Medevac Helicopters....

[MarkC]

You're being obtuse.
I'm not disputing the operating cost of a helicopter, I'm saying that charging ten's of thousands of dollars for medevac is wrong.

When I used the cost of food as an example, I'm talking more along the lines of "So, you and your children are starving and going to die? You need some of this bread. Only $500 a loaf. You know,we have to figure in the cost of making it, transporting it, etc. You should be grateful to pay."

 

[Gary Allan]

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sk them to explain to you what is required by the FAA and the various equipment manufacturers to equip the aircraft of medevac operations. Ask them what their annual insurance expense is.

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Exactly

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It's a funny thing about non-profit or not for profit enterprises ..there's profit being made all around them. The problem that we have now is the impression of non-profit where many of our medical sectors are not non-profit ..yet the support services may be. Even with non-profit status, the institution becomes a horn o' plenty in watershed gain.

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None of those "required" suppliers seem to have any humanity in their manner of conducting business. Isn't life important to them? Can't they work for less ..get less profit ..do without ..to afford the saving of more lives?? Nope ...you pay full boat to allow everyone else to pay the freight. Ever see a discount ambulance? Firetruck? They save lives too ..but the companies that make them seem flush enough.

See what I mean? WE are the only ones who are supposed to sacrifice with $$$ when anything medical is involved.

 

[rotorray]

My final statement on this subject is if you or your family are ever unfortunate enought to be involved in a life-threatening situation you will NOT be thinking about how much it is going to cost you to save your life. Your attending physician won't either. Neither will the other 8-10 technicians trying to save you. Quality of care necessary to save your life is the ONLY consideration, as it should be. If you don't want to make the investment in your life that's your choice. You seem to have made up your mind that $91K or $50K, or whatever amount you choose, is outrageously expensive to save your life. I guarantee you, however, that when your life is on the line you won't be thinking about your checkbook and, hopefully, neither will your doctor. Instead you will be literally SCREAMING for someone to help you. I've witnessed it many, many times.

I can also guarantee you that, eventually, you will need the services of a police officer. I only hope you survive the experience but fear not, the police won't bill you for their saving your life.

I'm also sure that if a doctor or law enforcement officer failed to do this or that for you, and you or a family member lost his/her life because of it, you, YES YOU!, would be talking to a lawyer about suing for "damages" because they didn't do EVERYTHING that was necessary. Who will pay for any settlement? The people who use the services, of course. This will, of course, drive up the cost of subsequent services rendered. The very services which you complain are "outrageously expensive."

Time to go back and talk about OIL!

 

[Gary Allan]

..now I'll give you my last add here. Just who is putting the pricetag on a life? You're arguing about who gets to pay the bill. I'd say that the equipment manufacturers, their salesman, etc..etc...as well as everyone else involved with the whole enterprise appears to put the cost of saving a life very high. Why is that? Isn't it important to all of them too? Then again, they can afford it.

If you've got the bleeding heart vision from the victim end ..where's the bleeding heart vision from the fat cat end of it too? The medical community, and ancillary supporting services, has gotten a blank check for so long ..it has become an entitlement in the form of privately funded/administered socialized costs.

What do you do when you run out of gas? Order an Escalade?

The squids are running out of ink to write the checks.

 

[74DartSport]

Ok, I've been for a ride in medivac. From Mountain Peak in Vernon, NJ to Morristown Memorial. St Clare's Sussex didn't have a Level 1 neuro trauma unit so I got the flight. Don't have the records here in front of me but my wife seems to remember ~ $3000 for the flight; the neurosurgeon who operated on me 3 times in >12 hours billed my insurance $125,000.00 and they paid him $22,000.00 .

And no I don't begrudge anyone a penny of it. I'm thankful every day that I'm alive and not a vegetable.

 

[BradC]

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Yep, it's a matter of prestige. A hospital with a helicopter is going to have more business than the one without one due to the perception of the potential patients.

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The way it works here is that there is one helicopter that serves all the hospitals in the area that have helipads (currently three hospitals).

The air ambulance service is owned and operated by a private company. Service is $750 per flight.

 

[JHZR2]

The problem is that the market will support what people are willing to pay. Its not a problem per se, except for the fact that most likely, the fees for this service are more than gouged.

People will pay it when an important life is on the line, without thinking twice. This is why they can charge what they do... Nothing wrong with it, except when something oming from a non-profit, good for the populous-centric entity gouges prices in the name of the market. Meeting costs is one thing, reasonable profit, OK... gouging, which is the name of the game in the medical areas, is another.

My problem is that the doctor's and lawyers monopolies are ridiculous in what they charge for their so-called "intelligence". As an advanced degree engineer, with numerous doctor and lawyer friends, including a few who were engineers in their undergraduate training, I unfortunately know this is true - from THEIR mouths, and from reviewing their work, training, books, etc. Ive looked at the work, heck, Ive analyzed and done design work on medical systems. Tough? nope... Smart? some are, many arent.

Its a shame that there are much more knowledgable people out there, with far harder and more thurough training, that only charge far less for more work.

Free market? Sure. My choice, OK. But as you see the boat payments being made with little to no real value being provided, even in the pseudo-emergencies, it really does get to be disusting.

JMH

 

[moribundman]

In Germany, lifeguard flights are 100% covered by health insurance. You won't even see as much as a bill.

 

[Gary Allan]

We don't have a free market in medical care. You "may" be able to choose your doctor/group ..but there's no doing anything for you "for a few dollars less".

The funny money losses are spread among the fee paying customers. Do you see any alternative offerings that will take LESS than your insurance will pay??? No, they all get the same green regardless of who you go to...hence there is still no incentive to economize ...we still foot the bill.

Effectively, you inflate a bunch of pro bono services ..which you compound on more inflated services ..and claim inflated losses ..since you're dealing with "funny money" ......of which you'll get an elevated percentage of in REAL $$ when the spin dust settles.

The medical community, as a whole, is still living a fairytale existence ..and may, due to demographics, manage to extend the party for a good while longer.

It's like the architects who design new schools and accept a % of the project. They always design a big project.

Nobody is sweating it out in the medical field. The country is going down in (relatively) flames economically and they don't skip a beat.

I worked in a non-profit organization (I think most hospitals are now owned by for profit entities) and got a gander at the fairytale expenses. We would get $3500/month from NJ for their kids. We charged off $450 for their 2, 3, or 4 person room (that's up to $1800/month for a room - not a hotel suite)...on a building that's been paid for for over 70 years. Over the total units that the institution had, they had a 3 million $$ maintenance budget. Any individual unit was alloted so many hours. If you over did your allotment, you got fairytale charged for it ..but no one got credited for the hours that they didn't use due to you overdoing your allotment.

Basically one lie after another in inflating costs. A game of hide the baloney.

Sorry. I've just seen too many "institutions" that have done more work at serving themselves than they do in the serving those who they are supposedly benefiting. The weight of the organization makes it a hungry monster.

 

[rotorray]

"I think most hospitals are now owned by for profit entities" ;... on a building that's been paid for for over 70 years."

And what is wrong with someone investing their money and expecting a profit? What's unreasonable about that? And, WOW, a facility that's been paid for for over "70 years." I'm sure it's been upgraded many times during that 70 years at considerable expense to someone who invested THEIR money. After all, the money had to come from somewhere. When you invest YOUR money do you not expect to make a favorable return on it? I think that's what keeps the stock market running, and most all "investments"...investing for profit. I'm sure you don't want the value of your home to depreciate, or maybe you do. Or your savings, 401Ks, whatevers. I don't get your point. You have a choice. If you feel so strongly about the high cost of medical care you should flat REFUSE IT! Starting TODAY, don't go to a doctor, dentist, proctologist, or any medical technician. It's that simple. Let nature take its course. Not too long ago it used to be people could expect to live until they were 35 years of age. I wonder what has extended it to the point it is at today? If you're older than 35 you owe your longevity to medical science, not using dino oil in your car.

The doctor bill was $125K and he is paid $22K. Wow. He sure made out like a bandit on saving that life. Let me see...1 life saved for the value of a Prius! Of course, the patient was operated on 3 times in 12 hours and lived to tell about it. I'm sure his family is glad he's still around.

I'm amazed at the little value some folks put on life. I can only surmize that you have NEVER been in a life threatening situation. If you had you surely would not be saying what you are saying. When a simple absessed tooth can turn into a brain infection you had better be thanking someone that you have access to the quality medical services which are available to us today, no matter what they cost.

Now, let's get back to talking about synthetic oils vs. dino. We've pretty much beat the doctors to death.

 

[Auto-Union]

I think part of the peoblem is that we, as a group, value money so much that life isn't worth living without it. Many would rather pass it on to their heirs than recive some extreme treatment that may or may not work.

 

[Gary Allan]

My reference to a paid for building is with a "non-profit" organization. Trust me. Most of your non-profits are corrupt in one form or another. They serve the institution. Anyone remember what the Red Cross wanted to do with all the donated money from 911? They wanted to "administer services" with it (counseling and whatnot). Services that they would be bleeding off all the money with. Very revealing view if you picked up on it.

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I'm sure you don't want the value of your home to depreciate, or maybe you do.

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I don't, however, profess that my house is "for the good of mankind" in my investment. It's good or bad for ME. I attach no false nobility to my greed in this matter. I don't see why the medical community does either

They still say "show me the money!!".

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You have a choice. If you feel so strongly about the high cost of medical care you should flat REFUSE IT! Starting TODAY, don't go to a doctor, dentist, proctologist, or any medical technician.

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No, I don't have a choice. If I want medical care I'm going to pay the "prevailing rate". There's no alternative competitive offering in the market place. It's a monopoly. No matter where I go they don't offer a discount. Whether they're lousy or great ..they get paid the same.

So, I'm offered an ever increasing insurance premium while my real wages are stagnant or receding (as are most everyone else's).

...and you want me to make this sound warm and fuzzy?? Why

A hospital is a facility. It facilitates money making for practitioners. Sorta like a "rent-a-bay" for broken people to be fixed by mechanics. The more equipped the rent-a-bay ..the more expensive the repairs the mechanics can do. That's why the most advanced mechanics flock to the most advanced rent-a-bays. They can make more money that way.

That's the way I see it

Is this one of those "the cup is half full" things

 

[Cutehumor]

There are sensitive people when it comes to money and hospital costs. I had a patient get angry that I was replacing an IV bag with 100cc left before my shift was over so the pump wouldn't beep that it was empty during change of shifts. He was telling me how the last time he was in the hospital, he got a bill for $36k. "These IV bags are $500 a piece", he says. (lie) Mind you, this guy didn't have health insurance either. I told him when they take him off the iv fluids and can tolerate/eat regular food. He'll have some IV fluid left in a bag. I told him he can take the bag home and drink it if he doesn't want to waste it and get his $500 worth.

With medevacs, I've seen illegals get airlifted to the hospital who have been ejected from their car. I'm sure the costs are distributed to those who have insurance. There is always one person with the family that speaks perfect English who is on me about their health care. One guy got his fractured jaw popped back into place at the bedside. Lidocaine,versed, and morphine is all he got. They told them at first he was supposed to have surgery. I guess the surgeons changed their minds. She was asking me was it because he didn't have insurance and they had no money to pay. She was pretty upset.

 

[Shannow]

I'd mention that at $1200 per hour (quite a realistic and reasonable rate IMHO), a single lift costing $50k would obviously take 41 hours, and $90k would take 72 hours, but it would be pointless.

I'd be prepared to pay all costs including overhead and reasonable profit, and then make an equivalent donation of the same amount to a charity nominated by the company...but "fishing" for people who will pay a ludicrous bill based on the fact that others won't/can't pay is wrong...morally.

Anyway, I wont say those things, I've daedra to slay and welkynd stones to gather.

 

[JHZR2]

[quoteThe doctor bill was $125K and he is paid $22K. Wow. He sure made out like a bandit on saving that life. Let me see...1 life saved for the value of a Prius! Of course, the patient was operated on 3 times in 12 hours and lived to tell about it. I'm sure his family is glad he's still around.

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Show me a smart doctor and Ill say that they are worth it. Show me just another med school grad getting money for their boat payment, and Ill say they are gouging. If the doctor was really so bad off for taking $22k for 12 hours worth of work, then he would have rebilled the patient or insurance company... or else gone out of business. Nobody forces the doctor to work in that industry to 'only' get $22k for 12hr worth of services rendered.

Again, when I see that doctors are really smart (try biomedical or biochemical engineering in undergraduate instead of biology), Ill say that their time is worth a little more than the average person. Life, well what is the actuarial value? $6MM/life, IIRC. Valuable for sure! And does anybody want to feel sick, feel lousy, be in pain, die? Nope. So people will pay because to every person, their own self is #1. The ability and desire to do this, coupled with a "free money" system, facilitated by the fact that insurance allows people to obtain significantly more costly services than the person could afford, allows prices to raise up as desired. Additionally, doctors know how to play the game. Insurance pays one way, so they bill another to eek out every penny they can.

Smart? I have my doubts most of the time. Serving the good of man? The only man they're serving is themself. Monopoly? you can be sure. Value for the time? definitely not for 99% of services rendered.

Nope, the medical monopoly, just like the lawyers' monopoly is just a convenient way to suck excessive amounts of money from people because of laws or procedures that don't allow the common person to take care of themself.

JMH

 

[Gary Allan]

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The air ambulance service is owned and operated by a private company. Service is $750 per flight.

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That figure's a bargain. That's close to what an ambulance ride cost here if they put an 02 mask or you have an IV installed. It graduates it to "advanced life support".

My daughter, with some asthma condition, was being transferred to Children's Hosp of Phila. The attending was calling CHOP and said that he would contact the local ambulance company (the ones that have the 9 idle units 24/7/365) when the person on the other end said "We'll just send our transport". A private ambulance company showed up ...She was on O2 at the hospital. They placed her in the ambulance and drove to CHOP. She was in no shape, way, or form in any state requiring "advanced life support" ..but because she had O2 ..they billed $1700 vs. $1100 for the standard transport. My insurance only paid $150.

I called the ambulance company and not only complained about the $500 gouge for ROUTINE transport because of the 02 ..but the fact that BECAUSE I was covered (but under covered) by insurance I got to PAY THE FULL BILL, while #@$%!/BC = Medicare/DPW/ or anyone else would have paid about 50-60% of the listed fee. I asked "what's wrong with this picture?". So, everyone else got to pay about $600+/- ..but from me and my insurance they want $1700.

When I countered that I could have hired two agency nurses and rented a motorhome for less ...they agreed.

I then stated that I was going to research the relationship between the hospital and the private ambulance company with the Attorney General.

I never received another bill.

 

[rotorray]

Gary Allen wrote, "No, I don't have a choice."

Sure you do. I'll say again, if you don't like it, DON'T USE IT!! It's simply that simple! No one is forcing you to do ANYTHING. You don't like ambulance costs for you asthmatic daughter? Drive her yourself or rent the motorhome. That's surely a safe transport for someone in breathing distress. I'm suprised you're complaining about their charging you additionally for giving your daughter supplemental oxygen while she's in breating distress. Seems to be proper treatment for someone who cannot breath or cannot get enough oxygen on their own. I'll bet if they hooked up the nitrogen by mistake, and she suffered brain damage, you'd be suing them for not giving the proper oxygen when that is what she needed. But I digress. There are a LOT of alternatives. You don't like doctor fees? go to the nearest indian reservation and see the local shaman. Become a physician and treat your own for free. The choices are yours. You just seem to take the most efficient, capable, successful choice and then complain about the cost after you receive successful, possibly life saving, treatment. Like I said in one of my earlier posts, you get the service done and worry about the costs later, and be happy that you or your daughter are still alive to do that. Hope she's better, by the way.

 

[Larry the Cable Guy]

Where I live we really appreciate the availability of MercyAir as well as the Sheriff's Air Rescue Helos.

Ground transport to the nearest trauma center (Loma Linda) takes about one hour rolling code - and that's a relatively rough trip on the winding mountain roads. It's about 15 minutes pad to pad by air - weather permitting - and without the patient being tossed around inside an ambulance. I have heard that the flight is $6k to $10k. Ground transport is about $1k. Either way is dirt cheap when life is in the balance.

We recently lost a helo & crew, in the Cajon Pass area, that was returning to base. It's hazardous duty even in good flight conditions.

 

[74DartSport]

rotorray rrote- "Sure you do. I'll say again, if you don't like it, DON'T USE IT!!"
I've got a beef the same as others. Relative had hospital care of a certain type. Billed my insurance, EOB came back- Billed 3.5K, allowed .9K but not paid due to type of service. Hospital sends me bill for 3.5K, I ask nicely since I gotta pay out of pocket I'd like to pay the 900 bux. No way no how.

I paid the 3500.

 

[Gary Allan]

Put them on the $5/month club for an eternity. That's what I do. They are absolutely powerless to do anything about it as long as you pay every month. I set it up on Quicken Paybill.

This isn't to give the impression that I have any ill feelings to any practitioner in any capacity (doctor, nurse, EMT, med tech). The problems that I cite are systemic in terms of funding medical treatment and would be emergency services. The "noble deeds" myth has been promoted for a long time ..and the facade is well entrenched.

I think you too will see the collision of having very high standards and running out of money. This you will see in your public education sectors and municipal services sectors. They too have an assured way into your wallet and, out of no "greed" per se~, are going to continue to "go about business" in the manner that they always have. This "business as usual" attitude is going to get VERY expensive. This is exclusive of any localized "Empire" or "Institution" building that may be going on. Nobody appears to leave anything compact and economical. They insist on seeing it grow ..even when they can't find a personal motivation for doing so.

I had a personal talk with the CEO-general manager of the local hospital. This is after I sat with ONE other patient in the ER for over 4 hours. The triage nurse didn't even determine the extent of my injury in that time. The public relations nurse and the nursing supervisor listened to my rant. I assured them that no treatment was going on in the E.R. and that all the personnel would be standing there in a leisurely manner putting notations on clip boards. She became rather flustered with me.

Apparently about 4 senior citizens were brought in by ambulance and were occupying 4 of the treatment areas. What they were really waiting for was the paperwork to make its way around and for someone to take them to the CCU or the ICU. Meanwhile, while doing "nothing" to them, everything else was put into a holding pattern ..meaning me with my 4" gash and the other patient, another cut victim, playing with outselves.

When the PR nurse said that the GM/CEO would talk with me ..they led me through the ER treatment area. Sure enough, no treatment being conducted ...and the only thing moving were pens and clipboards. The seniors were by themselves ..monitors beeping away ..IV's dripping or infusion pumps running ...respirators cycling ...and no one standing or doing anything with them. Lots of leisurely paced stuff going on. I was informed that they were waiting for call backs from the patients doctors. I said, "So? What does this have to do people who have injuries within your reach and ability to treat NOW? No one is doing anything productive here in terms of treatment. The doctor is sitting on his behind with a pen. 6 nurses (or other qualified staff) aren't needed to watch 4 patients.". I got silence as a response.

When I talked to the GM/CEO I said "You could put a "Doc in the box" right next door and unload 90% of the lag time that you have with patient throughput. Heck, GIVE HIM THE FACILITY, and let him worry about the costs incurred. He'll walk out a millionaire and people won't have to get NO TREATMENT from an emergency room. He questioned if I got the impression of ER activity from television. I had actually not ever seen the show at that time and got most of my insight from nursing friends that worked in bona fide trauma units (Lehigh = and in Phila) ..and their views on how lame some people who come to the ER are in terms of services that they seek.

My final word on the matter was that if there was suffering within your reach there was a moral mandate for it to be relieved. That doesn't mean "at your convenience". If your staff and or procedures can't comply with that simple tenet ...get other people in the positions and/or alter the procedures.