he can think of a better way to help the Dallas system and

taxpayers. Heck, maybe he can think of something better that ALL agencies

could benefit from.

>

> Jane Dinsmore

>

>

> To: texasems-l@...: bbledsoe@...: Wed, 21

May 2008 17:44:48 -0500Subject: RE: Councilman Proposes

Payment Up Front Before Ambulance Ride

>

>

>

>

> The point is this, nobody has found a solution to the ambulance abuse

issuethat is suitable to all parties.1. DFD did refuse transport for years

and were sued numerous times.Sure there was abuse. But there were

paramedics who followed the rules andstill got into trouble because their

education did not allow them the skillsto determine who is really sick and

who is not. It was not the fault of DFDor the paramedics It was the City.

Slowly, " automatic carry " policies wereput in place to assure that

high-risk patients were transported. Thelawsuits continued.2. The City of

Dallas used to turn the water off if people didn't paytheir bill. One story

in the Dallas Times Herald about a poor pensionerwhose water was shut off

brought that to an end.3. The use of nurses as call screeners was a

disaster. The case Genementioned was an effeminate sounding man who was

begging to come and get hismother (who was in the final throes of death).

The tape would piss anybodyoff. People are not to be treated that way.4. In

Fort Worth, we had to collect money for ambulance calls. The EMTwith the

highest collections got a dinner. It was expected. More than that,it was

required if you liked your job. We also got bonuses for gettingfunerals. We

even had to ask for payment on death calls (although the billwas $40.00) it

hurt to see some widower write out a check minutes after hiswife of 50

years passed away.5. London Ambulance has tried to refer calls to

non-emergency centersonly to find the MPDS is a horrible screening tool for

sick, non-sick. Theprogram stopped.6. The Red River Project withered on the

vine.7. An eastern seaboard city allowed paramedics to give free

cabvouchers to nonemergency patients only to have the ACLU complain

thatminorities were made to ride in cabs while whites were transported

byambulance. When they ran the numbers, the ACLU was on to something and

theprogram went quietly away.Every one of us has done something to dissuade

a person from taking anambulance (who we thought didn't need it). Heck, I

even helped jumpstart anOldsmobile that had not run in 3 months (and had no

inspection sticker orregistration) so we could get back to a dinner that

was just served before acall because of an ingrown toenail. It is like

being a mercenary-it worksfor a while but eventually you screw up. As I

matured, I learned, by thetime you talk the patient out of going, you could

have had them at thehospital. Then, you did not have to worry about the

repercussions.Don't think it is just EMS. Many times I have sat on a stool

at 3:00 AMlooking at a patient in total disbelief as she described

intermittent pelvicpain that had been present off or on for 20 years has

seen every doctor inTexas, and expected me to figure it out, in the middle

of a thunderstorm,while I have 45 people coughing and hacking in the

waiting room. I waste afew grand on labs and ultrasound that left me no

closer to solving herproblem than I was when she walked in. But, the

ultrasound films we shot gotto join the 56 prior ultrasound films that are

stored in Part 4 of 4 of herx-ray folder. If I did not make an effort to

treat her I would be hearingfrom the administrator the next day.Ambulance

abuse is a complex problem (social, educational, racial,religious, medical,

financial). As it has been said, there are no simplesolutions to complex

problems. My point in the original post is that theHonorable City

Councilman, like so many before him, is simply pissin' in thewind.

[Guest guest]

It all comes down to:

Is health care a right or a privilege?

In the United States, it is a privilege. But, through unfunded mandates

(OBRA, COBRA, EMTALA) the government gives people de facto rights to

emergency health care and EMS. By making EMTALA comprehensive (very specific

definition of stabilization), the federal government makes EMS systems,

hospitals and physicians give free care or be sanctioned. Then, the

government pays less than it costs for people to operate a hospital or

medical practice. I actually sat in on a meeting where the discussion

centered around giving every Medicare patient who needed cataract surgery

$100 and send them to Dallas because we were losing $260.00 per cataract

surgery we were doing (90% Medicare). It is the typical government way of

avoiding the pressing issue and fixing the system with a case of Band-aids.

I am not some conspiracy geek--just call it as I see it. Given the way the

US operates, a national health care system would be a cross between the

Internal Revenue Service the United States Postal service.

And people wonder why boutique hospitals and freestanding surgery centers

and freestanding emergency departments are going up everywhere. You don't

accept Medicare and then you don't have to take call!! You can turn away

who you want. Before long, the only hospitals taking care of charity hits

will be teaching and public hospitals. Money follows the surgeons and

surgeons are leaving hospitals in droves for freestanding centers. I had a

call from a recruiter today who is looking for emergency doctors to staff

freestanding surgery centers after hours. They pay as much as an average

emergency department and report that you will rarely, if ever, see a

patient. They just need a doctor in house for medical legal reasons.

BEB

[Guest guest]

Dr.Bledsoe: Healthcare is a right,our founding fathers put this in writing, in

at least the Bill Of Rights and other amendments to our constititution .State

government has followed too,with amendments specifically outlining the

protection of public health.What I see here again is an issue known as

walletectomy.We are concerned about the money.Can our patient pay? then he

deserves a ride to the hospital. We are the most afflluent county on earth right

now.We have a sizeable and shameful portion of our population uninsured and

unable to access health care. We do not need to further ration healthcare. I

find it shameful that we cannot endeavor to take care of our citizens better,and

my medics tell me they are trying to help Iraqis get a system going.They have

the right idea,take care of your people,now that Saddam is gone. I find it

shameful in our country that we decides who need s healthcare based on a

walletectomy. I don't like it when the dog and cat hospitals in Mexico do

this and find it socially,and morally acceptable.WE Americans for one reason,we

beleive in fair play and everybody should have access to health care.This is

what sets us apart from others on this planet who don't with few

exceptions(Canada and Europe)

Respectfully,Rabbiems.P.s I am now a retired army medic who has seen combat

since Viet nam and its a touchy issue especially for Vets.

" Bledsoe, DO " wrote:

It all comes down to:

Is health care a right or a privilege?

In the United States, it is a privilege. But, through unfunded mandates

(OBRA, COBRA, EMTALA) the government gives people de facto rights to

emergency health care and EMS. By making EMTALA comprehensive (very specific

definition of stabilization), the federal government makes EMS systems,

hospitals and physicians give free care or be sanctioned. Then, the

government pays less than it costs for people to operate a hospital or

medical practice. I actually sat in on a meeting where the discussion

centered around giving every Medicare patient who needed cataract surgery

$100 and send them to Dallas because we were losing $260.00 per cataract

surgery we were doing (90% Medicare). It is the typical government way of

avoiding the pressing issue and fixing the system with a case of Band-aids.

I am not some conspiracy geek--just call it as I see it. Given the way the

US operates, a national health care system would be a cross between the

Internal Revenue Service the United States Postal service.

And people wonder why boutique hospitals and freestanding surgery centers

and freestanding emergency departments are going up everywhere. You don't

accept Medicare and then you don't have to take call!! You can turn away

who you want. Before long, the only hospitals taking care of charity hits

will be teaching and public hospitals. Money follows the surgeons and

surgeons are leaving hospitals in droves for freestanding centers. I had a

call from a recruiter today who is looking for emergency doctors to staff

freestanding surgery centers after hours. They pay as much as an average

emergency department and report that you will rarely, if ever, see a

patient. They just need a doctor in house for medical legal reasons.

BEB

[Guest guest]

Can you make a citation to the explicit right to healthcare??? I am not aware of

any enumerated constitutional right to healthcare in either the United States or

in any state constitution.

But then, what do I know?? I'm just a lawyer.

-Wes Ogilvie

RE: Councilman Proposes Payment Up Front BeforeAmbulance

Ride

Dr.Bledsoe: Healthcare is a right,our founding fathers put this in writing, in

at least the Bill Of Rights and other amendments to our constititution .State

government has followed too,with amendments specifically outlining the

protection of public health.What I see here again is an issue known as

walletectomy.We are concerned about the money.Can our patient pay? then he

deserves a ride to the hospital. We are the most afflluent county on earth right

now.We have a sizeable and shameful portion of our population uninsured and

unable to access health care. We do not need to further ration healthcare. I

find it shameful that we cannot endeavor to take care of our citizens better,and

my medics tell me they are trying to help Iraqis get a system going.They have

the right idea,take care of your people,now that Saddam is gone. I find it

shameful in our country that we decides who need s healthcare based on a

walletectomy. I don't like it when the dog and cat hospitals in Mexico do

this and find it socially,and morally acceptable.WE Americans for one reason,we

beleive in fair play and everybody should have access to health care.This is

what sets us apart from others on this planet who don't with few

exceptions(Canada and Europe)

Respectfully,Rabbiems.P.s I am now a retired army medic who has seen combat

since Viet nam and its a touchy issue especially for Vets.

" Bledsoe, DO " wrote:

It all comes down to:

Is health care a right or a privilege?

In the United States, it is a privilege. But, through unfunded mandates

(OBRA, COBRA, EMTALA) the government gives people de facto rights to

emergency health care and EMS. By making EMTALA comprehensive (very specific

definition of stabilization), the federal government makes EMS systems,

hospitals and physicians give free care or be sanctioned. Then, the

government pays less than it costs for people to operate a hospital or

medical practice. I actually sat in on a meeting where the discussion

centered around giving every Medicare patient who needed cataract surgery

$100 and send them to Dallas because we were losing $260.00 per cataract

surgery we were doing (90% Medicare). It is the typical government way of

avoiding the pressing issue and fixing the system with a case of Band-aids.

I am not some conspiracy geek--just call it as I see it. Given the way the

US operates, a national health care system would be a cross between the

Internal Revenue Service the United States Postal service.

And people wonder why boutique hospitals and freestanding surgery centers

and freestanding emergency departments are going up everywhere. You don't

accept Medicare and then you don't have to take call!! You can turn away

who you want. Before long, the only hospitals taking care of charity hits

will be teaching and public hospitals. Money follows the surgeons and

surgeons are leaving hospitals in droves for freestanding centers. I had a

call from a recruiter today who is looking for emergency doctors to staff

freestanding surgery centers after hours. They pay as much as an average

emergency department and report that you will rarely, if ever, see a

patient. They just need a doctor in house for medical legal reasons.

BEB

[Guest guest]

Yes I can Wesley,the preamble to the US constitution,the 10th and 14th

amendments. States of the union have followed suit. Ask Hawaii,their citizens

are getting healthcare at taxpayer expense including EMS rides. Again I say,We

are a better nation than most.We have the most advanced healthcare system,even

if it needs some major league tinkering to improve it. Our citizens,deserve

healthcare irrespective of a walletectomy.Wes, we must do better by the citizens

of our nation,not just our veterans long overdue for their needs being taken

care of as our citizens are. Rabbiems

RE: Councilman Proposes Payment Up Front BeforeAmbulance

Ride

Dr.Bledsoe: Healthcare is a right,our founding fathers put this in writing, in

at least the Bill Of Rights and other amendments to our constititution .State

government has followed too,with amendments specifically outlining the

protection of public health.What I see here again is an issue known as

walletectomy.We are concerned about the money.Can our patient pay? then he

deserves a ride to the hospital. We are the most afflluent county on earth right

now.We have a sizeable and shameful portion of our population uninsured and

unable to access health care. We do not need to further ration healthcare. I

find it shameful that we cannot endeavor to take care of our citizens better,and

my medics tell me they are trying to help Iraqis get a system going.They have

the right idea,take care of your people,now that Saddam is gone. I find it

shameful in our country that we decides who need s healthcare based on a

walletectomy. I don't like it when the dog and cat hospitals in Mexico do

this and find it socially,and morally acceptable.WE Americans for one reason,we

beleive in fair play and everybody should have access to health care.This is

what sets us apart from others on this planet who don't with few

exceptions(Canada and Europe)

Respectfully,Rabbiems.P.s I am now a retired army medic who has seen combat

since Viet nam and its a touchy issue especially for Vets.

" Bledsoe, DO " wrote:

It all comes down to:

Is health care a right or a privilege?

In the United States, it is a privilege. But, through unfunded mandates

(OBRA, COBRA, EMTALA) the government gives people de facto rights to

emergency health care and EMS. By making EMTALA comprehensive (very specific

definition of stabilization), the federal government makes EMS systems,

hospitals and physicians give free care or be sanctioned. Then, the

government pays less than it costs for people to operate a hospital or

medical practice. I actually sat in on a meeting where the discussion

centered around giving every Medicare patient who needed cataract surgery

$100 and send them to Dallas because we were losing $260.00 per cataract

surgery we were doing (90% Medicare). It is the typical government way of

avoiding the pressing issue and fixing the system with a case of Band-aids.

I am not some conspiracy geek--just call it as I see it. Given the way the

US operates, a national health care system would be a cross between the

Internal Revenue Service the United States Postal service.

And people wonder why boutique hospitals and freestanding surgery centers

and freestanding emergency departments are going up everywhere. You don't

accept Medicare and then you don't have to take call!! You can turn away

who you want. Before long, the only hospitals taking care of charity hits

will be teaching and public hospitals. Money follows the surgeons and

surgeons are leaving hospitals in droves for freestanding centers. I had a

call from a recruiter today who is looking for emergency doctors to staff

freestanding surgery centers after hours. They pay as much as an average

emergency department and report that you will rarely, if ever, see a

patient. They just need a doctor in house for medical legal reasons.

BEB

[Guest guest]

The preamble is not binding.? The 10th and 14th amendments do not address

healthcare.? Plain and simple.

-Wes

Re: Councilman Proposes Payment Up Front BeforeAmbulance

Ride

Yes I can Wesley,the preamble to the US constitution,the 10th and 14th

amendments. States of the union have followed suit. Ask Hawaii,their citizens

are getting healthcare at taxpayer expense including EMS rides. Again I say,We

are a better nation than most.We have the most advanced healthcare system,even

if it needs some major league tinkering to improve it. Our citizens,deserve

healthcare irrespective of a walletectomy.Wes, we must do better by the citizens

of our nation,not just our veterans long overdue for their needs being taken

care of as our citizens are. Rabbiems

RE: Councilman Proposes Payment Up Front BeforeAmbulance

Ride

Dr.Bledsoe: Healthcare is a right,our founding fathers put this in writing, in

at least the Bill Of Rights and other amendments to our constititution .State

government has followed too,with amendments specifically outlining the

protection of public health.What I see here again is an issue known as

walletectomy.We are concerned about the money.Can our patient pay? then he

deserves a ride to the hospital. We are the most afflluent county on earth right

now.We have a sizeable and shameful portion of our population uninsured and

unable to access health care. We do not need to further ration healthcare. I

find it shameful that we cannot endeavor to take care of our citizens better,and

my medics tell me they are trying to help Iraqis get a system going.They have

the right idea,take care of your people,now that Saddam is gone. I find it

shameful in our country that we decides who need s healthcare based on a

walletectomy. I don't like it when the dog and cat hospitals in Mexico do

this and find it socially,and morally acceptable.WE Americans for one reason,we

beleive in fair play and everybody should have access to health care.This is

what sets us apart from others on this planet who don't with few

exceptions(Canada and Europe)

Respectfully,Rabbiems.P.s I am now a retired army medic who has seen combat

since Viet nam and its a touchy issue especially for Vets.

" Bledsoe, DO " wrote:

It all comes down to:

Is health care a right or a privilege?

In the United States, it is a privilege. But, through unfunded mandates

(OBRA, COBRA, EMTALA) the government gives people de facto rights to

emergency health care and EMS. By making EMTALA comprehensive (very specific

definition of stabilization), the federal government makes EMS systems,

hospitals and physicians give free care or be sanctioned. Then, the

government pays less than it costs for people to operate a hospital or

medical practice. I actually sat in on a meeting where the discussion

centered around giving every Medicare patient who needed cataract surgery

$100 and send them to Dallas because we were losing $260.00 per cataract

surgery we were doing (90% Medicare). It is the typical government way of

avoiding the pressing issue and fixing the system with a case of Band-aids.

I am not some conspiracy geek--just call it as I see it. Given the way the

US operates, a national health care system would be a cross between the

Internal Revenue Service the United States Postal service.

And people wonder why boutique hospitals and freestanding surgery centers

and freestanding emergency departments are going up everywhere. You don't

accept Medicare and then you don't have to take call!! You can turn away

who you want. Before long, the only hospitals taking care of charity hits

will be teaching and public hospitals. Money follows the surgeons and

surgeons are leaving hospitals in droves for freestanding centers. I had a

call from a recruiter today who is looking for emergency doctors to staff

freestanding surgery centers after hours. They pay as much as an average

emergency department and report that you will rarely, if ever, see a

patient. They just need a doctor in house for medical legal reasons.

BEB

[Guest guest]

There is no mention of health care in the United States or Texas

Constitution (including amendments). I don't think it was even discussed in

the Federalist Papers.

BEB

From: texasems-l [mailto:texasems-l ] On

Behalf Of richard borenstein

Sent: Wednesday, May 21, 2008 8:38 PM

To: texasems-l

Subject: RE: Councilman Proposes Payment Up Front

BeforeAmbulance Ride

Dr.Bledsoe: Healthcare is a right,our founding fathers put this in writing,

in at least the Bill Of Rights and other amendments to our constititution

..State government has followed too,with amendments specifically outlining

the protection of public health.What I see here again is an issue known as

walletectomy.We are concerned about the money.Can our patient pay? then he

deserves a ride to the hospital. We are the most afflluent county on earth

right now.We have a sizeable and shameful portion of our population

uninsured and unable to access health care. We do not need to further ration

healthcare. I find it shameful that we cannot endeavor to take care of our

citizens better,and my medics tell me they are trying to help Iraqis get a

system going.They have the right idea,take care of your people,now that

Saddam is gone. I find it shameful in our country that we decides who need s

healthcare based on a walletectomy. I don't like it when the dog and cat

hospitals in Mexico do

this and find it socially,and morally acceptable.WE Americans for one

reason,we beleive in fair play and everybody should have access to health

care.This is what sets us apart from others on this planet who don't with

few exceptions(Canada and Europe)

Respectfully,Rabbiems.P.s I am now a retired army medic who has seen combat

since Viet nam and its a touchy issue especially for Vets.

" Bledsoe, DO " <bbledsoe@...

<mailto:bbledsoe%40earthlink.net> > wrote:

It all comes down to:

Is health care a right or a privilege?

In the United States, it is a privilege. But, through unfunded mandates

(OBRA, COBRA, EMTALA) the government gives people de facto rights to

emergency health care and EMS. By making EMTALA comprehensive (very specific

definition of stabilization), the federal government makes EMS systems,

hospitals and physicians give free care or be sanctioned. Then, the

government pays less than it costs for people to operate a hospital or

medical practice. I actually sat in on a meeting where the discussion

centered around giving every Medicare patient who needed cataract surgery

$100 and send them to Dallas because we were losing $260.00 per cataract

surgery we were doing (90% Medicare). It is the typical government way of

avoiding the pressing issue and fixing the system with a case of Band-aids.

I am not some conspiracy geek--just call it as I see it. Given the way the

US operates, a national health care system would be a cross between the

Internal Revenue Service the United States Postal service.

And people wonder why boutique hospitals and freestanding surgery centers

and freestanding emergency departments are going up everywhere. You don't

accept Medicare and then you don't have to take call!! You can turn away

who you want. Before long, the only hospitals taking care of charity hits

will be teaching and public hospitals. Money follows the surgeons and

surgeons are leaving hospitals in droves for freestanding centers. I had a

call from a recruiter today who is looking for emergency doctors to staff

freestanding surgery centers after hours. They pay as much as an average

emergency department and report that you will rarely, if ever, see a

patient. They just need a doctor in house for medical legal reasons.

BEB

[Guest guest]

Hawaii is no different than any other state (I go there once or twice a

year). They do not have socialized health care. They have Medicaid like all

statese. The only people guaranteed health care are Native Americans,

certain Pacific Islanders and Eskimos, and veterans. We must have had much

different civics classes.

BEB

From: texasems-l [mailto:texasems-l ] On

Behalf Of rabbiems@...

Sent: Wednesday, May 21, 2008 9:12 PM

To: texasems-l

Subject: Re: Councilman Proposes Payment Up Front

BeforeAmbulance Ride

Yes I can Wesley,the preamble to the US constitution,the 10th and 14th

amendments. States of the union have followed suit. Ask Hawaii,their

citizens are getting healthcare at taxpayer expense including EMS rides.

Again I say,We are a better nation than most.We have the most advanced

healthcare system,even if it needs some major league tinkering to improve

it. Our citizens,deserve healthcare irrespective of a walletectomy.Wes, we

must do better by the citizens of our nation,not just our veterans long

overdue for their needs being taken care of as our citizens are. Rabbiems

RE: Councilman Proposes Payment Up Front

BeforeAmbulance Ride

Dr.Bledsoe: Healthcare is a right,our founding fathers put this in writing,

in at least the Bill Of Rights and other amendments to our constititution

..State government has followed too,with amendments specifically outlining

the protection of public health.What I see here again is an issue known as

walletectomy.We are concerned about the money.Can our patient pay? then he

deserves a ride to the hospital. We are the most afflluent county on earth

right now.We have a sizeable and shameful portion of our population

uninsured and unable to access health care. We do not need to further ration

healthcare. I find it shameful that we cannot endeavor to take care of our

citizens better,and my medics tell me they are trying to help Iraqis get a

system going.They have the right idea,take care of your people,now that

Saddam is gone. I find it shameful in our country that we decides who need s

healthcare based on a walletectomy. I don't like it when the dog and cat

hospitals in Mexico do

this and find it socially,and morally acceptable.WE Americans for one

reason,we beleive in fair play and everybody should have access to health

care.This is what sets us apart from others on this planet who don't with

few exceptions(Canada and Europe)

Respectfully,Rabbiems.P.s I am now a retired army medic who has seen combat

since Viet nam and its a touchy issue especially for Vets.

" Bledsoe, DO " <bbledsoe@...

<mailto:bbledsoe%40earthlink.net> > wrote:

It all comes down to:

Is health care a right or a privilege?

In the United States, it is a privilege. But, through unfunded mandates

(OBRA, COBRA, EMTALA) the government gives people de facto rights to

emergency health care and EMS. By making EMTALA comprehensive (very specific

definition of stabilization), the federal government makes EMS systems,

hospitals and physicians give free care or be sanctioned. Then, the

government pays less than it costs for people to operate a hospital or

medical practice. I actually sat in on a meeting where the discussion

centered around giving every Medicare patient who needed cataract surgery

$100 and send them to Dallas because we were losing $260.00 per cataract

surgery we were doing (90% Medicare). It is the typical government way of

avoiding the pressing issue and fixing the system with a case of Band-aids.

I am not some conspiracy geek--just call it as I see it. Given the way the

US operates, a national health care system would be a cross between the

Internal Revenue Service the United States Postal service.

And people wonder why boutique hospitals and freestanding surgery centers

and freestanding emergency departments are going up everywhere. You don't

accept Medicare and then you don't have to take call!! You can turn away

who you want. Before long, the only hospitals taking care of charity hits

will be teaching and public hospitals. Money follows the surgeons and

surgeons are leaving hospitals in droves for freestanding centers. I had a

call from a recruiter today who is looking for emergency doctors to staff

freestanding surgery centers after hours. They pay as much as an average

emergency department and report that you will rarely, if ever, see a

patient. They just need a doctor in house for medical legal reasons.

BEB

[Guest guest]

Wes;

We are the most affluent nation on this planet.Everyone deserves an equal

share of the health care pie.All of us do.I known many foreigners who marvel at

our system ,yet are puzzled as to why over 50million and growing lack adequate

healthcare.Something is wrong with this picture. Little Israel,with her weight

and heavy military spending burden finds adequate resources to get healthcare to

its citizens and they do pay for it heavily.They also fund their 911 system

well,their private subscription ambulance services give rides to the hospital

for their citizens.What's our excuse? This is why we got lots of Loncar's.

I see too many Mercedes Benz doctors. My dad,who was a doctor found a way to

treat all of his pediatric patients,irrespective of their ability to pay. We

lived well while he was alive.I think he would be repulsed by this evenings

discussion.He was a vet like me,Pacific theatre and a combat medic like me. He

definitely felt the citizens deserved better than

the current healthcare system to me which is in critical condition and long

overdue for an overhaul and new mindset. Rabbiems

Wes Ogilvie wrote:

The preamble is not binding.? The 10th and 14th amendments do not

address healthcare.? Plain and simple.

-Wes

Re: Councilman Proposes Payment Up Front BeforeAmbulance

Ride

Yes I can Wesley,the preamble to the US constitution,the 10th and 14th

amendments. States of the union have followed suit. Ask Hawaii,their citizens

are getting healthcare at taxpayer expense including EMS rides. Again I say,We

are a better nation than most.We have the most advanced healthcare system,even

if it needs some major league tinkering to improve it. Our citizens,deserve

healthcare irrespective of a walletectomy.Wes, we must do better by the citizens

of our nation,not just our veterans long overdue for their needs being taken

care of as our citizens are. Rabbiems

RE: Councilman Proposes Payment Up Front BeforeAmbulance

Ride

Dr.Bledsoe: Healthcare is a right,our founding fathers put this in writing, in

at least the Bill Of Rights and other amendments to our constititution .State

government has followed too,with amendments specifically outlining the

protection of public health.What I see here again is an issue known as

walletectomy.We are concerned about the money.Can our patient pay? then he

deserves a ride to the hospital. We are the most afflluent county on earth right

now.We have a sizeable and shameful portion of our population uninsured and

unable to access health care. We do not need to further ration healthcare. I

find it shameful that we cannot endeavor to take care of our citizens better,and

my medics tell me they are trying to help Iraqis get a system going.They have

the right idea,take care of your people,now that Saddam is gone. I find it

shameful in our country that we decides who need s healthcare based on a

walletectomy. I don't like it when the dog and cat hospitals in Mexico do

this and find it socially,and morally acceptable.WE Americans for one reason,we

beleive in fair play and everybody should have access to health care.This is

what sets us apart from others on this planet who don't with few

exceptions(Canada and Europe)

Respectfully,Rabbiems.P.s I am now a retired army medic who has seen combat

since Viet nam and its a touchy issue especially for Vets.

" Bledsoe, DO " wrote:

It all comes down to:

Is health care a right or a privilege?

In the United States, it is a privilege. But, through unfunded mandates

(OBRA, COBRA, EMTALA) the government gives people de facto rights to

emergency health care and EMS. By making EMTALA comprehensive (very specific

definition of stabilization), the federal government makes EMS systems,

hospitals and physicians give free care or be sanctioned. Then, the

government pays less than it costs for people to operate a hospital or

medical practice. I actually sat in on a meeting where the discussion

centered around giving every Medicare patient who needed cataract surgery

$100 and send them to Dallas because we were losing $260.00 per cataract

surgery we were doing (90% Medicare). It is the typical government way of

avoiding the pressing issue and fixing the system with a case of Band-aids.

I am not some conspiracy geek--just call it as I see it. Given the way the

US operates, a national health care system would be a cross between the

Internal Revenue Service the United States Postal service.

And people wonder why boutique hospitals and freestanding surgery centers

and freestanding emergency departments are going up everywhere. You don't

accept Medicare and then you don't have to take call!! You can turn away

who you want. Before long, the only hospitals taking care of charity hits

will be teaching and public hospitals. Money follows the surgeons and

surgeons are leaving hospitals in droves for freestanding centers. I had a

call from a recruiter today who is looking for emergency doctors to staff

freestanding surgery centers after hours. They pay as much as an average

emergency department and report that you will rarely, if ever, see a

patient. They just need a doctor in house for medical legal reasons.

BEB

[Guest guest]

Great arguments, but no legal weight.

-Wes

Re: Councilman Proposes Payment Up Front BeforeAmbulance

Ride

Yes I can Wesley,the preamble to the US constitution,the 10th and 14th

amendments. States of the union have followed suit. Ask Hawaii,their citizens

are getting healthcare at taxpayer expense including EMS rides. Again I say,We

are a better nation than most.We have the most advanced healthcare system,even

if it needs some major league tinkering to improve it. Our citizens,deserve

healthcare irrespective of a walletectomy.Wes, we must do better by the citizens

of our nation,not just our veterans long overdue for their needs being taken

care of as our citizens are. Rabbiems

RE: Councilman Proposes Payment Up Front BeforeAmbulance

Ride

Dr.Bledsoe: Healthcare is a right,our founding fathers put this in writing, in

at least the Bill Of Rights and other amendments to our constititution .State

government has followed too,with amendments specifically outlining the

protection of public health.What I see here again is an issue known as

walletectomy.We are concerned about the money.Can our patient pay? then he

deserves a ride to the hospital. We are the most afflluent county on earth right

now.We have a sizeable and shameful portion of our population uninsured and

unable to access health care. We do not need to further ration healthcare. I

find it shameful that we cannot endeavor to take care of our citizens better,and

my medics tell me they are trying to help Iraqis get a system going.They have

the right idea,take care of your people,now that Saddam is gone. I find it

shameful in our country that we decides who need s healthcare based on a

walletectomy. I don't like it when the dog and cat hospitals in Mexico do

this and find it socially,and morally acceptable.WE Americans for one reason,we

beleive in fair play and everybody should have access to health care.This is

what sets us apart from others on this planet who don't with few

exceptions(Canada and Europe)

Respectfully,Rabbiems.P.s I am now a retired army medic who has seen combat

since Viet nam and its a touchy issue especially for Vets.

" Bledsoe, DO " wrote:

It all comes down to:

Is health care a right or a privilege?

In the United States, it is a privilege. But, through unfunded mandates

(OBRA, COBRA, EMTALA) the government gives people de facto rights to

emergency health care and EMS. By making EMTALA comprehensive (very specific

definition of stabilization), the federal government makes EMS systems,

hospitals and physicians give free care or be sanctioned. Then, the

government pays less than it costs for people to operate a hospital or

medical practice. I actually sat in on a meeting where the discussion

centered around giving every Medicare patient who needed cataract surgery

$100 and send them to Dallas because we were losing $260.00 per cataract

surgery we were doing (90% Medicare). It is the typical government way of

avoiding the pressing issue and fixing the system with a case of Band-aids.

I am not some conspiracy geek--just call it as I see it. Given the way the

US operates, a national health care system would be a cross between the

Internal Revenue Service the United States Postal service.

And people wonder why boutique hospitals and freestanding surgery centers

and freestanding emergency departments are going up everywhere. You don't

accept Medicare and then you don't have to take call!! You can turn away

who you want. Before long, the only hospitals taking care of charity hits

will be teaching and public hospitals. Money follows the surgeons and

surgeons are leaving hospitals in droves for freestanding centers. I had a

call from a recruiter today who is looking for emergency doctors to staff

freestanding surgery centers after hours. They pay as much as an average

emergency department and report that you will rarely, if ever, see a

patient. They just need a doctor in house for medical legal reasons.

BEB

[Guest guest]

Whether we deserve it or not is not the question. All Wes is saying is there is

no legal binding law, constitutional article, or amendment that forces our

government to provide us with healthcare.

Vondran EMT-P

To: texasems-l@...: rabbiems2000@...: Wed, 21 May 2008

19:33:01 -0700Subject: Re: Councilman Proposes Payment Up Front

BeforeAmbulance Ride

Wes;We are the most affluent nation on this planet.Everyone deserves an equal

share of the health care pie.All of us do.I known many foreigners who marvel at

our system ,yet are puzzled as to why over 50million and growing lack adequate

healthcare.Something is wrong with this picture. Little Israel,with her weight

and heavy military spending burden finds adequate resources to get healthcare to

its citizens and they do pay for it heavily.They also fund their 911 system

well,their private subscription ambulance services give rides to the hospital

for their citizens.What's our excuse? This is why we got lots of Loncar's.

I see too many Mercedes Benz doctors. My dad,who was a doctor found a way to

treat all of his pediatric patients,irrespective of their ability to pay. We

lived well while he was alive.I think he would be repulsed by this evenings

discussion.He was a vet like me,Pacific theatre and a combat medic like me. He

definitely felt the citizens deserved better thanthe current healthcare system

to me which is in critical condition and long overdue for an overhaul and new

mindset. Rabbiems Wes Ogilvie wrote:The preamble is not

binding.? The 10th and 14th amendments do not address healthcare.? Plain and

simple.-Wes RE: Councilman Proposes Payment Up

Front BeforeAmbulance RideDr.Bledsoe: Healthcare is a right,our founding fathers

put this in writing, in at least the Bill Of Rights and other amendments to our

constititution .State government has followed too,with amendments specifically

outlining the protection of public health.What I see here again is an issue

known as walletectomy.We are concerned about the money.Can our patient pay? then

he deserves a ride to the hospital. We are the most afflluent county on earth

right now.We have a sizeable and shameful portion of our population uninsured

and unable to access health care. We do not need to further ration healthcare. I

find it shameful that we cannot endeavor to take care of our citizens better,and

my medics tell me they are trying to help Iraqis get a system going.They have

the right idea,take care of your people,now that Saddam is gone. I find it

shameful in our country that we decides who need s healthcare based on a

walletectomy. I don't like it when the dog and cat hospitals in Mexico dothis

and find it socially,and morally acceptable.WE Americans for one reason,we

beleive in fair play and everybody should have access to health care.This is

what sets us apart from others on this planet who don't with few

exceptions(Canada and Europe)Respectfully,Rabbiems.P.s I am now a retired army

medic who has seen combat since Viet nam and its a touchy issue especially for

Vets. " Bledsoe, DO " wrote:It all comes down to:Is

health care a right or a privilege?In the United States, it is a privilege. But,

through unfunded mandates(OBRA, COBRA, EMTALA) the government gives people de

facto rights toemergency health care and EMS. By making EMTALA comprehensive

(very specificdefinition of stabilization), the federal government makes EMS

systems,hospitals and physicians give free care or be sanctioned. Then,

thegovernment pays less than it costs for people to operate a hospital ormedical

practice. I actually sat in on a meeting where the discussioncentered around

giving every Medicare patient who needed cataract surgery$100 and send them to

Dallas because we were losing $260.00 per cataractsurgery we were doing (90%

Medicare). It is the typical government way ofavoiding the pressing issue and

fixing the system with a case of Band-aids.I am not some conspiracy geek--just

call it as I see it. Given the way theUS operates, a national health care system

would be a cross between theInternal Revenue Service the United States Postal

service. And people wonder why boutique hospitals and freestanding surgery

centersand freestanding emergency departments are going up everywhere. You

don'taccept Medicare and then you don't have to take call!! You can turn awaywho

you want. Before long, the only hospitals taking care of charity hitswill be

teaching and public hospitals. Money follows the surgeons andsurgeons are

leaving hospitals in droves for freestanding centers. I had acall from a

recruiter today who is looking for emergency doctors to stafffreestanding

surgery centers after hours. They pay as much as an averageemergency department

and report that you will rarely, if ever, see apatient. They just need a doctor

in house for medical legal reasons.BEB[Non-text portions of this message have

been removed]

[Guest guest]

Mike:

We are not totally bound by legal obligation to provide healthcare.Yet, I find

cities,states,and counties providing public healthcare. I am looking beyond

laws,and looking at moral,and ethical standards which obligate us to do the

right thing by the public.We have classes of citizens who do have healthcare as

the good doctor pointed out.We have had a good discussion tonight,which is very

healthy. My father was a doctor,and we lived well while he was alive.Many of his

patients children did not have government assistance,yet he took care of them

and his patients thought well of him. We did not own a Mercedes Benz either,and

we didn't care too. We have a rat race for getting affluence,and we as EMS

professionals live as paupers and stay in this job because we do love it. I am

finally puzzled as to why we are the most affluent country on this planet and we

cannot provide a sizeable portion of our population health insurance or access

to care.We as EMS providers have the

chutzpah to argue as to why or why not we should not or should transport a

patient to a Hospital. We have an obligation to people here to prevent the

spread of disease and see that citizens can see a doctor.It should be measured

out based on how full of cash your wallet is. I am disturbed with the healthcare

Mexican and or Americans get from what I regard as a below standard dog and cat

hospital that passes for adequate healthcare.I as an American have travelled

abroad thanks to the US Armed forces for thirty-three years plus and have

marveled that many countries have attempted or are taking care of their

citizens,cheif among them Israel.What is our excuse? We don't have a crushing

military budget as they do.We have a bloated bureaucracy with politicians who

have too much money and perks.(Healthcare included).We are the most affluent

nation on this planet,yet healthcare is not the priority it should be.I don't

want an Avian flu or other pandemic to hit this country and

see massive suffering. Bottom line,America is better than most countrys.Canada

even provides it citizens healthcare and its doctors are well paid.Their EMS

agencies are well funded.Nobody,bickers about who gets a ride to the hospital.

Money and the profits,are our key problem in the healthcare field as it is with

the oil companies of our country. Taking care of all classes of citizens and

wallet fullness should be our priority. I never had this though when a trooper

on the battlefield cried or yelled " Medic " as did the opposite side when I

fought in Desert Shield and Storm, we gave them good care equal to that of our

soldiers.What is the civilians excuse? Rabbiems (PS I had two dear freinds who

lost their lives in the process,plus some " ghosts " I have from VietNam that I

think of everyday who never came home alive.(Friends and family)

Vondran wrote:

Whether we deserve it or not is not the question. All Wes is saying is there

is no legal binding law, constitutional article, or amendment that forces our

government to provide us with healthcare.

Vondran EMT-P

To: texasems-l@...: rabbiems2000@...: Wed, 21 May 2008

19:33:01 -0700Subject: Re: Councilman Proposes Payment Up Front

BeforeAmbulance Ride

Wes;We are the most affluent nation on this planet.Everyone deserves an equal

share of the health care pie.All of us do.I known many foreigners who marvel at

our system ,yet are puzzled as to why over 50million and growing lack adequate

healthcare.Something is wrong with this picture. Little Israel,with her weight

and heavy military spending burden finds adequate resources to get healthcare to

its citizens and they do pay for it heavily.They also fund their 911 system

well,their private subscription ambulance services give rides to the hospital

for their citizens.What's our excuse? This is why we got lots of Loncar's.

I see too many Mercedes Benz doctors. My dad,who was a doctor found a way to

treat all of his pediatric patients,irrespective of their ability to pay. We

lived well while he was alive.I think he would be repulsed by this evenings

discussion.He was a vet like me,Pacific theatre and a combat medic like me. He

definitely felt the citizens deserved better

thanthe current healthcare system to me which is in critical condition and long

overdue for an overhaul and new mindset. Rabbiems Wes Ogilvie wrote:The preamble

is not binding.? The 10th and 14th amendments do not address healthcare.? Plain

and simple.-Wes Re:

Councilman Proposes Payment Up Front BeforeAmbulance RideYes I can

Wesley,the preamble to the US constitution,the 10th and 14th amendments. States

of the union have followed suit. Ask Hawaii,their citizens are getting

healthcare at taxpayer expense including EMS rides. Again I say,We are a better

nation than most.We have the most advanced healthcare system,even if it needs

some major league tinkering to improve it. Our citizens,deserve healthcare

irrespective of a walletectomy.Wes, we must do better by the citizens of our

nation,not just our veterans long overdue for their needs

being taken care of as our citizens are. Rabbiems RE:

Councilman Proposes Payment Up Front BeforeAmbulance

RideDr.Bledsoe: Healthcare is a right,our founding fathers put this in writing,

in at least the Bill Of Rights and other amendments to our constititution .State

government has followed too,with amendments specifically outlining the

protection of public health.What I see here again is an issue known as

walletectomy.We are concerned about the money.Can our patient pay? then he

deserves a ride to the hospital. We are the most afflluent county on earth right

now.We have a sizeable and shameful portion of our population uninsured and

unable to access health care. We do not need to further ration healthcare. I

find it shameful that we cannot endeavor to take care of our citizens better,and

my medics tell me they are trying to help Iraqis get a system going.They have

the right idea,take care of your people,now that Saddam is gone. I find it

shameful in our country that we decides who need s healthcare based on a

walletectomy. I don't like it when the dog and cat hospitals in Mexico dothis

and find it socially,and morally acceptable.WE Americans for one reason,we

beleive in fair play and everybody should have access to health care.This is

what sets us apart from others on this planet who don't with few

exceptions(Canada and Europe)Respectfully,Rabbiems.P.s I am now a retired

army medic who has seen combat since Viet nam and its a touchy issue especially

for Vets. " Bledsoe, DO " wrote:It all comes down to:Is health care a right

or a privilege?In the United States, it is a privilege. But, through unfunded

mandates(OBRA, COBRA, EMTALA) the government gives people de facto rights

toemergency health care and EMS. By making EMTALA comprehensive (very

specificdefinition of stabilization), the federal government makes EMS

systems,hospitals and physicians give free care or be sanctioned. Then,

thegovernment pays less than it costs for people to operate a hospital ormedical

practice. I actually sat in on a meeting where the discussioncentered around

giving every Medicare patient who needed cataract surgery$100 and send them to

Dallas because we were losing $260.00 per cataractsurgery we were doing (90%

Medicare). It is the typical government way ofavoiding the pressing issue and

fixing the system with a case of Band-aids.I am not some conspiracy

geek--just call it as I see it. Given the way theUS operates, a national health

care system would be a cross between theInternal Revenue Service the United

States Postal service. And people wonder why boutique hospitals and freestanding

surgery centersand freestanding emergency departments are going up everywhere.

You don'taccept Medicare and then you don't have to take call!! You can turn

awaywho you want. Before long, the only hospitals taking care of charity

hitswill be teaching and public hospitals. Money follows the surgeons

andsurgeons are leaving hospitals in droves for freestanding centers. I had

acall from a recruiter today who is looking for emergency doctors to

stafffreestanding surgery centers after hours. They pay as much as an

averageemergency department and report that you will rarely, if ever, see

apatient. They just need a doctor in house for medical legal

reasons.BEB

[Guest guest]

Rabbi:

We are arguing the same thing, from different angles. Luther King

once said, " Of all the forms of inequality, injustice in health care is the

most shocking and inhumane. " He was right. We spend 15% of our Gross

Domestic Product on health care, yet we rank 37th in health care quality.

Cuba ranks higher. At the GM plant in Arlington, more money is spent on

health care for the employees per car than the steel in the car (>10% of the

cost of a US car is due to employee health costs). I think many physicians

are overpaid. I think it is ridiculous for a radiologist to make $450,000

living in the shadows while a pediatrician works hard to make $100,000 a

year. But, while we are lamenting problems with health care, the insurance

companies are making record profits. It is just like gas-I paid $3.99 today

for Premium in Waxahachie. EXXONSHELLMOBIL are having record profits. I have

many classmates who graduated school altruistic. They were going to see

every patient, regardless of the ability to pay, or work a day in a week in

a free clinic. They found what most of us have found. The users of free and

welfare clinics tend miss appointments, not complete medication regimens,

take more time per patient, require more phone calls, try and bring multiple

people per visit, want antibiotics when they are not necessary, and tend to

sue more. They take a lot more work than an average clinic. At some point in

your career your altruism fails because you have to pay staff and bills.

So Loncar drives a Bentley. Is he worse than a high-school graduate NBA

player that has 5 Bentleys? You should go to California. The PCH is nothing

but Mercedes, Bentleys, Ferraris, Lexus, Lamborghinis-we are whom we are.

There is no constitutional guarantee for health care. Go to 's

clinic in Dallas and tell the receptionist you want the free health care

guaranteed to you as a birthright under the Preamble and 10th and 14th

amendments of the constitution. Very shortly thereafter, people empowered

by the Texas Constitution will handcuff you and take you away.

Your passion is admirable. The solution, however, is beyond all of us.

[Guest guest]

" I known many foreigners who marvel at our system ,yet are puzzled as to

why over 50 million and growing lack adequate health care. "

Everyone in this country has access to emergency medical care, even the

ones who are here illegally. It's called EMTALA. And it has spawned a

whole host of negative, unintended consequences.

The people who need emergency care often have a problem getting it in a

timely fashion because of ERs inundated with the segment of society that

uses the ER as their preferred avenue to healthcare, even for conditions

that can be managed at home by all but the lazy, stupid or woefully

uneducated.

Interestingly enough, it's that segment of society that believes most

fervently in an inherent universal right to health care.

Healthcare isn't a *right.* It is a *privilege.* Nowhere in the

constitution does it enumerate a right to healthcare, and most certainly

not a right to an ambulance ride to the ER for a free pregnancy test at

3 am and a cab voucher for the ride home.

Me, I don't see anyone having a *right* to free anything that is the

fruit of my labor. I provide a service, and that service costs money.

Whether they pay for it directly, or indirectly through the forced

coercion of my tax dollars...it still costs money. When the federal

government can learn to operate a whorehouse with an already established

clientele without losing money at it, then I'll consider trusting them

with the responsibility of providing universal healthcare.

Currently, every plan the politicians - Democrat and Republican alike -

propose is nothing more than shameless pandering to voters either too

naive or too ignorant of simple economics to know that their proposals

will. not. work.

And you know...there is absolutely nothing wrong with Mercedes Benz

doctors. They went through an arduous college curriculum for 4 years, 4

years of exponentially tougher medical school, and anywhere from 2 to 10

years of a grueling residency where they made less than many of us

paramedics. They graduate with an average of $250,000 in debt, and if

they were dumb or altruistic enough to go into primary care - one of the

most sorely needed disciplines - they get to face at least 10 more years

making scarcely more than us paramedics until they pay off those loans.

And yet, you resent the fact that they live in a lifestyle commensurate

with their education, financial investment, and contribution to society?

How...*entitled* of you.

If you want to see a good analogy of how your universal health care

system would operate (and we're already most of the way there, and

getting worse), read this:

http://thehappyhospitalist.blogspot.com/2008/03/you-are-living-in-medicare-tomat\

o.html

--

Grayson, CCEMT-P

www.kellygrayson.com

[Guest guest]

:

We have a medical system that is in grave condition for many of the reasons

you have mentioned and more.We have hospital adminstrators who can't

administrate as we do a government that cannot or is unwilling to demolish or

fix. Lately,I have seen too many nursing homes, and hospitals I would not permit

my family dog near.Both in the US and our neighbors from Mexico.Those who have

come here illegally come for many reasons.I found this out when I participated

in Operation Jump Start. We have created a system where we lack primary medical

care,less emergent care,which puts the heat on our ERs not to mention what we

bring them off the street in EMS. I am ashamed that Cuba, and Fidel at least

have the stones our politicians lack to adequately provide healthcare for their

citizens.This may be one reason why and Fidel have hung in Cuba with

popular support since 1959 and US blockades.My father was a doctor while he was

alive,and felt that citizens deserved better.We

both served as combat medics and provided good health care to our troopers

wounded or many times not,because we followed up and gave a rats butt.My dad may

or may not have been in debt as the GI bill he got and what he worked for with a

tribe of three of us got him through med school and he had a flourishing

practice.I know many doctors in hock up to their eyeballs,yet they are providing

good medical care to their patients.,I think we need better ways to manage

ambulance transport for those who do not have an emergency.We need better ways

to get citizens to testing they need.Our system is broken down and it is

failing.We have a lot greedy private ambulance service owners who could

transport the non-emergent. I know some who aren't and do just that at a

loss.Our problem is the size of a persons wallet, how much cash or plastic there

is to pay health care fees. If our military can care for its active duty

troops,why can't the civilians do the same. We need

accessible and affordable healthcare,not neccessarily universal health care. We

have a shamefully inadequate system in need of demolition and restructuring.

Rabbiems

Grayson wrote:

" I known many foreigners who marvel at our system ,yet are puzzled as

to

why over 50 million and growing lack adequate health care. "

Everyone in this country has access to emergency medical care, even the

ones who are here illegally. It's called EMTALA. And it has spawned a

whole host of negative, unintended consequences.

The people who need emergency care often have a problem getting it in a

timely fashion because of ERs inundated with the segment of society that

uses the ER as their preferred avenue to healthcare, even for conditions

that can be managed at home by all but the lazy, stupid or woefully

uneducated.

Interestingly enough, it's that segment of society that believes most

fervently in an inherent universal right to health care.

Healthcare isn't a *right.* It is a *privilege.* Nowhere in the

constitution does it enumerate a right to healthcare, and most certainly

not a right to an ambulance ride to the ER for a free pregnancy test at

3 am and a cab voucher for the ride home.

Me, I don't see anyone having a *right* to free anything that is the

fruit of my labor. I provide a service, and that service costs money.

Whether they pay for it directly, or indirectly through the forced

coercion of my tax dollars...it still costs money. When the federal

government can learn to operate a whorehouse with an already established

clientele without losing money at it, then I'll consider trusting them

with the responsibility of providing universal healthcare.

Currently, every plan the politicians - Democrat and Republican alike -

propose is nothing more than shameless pandering to voters either too

naive or too ignorant of simple economics to know that their proposals

will. not. work.

And you know...there is absolutely nothing wrong with Mercedes Benz

doctors. They went through an arduous college curriculum for 4 years, 4

years of exponentially tougher medical school, and anywhere from 2 to 10

years of a grueling residency where they made less than many of us

paramedics. They graduate with an average of $250,000 in debt, and if

they were dumb or altruistic enough to go into primary care - one of the

most sorely needed disciplines - they get to face at least 10 more years

making scarcely more than us paramedics until they pay off those loans.

And yet, you resent the fact that they live in a lifestyle commensurate

with their education, financial investment, and contribution to society?

How...*entitled* of you.

If you want to see a good analogy of how your universal health care

system would operate (and we're already most of the way there, and

getting worse), read this:

http://thehappyhospitalist.blogspot.com/2008/03/you-are-living-in-medicare-tomat\

o.html

--

Grayson, CCEMT-P

www.kellygrayson.com

[Guest guest]

You propose private ambulance services, for profit services, to carry even more

patients that end up being unpaid. How long do you think it will be before all

but the most ruthless services are left? If they really want to fix health care

they need a way of getting more people insured. I can't begin to say how this

should be accomplished but any time the government is involved I can assure you

there is no simple fix. What it boils down to is too many employers will not or

can not provide healthcare for their employees. Maybe groups of smaller

companies could leverage better rates acting as a larger group. Congress could

legislate laws to protect the right to group together rather than legislating

universal access. If more had even basic insurance that covered primary care

and prescriptions it would ease the burden on the ER. I think most people want

to pay for their healthcare but like my family we just don't have the extra

income to pay for that and the other basic necessities of life. If you have to

choose between feeding your kids or paying for insurance who is going to win?

Vondran EMT-P

To: texasems-l@...: rabbiems2000@...: Wed, 21 May 2008

20:56:22 -0700Subject: Re: Councilman Proposes Payment Up Front

BeforeAmbulance Ride

:We have a medical system that is in grave condition for many of the

reasons you have mentioned and more.We have hospital adminstrators who can't

administrate as we do a government that cannot or is unwilling to demolish or

fix. Lately,I have seen too many nursing homes, and hospitals I would not permit

my family dog near.Both in the US and our neighbors from Mexico.Those who have

come here illegally come for many reasons.I found this out when I participated

in Operation Jump Start. We have created a system where we lack primary medical

care,less emergent care,which puts the heat on our ERs not to mention what we

bring them off the street in EMS. I am ashamed that Cuba, and Fidel at least

have the stones our politicians lack to adequately provide healthcare for their

citizens.This may be one reason why and Fidel have hung in Cuba with

popular support since 1959 and US blockades.My father was a doctor while he was

alive,and felt that citizens deserved better.Weboth served as combat medics and

provided good health care to our troopers wounded or many times not,because we

followed up and gave a rats butt.My dad may or may not have been in debt as the

GI bill he got and what he worked for with a tribe of three of us got him

through med school and he had a flourishing practice.I know many doctors in hock

up to their eyeballs,yet they are providing good medical care to their

patients.,I think we need better ways to manage ambulance transport for

those who do not have an emergency.We need better ways to get citizens to

testing they need.Our system is broken down and it is failing.We have a lot

greedy private ambulance service owners who could transport the non-emergent. I

know some who aren't and do just that at a loss.Our problem is the size of a

persons wallet, how much cash or plastic there is to pay health care fees. If

our military can care for its active duty troops,why can't the civilians do the

same. We needaccessible and affordable healthcare,not neccessarily universal

health care. We have a shamefully inadequate system in need of demolition and

restructuring. Rabbiems Grayson wrote: " I known many

foreigners who marvel at our system ,yet are puzzled as to why over 50 million

and growing lack adequate health care. " Everyone in this country has access to

emergency medical care, even the ones who are here illegally. It's called

EMTALA. And it has spawned a whole host of negative, unintended consequences.The

people who need emergency care often have a problem getting it in a timely

fashion because of ERs inundated with the segment of society that uses the ER as

their preferred avenue to healthcare, even for conditions that can be managed at

home by all but the lazy, stupid or woefully uneducated.Interestingly enough,

it's that segment of society that believes most fervently in an inherent

universal right to health care.Healthcare isn't a *right.* It is a *privilege.*

Nowhere in the constitution does it enumerate a right to healthcare, and most

certainly not a right to an ambulance ride to the ER for a free pregnancy test

at 3 am and a cab voucher for the ride home.Me, I don't see anyone having a

*right* to free anything that is the fruit of my labor. I provide a service, and

that service costs money. Whether they pay for it directly, or indirectly

through the forced coercion of my tax dollars...it still costs money. When the

federal government can learn to operate a whorehouse with an already established

clientele without losing money at it, then I'll consider trusting them with the

responsibility of providing universal healthcare.Currently, every plan the

politicians - Democrat and Republican alike - propose is nothing more than

shameless pandering to voters either too naive or too ignorant of simple

economics to know that their proposals will. not. work.And you know...there is

absolutely nothing wrong with Mercedes Benz doctors. They went through an

arduous college curriculum for 4 years, 4 years of exponentially tougher medical

school, and anywhere from 2 to 10 years of a grueling residency where they made

less than many of us paramedics. They graduate with an average of $250,000 in

debt, and if they were dumb or altruistic enough to go into primary care - one

of the most sorely needed disciplines - they get to face at least 10 more years

making scarcely more than us paramedics until they pay off those loans.And yet,

you resent the fact that they live in a lifestyle commensurate with their

education, financial investment, and contribution to society? How...*entitled*

of you.If you want to see a good analogy of how your universal health care

system would operate (and we're already most of the way there, and getting

worse), read

this:http://thehappyhospitalist.blogspot.com/2008/03/you-are-living-in-medicare-\

tomato.html-- Grayson, CCEMT-Pwww.kellygrayson.com[Non-text portions of

this message have been removed]

_________________________________________________________________

Keep your kids safer online with Windows Live Family Safety.

http://www.windowslive.com/family_safety/overview.html?ocid=TXT_TAGLM_WL_Refresh\

_family_safety_052008

[Guest guest]

I just finished reading the US Constitution and the Texas State constitution.

(Makes my head hurt) but I did it, and there was not a word about health care.

Tom

  Tom & Marsha LeNeveu

Paramedic, Future RN; & RN

Fort Worth Texas

Email: TomMarshaLeNeveu@...

http://www.emstock.com/

RE: Councilman Proposes Payment Up Front

BeforeAmbulance Ride

Dr.Bledsoe: Healthcare is a right,our founding fathers put this in writing,

in at least the Bill Of Rights and other amendments to our constititution

..State government has followed too,with amendments specifically outlining

the protection of public health.What I see here again is an issue known as

walletectomy. We are concerned about the money.Can our patient pay? then he

deserves a ride to the hospital. We are the most afflluent county on earth

right now.We have a sizeable and shameful portion of our population

uninsured and unable to access health care. We do not need to further ration

healthcare. I find it shameful that we cannot endeavor to take care of our

citizens better,and my medics tell me they are trying to help Iraqis get a

system going.They have the right idea,take care of your people,now that

Saddam is gone. I find it shameful in our country that we decides who need s

healthcare based on a walletectomy. I don't like it when the dog and cat

hospitals in Mexico do

this and find it socially,and morally acceptable.WE Americans for one

reason,we beleive in fair play and everybody should have access to health

care.This is what sets us apart from others on this planet who don't with

few exceptions(Canada and Europe)

Respectfully, Rabbiems. P.s I am now a retired army medic who has seen combat

since Viet nam and its a touchy issue especially for Vets.

" Bledsoe, DO " <bbledsoe (AT) earthlink (DOT) net

<mailto:bbledsoe% 40earthlink. net> > wrote:

It all comes down to:

Is health care a right or a privilege?

In the United States, it is a privilege. But, through unfunded mandates

(OBRA, COBRA, EMTALA) the government gives people de facto rights to

emergency health care and EMS. By making EMTALA comprehensive (very specific

definition of stabilization) , the federal government makes EMS systems,

hospitals and physicians give free care or be sanctioned. Then, the

government pays less than it costs for people to operate a hospital or

medical practice. I actually sat in on a meeting where the discussion

centered around giving every Medicare patient who needed cataract surgery

$100 and send them to Dallas because we were losing $260.00 per cataract

surgery we were doing (90% Medicare). It is the typical government way of

avoiding the pressing issue and fixing the system with a case of Band-aids.

I am not some conspiracy geek--just call it as I see it. Given the way the

US operates, a national health care system would be a cross between the

Internal Revenue Service the United States Postal service.

And people wonder why boutique hospitals and freestanding surgery centers

and freestanding emergency departments are going up everywhere. You don't

accept Medicare and then you don't have to take call!! You can turn away

who you want. Before long, the only hospitals taking care of charity hits

will be teaching and public hospitals. Money follows the surgeons and

surgeons are leaving hospitals in droves for freestanding centers. I had a

call from a recruiter today who is looking for emergency doctors to staff

freestanding surgery centers after hours. They pay as much as an average

emergency department and report that you will rarely, if ever, see a

patient. They just need a doctor in house for medical legal reasons.

BEB

[Guest guest]

,

Why do they " Deserves an equal share of the health care pie. " ? Is that because

it makes the care giver feel good? What is your reasoning about this?

Tom

  Tom & Marsha LeNeveu

Paramedic, Future RN; & RN

Fort Worth Texas

Email: TomMarshaLeNeveu@...

http://www.emstock.com/

RE: Councilman Proposes Payment Up Front BeforeAmbulance

Ride

Dr.Bledsoe: Healthcare is a right,our founding fathers put this in writing, in

at least the Bill Of Rights and other amendments to our constititution .State

government has followed too,with amendments specifically outlining the

protection of public health.What I see here again is an issue known as

walletectomy. We are concerned about the money.Can our patient pay? then he

deserves a ride to the hospital. We are the most afflluent county on earth right

now.We have a sizeable and shameful portion of our population uninsured and

unable to access health care. We do not need to further ration healthcare. I

find it shameful that we cannot endeavor to take care of our citizens better,and

my medics tell me they are trying to help Iraqis get a system going.They have

the right idea,take care of your people,now that Saddam is gone. I find it

shameful in our country that we decides who need s healthcare based on a

walletectomy. I don't like it when the dog and cat

hospitals in Mexico do

this and find it socially,and morally acceptable.WE Americans for one reason,we

beleive in fair play and everybody should have access to health care.This is

what sets us apart from others on this planet who don't with few

exceptions(Canada and Europe)

Respectfully, Rabbiems. P.s I am now a retired army medic who has seen combat

since Viet nam and its a touchy issue especially for Vets.

" Bledsoe, DO " <bbledsoe (AT) earthlink (DOT) net> wrote:

It all comes down to:

Is health care a right or a privilege?

In the United States, it is a privilege. But, through unfunded mandates

(OBRA, COBRA, EMTALA) the government gives people de facto rights to

emergency health care and EMS. By making EMTALA comprehensive (very specific

definition of stabilization) , the federal government makes EMS systems,

hospitals and physicians give free care or be sanctioned. Then, the

government pays less than it costs for people to operate a hospital or

medical practice. I actually sat in on a meeting where the discussion

centered around giving every Medicare patient who needed cataract surgery

$100 and send them to Dallas because we were losing $260.00 per cataract

surgery we were doing (90% Medicare). It is the typical government way of

avoiding the pressing issue and fixing the system with a case of Band-aids.

I am not some conspiracy geek--just call it as I see it. Given the way the

US operates, a national health care system would be a cross between the

Internal Revenue Service the United States Postal service.

And people wonder why boutique hospitals and freestanding surgery centers

and freestanding emergency departments are going up everywhere. You don't

accept Medicare and then you don't have to take call!! You can turn away

who you want. Before long, the only hospitals taking care of charity hits

will be teaching and public hospitals. Money follows the surgeons and

surgeons are leaving hospitals in droves for freestanding centers. I had a

call from a recruiter today who is looking for emergency doctors to staff

freestanding surgery centers after hours. They pay as much as an average

emergency department and report that you will rarely, if ever, see a

patient. They just need a doctor in house for medical legal reasons.

BEB

[Guest guest]

Tom:

The reasons we have OBRA,COBRA,and EMTALA was because hospitals did

wallectectomys on patients and refused to provide care for a patient and or

patients with empty wallets. I remember on from Richmond,Ca when I was a rookie

EMT and the hospital was successfully sued plus laws were changed. We have a

significant portion of our population without any kind of resources for medical

care,for various and many reasons. In a country with our affluence,this is

inexcusable. This councilman in Dallas is trying to do the same thing. Only he

proposes a walletectomy on a taxpayer funded ambulance. We would have a major

league howl by various segments of our population,not to mention ambulance

chasing attorneys wishing to cash in. Our healthcare system is in critical

condition. It is in urgent need of demolition and rebuilding to one provide for

the common welfare,and be affordable so that all may pay each according to their

means or with insurance. Bottom line,we don't go unpaid. My father,may he rest

in peace would stand with me and he was a doctor who took care of his patients

and families irrespective of how much much money was not in a wallet. We need

to rethink this concept of depriving healthcare to people for any reason.

Rabbiems

RE: Councilman Proposes Payment Up Front BeforeAmbulance

Ride

Dr.Bledsoe: Healthcare is a right,our founding fathers put this in writing, in

at least the Bill Of Rights and other amendments to our constititution .State

government has followed too,with amendments specifically outlining the

protection of public health.What I see here again is an issue known as

walletectomy. We are concerned about the money.Can our patient pay? then he

deserves a ride to the hospital. We are the most afflluent county on earth right

now.We have a sizeable and shameful portion of our population uninsured and

unable to access health care. We do not need to further ration healthcare. I

find it shameful that we cannot endeavor to take care of our citizens better,and

my medics tell me they are trying to help Iraqis get a system going.They have

the right idea,take care of your people,now that Saddam is gone. I find it

shameful in our country that we decides who need s healthcare based on a

walletectomy. I don't like it when the dog and cat

hospitals in Mexico do

this and find it socially,and morally acceptable.WE Americans for one reason,we

beleive in fair play and everybody should have access to health care.This is

what sets us apart from others on this planet who don't with few

exceptions(Canada and Europe)

Respectfully, Rabbiems. P.s I am now a retired army medic who has seen combat

since Viet nam and its a touchy issue especially for Vets.

" Bledsoe, DO " <bbledsoe (AT) earthlink (DOT) net> wrote:

It all comes down to:

Is health care a right or a privilege?

In the United States, it is a privilege. But, through unfunded mandates

(OBRA, COBRA, EMTALA) the government gives people de facto rights to

emergency health care and EMS. By making EMTALA comprehensive (very specific

definition of stabilization) , the federal government makes EMS systems,

hospitals and physicians give free care or be sanctioned. Then, the

government pays less than it costs for people to operate a hospital or

medical practice. I actually sat in on a meeting where the discussion

centered around giving every Medicare patient who needed cataract surgery

$100 and send them to Dallas because we were losing $260.00 per cataract

surgery we were doing (90% Medicare). It is the typical government way of

avoiding the pressing issue and fixing the system with a case of Band-aids.

I am not some conspiracy geek--just call it as I see it. Given the way the

US operates, a national health care system would be a cross between the

Internal Revenue Service the United States Postal service.

And people wonder why boutique hospitals and freestanding surgery centers

and freestanding emergency departments are going up everywhere. You don't

accept Medicare and then you don't have to take call!! You can turn away

who you want. Before long, the only hospitals taking care of charity hits

will be teaching and public hospitals. Money follows the surgeons and

surgeons are leaving hospitals in droves for freestanding centers. I had a

call from a recruiter today who is looking for emergency doctors to staff

freestanding surgery centers after hours. They pay as much as an average

emergency department and report that you will rarely, if ever, see a

patient. They just need a doctor in house for medical legal reasons.

BEB

[Guest guest]

You should be able to get at least 3 semester hours credit in Government and

Political Science if you really did that!!

Of course, many Constitutional provisions do not mention the specific areas

they have been applied to.

But I agree that health care is not guaranteed by the either any state

constitution I'm aware of or the US Constitution.

GG

>

> I just finished reading the US Constitution and the Texas State

> constitution.  (Makes my head hurt) but I did it, and there was not a word

about health

> care.

> Tom

>

>  Tom & Marsha LeNeveu

> Paramedic, Future RN; & RN

> Fort Worth Texas

> Email: TomMarshaLeNeveu@TomMarshaLTom

> http://www.emstock.http

>

> RE: Councilman Proposes Payment Up Front

> BeforeAmbulance Ride

>

> Dr.Bledsoe: Healthcare is a right,our founding fathers put this in writing,

> in at least the Bill Of Rights and other amendments to our constititution

> .State government has followed too,with amendments specifically outlining

> the protection of public health.What I see here again is an issue known as

> walletectomy. We are concerned about the money.Can our patient pay? then he

> deserves a ride to the hospital. We are the most afflluent county on earth

> right now.We have a sizeable and shameful portion of our population

> uninsured and unable to access health care. We do not need to further ration

> healthcare. I find it shameful that we cannot endeavor to take care of our

> citizens better,and my medics tell me they are trying to help Iraqis get a

> system going.They have the right idea,take care of your people,now that

> Saddam is gone. I find it shameful in our country that we decides who need s

> healthcare based on a walletectomy. I don't like it when the dog and cat

> hospitals in Mexico do

> this and find it socially,and morally acceptable.WE Americans for one

> reason,we beleive in fair play and everybody should have access to health

> care.This is what sets us apart from others on this planet who don't with

> few exceptions(Canada and Europe)

> Respectfully, Rabbiems. P.s I am now a retired army medic who has seen

> combat

> since Viet nam and its a touchy issue especially for Vets.

>

> " Bledsoe, DO " <bbledsoe@earthlinkbbled

> <mailto:bbledsoe% 40earthlink. net> > wrote:

> It all comes down to:

>

> Is health care a right or a privilege?

>

> In the United States, it is a privilege. But, through unfunded mandates

> (OBRA, COBRA, EMTALA) the government gives people de facto rights to

> emergency health care and EMS. By making EMTALA comprehensive (very specific

> definition of stabilization) , the federal government makes EMS systems,

> hospitals and physicians give free care or be sanctioned. Then, the

> government pays less than it costs for people to operate a hospital or

> medical practice. I actually sat in on a meeting where the discussion

> centered around giving every Medicare patient who needed cataract surgery

> $100 and send them to Dallas because we were losing $260.00 per cataract

> surgery we were doing (90% Medicare). It is the typical government way of

> avoiding the pressing issue and fixing the system with a case of Band-aids.

> I am not some conspiracy geek--just call it as I see it. Given the way the

> US operates, a national health care system would be a cross between the

> Internal Revenue Service the United States Postal service.

>

> And people wonder why boutique hospitals and freestanding surgery centers

> and freestanding emergency departments are going up everywhere. You don't

> accept Medicare and then you don't have to take call!! You can turn away

> who you want. Before long, the only hospitals taking care of charity hits

> will be teaching and public hospitals. Money follows the surgeons and

> surgeons are leaving hospitals in droves for freestanding centers. I had a

> call from a recruiter today who is looking for emergency doctors to staff

> freestanding surgery centers after hours. They pay as much as an average

> emergency department and report that you will rarely, if ever, see a

> patient. They just need a doctor in house for medical legal reasons.

>

> BEB

>

>

[Guest guest]

Been off list for a few days...hope I'm not too late to play in this...

, you are correct, our system needs an overhaul...but I FEAR the results

if it is done by the same organization that put us in this place...

When you dad was a doctor, insurance was not the thing it is today...and we

didn't have a welfare state.? An office visit to a doctor cost $25 or $30 or

less...not $120...and that was a full office visit...if someone had insurance,

they took the forms home, and filed them against their insurance....to meet the

deductible....and the amount of healthcare that could happen for catastrophic

issues wasn't anything that it is today...

Then, our beloved federal government (also known as our national parents who are

there to help us out of the situations our own bad choices put us into...at the

expense of our neighbors who didn't make such bad choices...read mortgage

bailouts, welfare, medicaid, income tax inequality, etc) stepped in and started

to provide healthcare to the elderly....only thing is...since they are the

federal gov'ment...they also wrote the laws that allowed them to get ALL these

services...at a rate far below cost...I mean...it was for the overall betterment

of society after all....

So, this now works as such....Medicare pays for an EMS transport, lets say

$350....but the actual cost of that is $550...so for every transport that is NOT

a medicare patient, you have to make up $200 that the federal government won't

pay...so the actual charge to those without insurance OR those with insurance

(that isn't federal insurance...Medicare, Tricare, Medicaid) have to pay this

additional amount...this leads private insurance companies to raise rates,

decline to pay for ambulance trips, and attempt to pay less than market

rates....

Add on top of this...that Medicaid will pay $250 per transport, regardless of

the severity of the patient (and if they actually pay) the costs again shift

towards those with cash or insurance...

Now, I do take exception to the statement that people do not have access to

healthcare....this is absolutely not true, because by law, anyone can walk into

any hospital for healthcare regardless of their ability to pay...this added to

the issues above has also seriously damaged our healthcare system.?

I believe our healthcare system is currently under reform...from the inside

out....but you can bet that the federal and state governments will attempt to

stick their paws into it and screw it up even further.? With the exception of

the one serious thing our forefathers intended for our government to do

(defense) our government has proven time and time again that it is not capable

of doing anything correctly or appropriately...yet our society continues to look

to it for all the answers...as we slide further and further down the slippery

slope to socialism...and when this happens to us....where will the Canadians,

Mexicans, and Great Britains all go for healthcare????? We need to watch that so

that we can go along with them when we don't want to have to wait for the bypass

or cancer surgery...

Go search on google for the California case from about 12 weeks ago where the

insurance company said they wouldn't allow a transplant because the young girl

had no statistical chance of survival...that won't be such an anomaly if we

continue to allow our federal gov'ment to " fix " our system.

Dudley

Re: Councilman Proposes Payment Up Front BeforeAmbulance

Ride

Tom:

The reasons we have OBRA,COBRA,and EMTALA was because hospitals did

wallectectomys on patients and refused to provide care for a patient and or

patients with empty wallets. I remember on from Richmond,Ca when I was a rookie

EMT and the hospital was successfully sued plus laws were changed. We have a

significant portion of our population without any kind of resources for medical

care,for various and many reasons. In a country with our affluence,this is

inexcusable. This councilman in Dallas is trying to do the same thing. Only he

proposes a walletectomy on a taxpayer funded ambulance. We would have a major

league howl by various segments of our population,not to mention ambulance

chasing attorneys wishing to cash in. Our healthcare system is in critical

condition. It is in urgent need of demolition and rebuilding to one provide for

the common welfare,and be affordable so that all may pay each according to their

means or with insurance. Bottom line,we don't go unpaid. My father,may he rest

in peace would stand with me and he was a doctor who took care of his patients

and families irrespective of how much much money was not in a wallet. We need to

rethink this concept of depriving healthcare to people for any reason. Rabbiems

RE: Councilman Proposes Payment Up Front BeforeAmbulance

Ride

Dr.Bledsoe: Healthcare is a right,our founding fathers put this in writing, in

at least the Bill Of Rights and other amendments to our constititution .State

government has followed too,with amendments specifically outlining the

protection of public health.What I see here again is an issue known as

walletectomy. We are concerned about the money.Can our patient pay? then he

deserves a ride to the hospital. We are the most afflluent county on earth right

now.We have a sizeable and shameful portion of our population uninsured and

unable to access health care. We do not need to further ration healthcare. I

find it shameful that we cannot endeavor to take care of our citizens better,and

my medics tell me they are trying to help Iraqis get a system going.They have

the right idea,take care of your people,now that Saddam is gone. I find it

shameful in our country that we decides who need s healthcare based on a

walletectomy. I don't like it when the dog and cat

hospitals in Mexico do

this and find it socially,and morally acceptable.WE Americans for one reason,we

beleive in fair play and everybody should have access to health care.This is

what sets us apart from others on this planet who don't with few

exceptions(Canada and Europe)

Respectfully, Rabbiems. P.s I am now a retired army medic who has seen combat

since Viet nam and its a touchy issue especially for Vets.

" Bledsoe, DO " <bbledsoe (AT) earthlink (DOT) net> wrote:

It all comes down to:

Is health care a right or a privilege?

In the United States, it is a privilege. But, through unfunded mandates

(OBRA, COBRA, EMTALA) the government gives people de facto rights to

emergency health care and EMS. By making EMTALA comprehensive (very specific

definition of stabilization) , the federal government makes EMS systems,

hospitals and physicians give free care or be sanctioned. Then, the

government pays less than it costs for people to operate a hospital or

medical practice. I actually sat in on a meeting where the discussion

centered around giving every Medicare patient who needed cataract surgery

$100 and send them to Dallas because we were losing $260.00 per cataract

surgery we were doing (90% Medicare). It is the typical government way of

avoiding the pressing issue and fixing the system with a case of Band-aids.

I am not some conspiracy geek--just call it as I see it. Given the way the

US operates, a national health care system would be a cross between the

Internal Revenue Service the United States Postal service.

And people wonder why boutique hospitals and freestanding surgery centers

and freestanding emergency departments are going up everywhere. You don't

accept Medicare and then you don't have to take call!! You can turn away

who you want. Before long, the only hospitals taking care of charity hits

will be teaching and public hospitals. Money follows the surgeons and

surgeons are leaving hospitals in droves for freestanding centers. I had a

call from a recruiter today who is looking for emergency doctors to staff

freestanding surgery centers after hours. They pay as much as an average

emergency department and report that you will rarely, if ever, see a

patient. They just need a doctor in house for medical legal reasons.

BEB

[Guest guest]

Howdy Dudman:

I think have been misunderstood first. I do not think we need free health

care.What we need is means so everyone can afford healthcare.Next, my father

was a doctor and did not care how much money a patient had in his wallet. He

thought that treating their children and adolescents had a priority,the bill did

not. A way to pay was always worked out.We got some our K9 family members in

this manner,not mention other things that got fixed around our home.My father

and I also served as combat medics ,he got a combat infantry badge and I combat

medic. We both ran to help troops and civilians who cried " medic " ,and we never

thought twice about it.Our medical system requires demolition.It needs

rebuilding.When we put 911 ambulances in our cities we knew abuse was to be a

part of the system. When we as 911 medics have an unspoken contract with the

citizens who call us we come. What is at the bottom line of this argument is

money and who pays the bill.When someone insists on wanting

ambulance transport we cannot say no.I fear the legal consequences for a no

answer,especially when ambulance chasing lawyers are looking to cash in for fame

and money.Yes, the system is in need of reform,paying up front for an ambulance

is not the solution. I think we as Americans make some sacrifice that the least

of us can get a ride on an ambulance. I also feel we can get our insurance

moguls to start insuring people each acccording to their means and pay doctors

and nurses etc for their services.No, I am not giving a free ride to people,all

need to pay each according to their means.PS I recently retired as a combat

medic rabbiems