October 23, 2009
When Reform Doesn't Fix What's Wrong
Firefighter and EMT Michael Morse, as he works to get his body back into occupational shape, reflects on the future of healthcare in a system that calls a city ambulance rather than permitting patients to take their cars to another building in the same medical campus:
... The medical community is as clueless as the rest of the population who abuse the 911 system on a daily basis. I can hardly wait for whatever healthcare reform comes out of Washington. Something tells me I'll be driving people to Physical Therapy appointments, at taxpayer expense.
And then what happens when the heathcare system planners work the cost of such transportation into the total cost of the therapy and begin denying treatment in some cases because the total expense is too high? I know, I know. It'll never happen. We can trust our government and its functionaries to be reasonable.
I think the answer herre is twofold, "potential liability" and "everyone has to eat".
I don't know a lot about the liability end, or Whether it is real or imagined. But, I suppose that when people are in your "care and custody" you have to be extra careful.
From there it is only one step to the ambulance. I am sure the ambulance people need to make a living, so it is hard to see them refusing. I imagine they underscore the liability threat as part of their marketing.
Posted by: Warrington Faust at October 23, 2009 2:12 PMI have to admit I get a big kick out of seeing my posts linked here. I never expect it and am usually well into the post before I realize I'm reading about myself! Thanks for noticing.
This is a complicated situation. Insurance companies provide ambulances, government supposedly provides a proper 911 response to emergencies. The line has been blurred over the last decade. Cash strapped municipalities, if not encouraging routine medical transport calls to be channeled through the 911 system, certainly don't discourage them.
True emergencies do happen, resources often are not available as as taxpayer funded rescues are chasing insurance money that ends up in the general fund.
Posted by: michael at October 23, 2009 2:29 PMI meant to write "insurance companies PAY FOR ambulances." At one time insurance companies did provide fire services to burgeoning cities, but that was a disaster as competing fire companies fought in the streets trying to "get the job," as the building burned to the ground. But that is another story.
Posted by: michael at October 23, 2009 2:39 PMMichael writes:
"competing fire companies fought in the streets trying to "get the job," as the building burned to the ground. But that is another story."
And a rather good story it is. There is a book about it "Gangs of New York" (the movie is only slightly related to the book) "Fire Companies" were simply gangs then.
Posted by: Warrington Faust at October 23, 2009 6:48 PMThe other aspect to the practice of "ambulances as taxicabs" (completely secondary, it should be emphasized, to the harm caused by the diversion of the ambulance to a less urgent situation) is the disrespect by elected officials of the tax dollar. Who cares if loose guidelines lead to an expensive overuse and abuse of ambulances? Someone else is paying.
[Once again, thanks to Michael M. for highlighting these abuses.]
Posted by: Monique at October 23, 2009 11:52 PM