- Joined
- Sep 28, 2002
- Messages
- 39,798
Very good post, medic. I didn't want to give the impression that the scam that was going on between THAT ambulance company and CHOP (or the person coordinating the transfer) was indicative of all. I will point out that the fees that they charged were in line with "norms".
True, my cousin, a FI-ah chief in Nahtahn, Mahss (Norton) said that the only time they get full fee is from auto insurance companies. They dispatch all the equipment to an auto accident and bill accordingly.
This was, in intent, to fund emergency services with vitally needed revenue ...what it's evolved into is a free lunch ..with breadcrumbs of the past graduating to carrying the load.
You make good points that someone ..inevitably ..has to pay. Now here's the rub. Suppose your city/municipality manages to assemble a large fleet of ambulances ..that on even the worst day, short of a massive local disaster, won't see routine service? Suppose they keep all the old ambulances and just build bigger buildings to house them? Hire more standby staff to man them?
Does the public or private sector deserve to pay for that excess (let's assume, for the moment that this is the case)? Now just spread that around with a pinch and a dash throughout the whole 'scape and you can see that, in general, there's a very comfy cushion between need and costs ..and it's always in the most expensive modality available ...typically without a competitive element to it at all.
No one tries to do this in an economical manner. The proportions in shear cost make sweating any sense of "economy" or "savings" inconceivable. Hence ..no one does. Whatever bill their presented with ..they pay ..they're just passing it on. Want a new truck? $750k? You buy it. You're just passing it on.
Now start at the top of the chain with everyone that supports the services doing the same thing. Everything in the most expensive manner possible.
What do you get? A self feeding entity that is never full and always hungry. Yet ..no one is at fault and everyone else is supposed to embrace it with open arms with an open wallet.
True, my cousin, a FI-ah chief in Nahtahn, Mahss (Norton) said that the only time they get full fee is from auto insurance companies. They dispatch all the equipment to an auto accident and bill accordingly.
This was, in intent, to fund emergency services with vitally needed revenue ...what it's evolved into is a free lunch ..with breadcrumbs of the past graduating to carrying the load.
You make good points that someone ..inevitably ..has to pay. Now here's the rub. Suppose your city/municipality manages to assemble a large fleet of ambulances ..that on even the worst day, short of a massive local disaster, won't see routine service? Suppose they keep all the old ambulances and just build bigger buildings to house them? Hire more standby staff to man them?
Does the public or private sector deserve to pay for that excess (let's assume, for the moment that this is the case)? Now just spread that around with a pinch and a dash throughout the whole 'scape and you can see that, in general, there's a very comfy cushion between need and costs ..and it's always in the most expensive modality available ...typically without a competitive element to it at all.
No one tries to do this in an economical manner. The proportions in shear cost make sweating any sense of "economy" or "savings" inconceivable. Hence ..no one does. Whatever bill their presented with ..they pay ..they're just passing it on. Want a new truck? $750k? You buy it. You're just passing it on.
Now start at the top of the chain with everyone that supports the services doing the same thing. Everything in the most expensive manner possible.
What do you get? A self feeding entity that is never full and always hungry. Yet ..no one is at fault and everyone else is supposed to embrace it with open arms with an open wallet.
