Entitled to what exactly? EMS reform too!

[lifevsdeathuk]

If you watch television, then you are given to believe health care reform is in the offing. God knows Ted Kennedy wrote articles about such reform and how it might help EMS in EMS Magazine decades ago.

But what reforms might we wish for?

Suggested list:

Decide if we are public health or public safety once and for all?

Let us bill for service rendered not by the call?

Let us bill for more than just 60% of expenses by employing a volume quota instead?

Establish a fair price for ALS, ILS and BLS in cities, suburbs, rural areas and wilderness and use it to set bills for service?

In plain English, unbundle us from the Medicare and Medicaid mess?

Set one paramedic standard for all 50 states and give one written exam for those training to be or remain one?

Set one set of standards fro EMT-B practicals for all 50 states?

Decide whether citizen first responders should get a tax break for volunteering to help us out?

Anyone have some other items?

[PhillyRube]

Set one paramedic standard for all 50 states and give one written exam for those training to be or remain one?

Set one set of standards fro EMT-B practicals for all 50 states?

Decide whether citizen first responders should get a tax break for volunteering to help us out?



I agree!!! Be nice instead of jumping thru hoops if you move. No one else but EMS gets hamstrung.

[RyanEMVFD]

They tried setting the same standards for paramedics and emts across the nation a couple of years ago. Most states saw it as a downgrade for what they could do and didn't want to do it. You would almost have to find the state that has the highest amount of stuff for say a medic and try to convince the other 49 states to spend the money to do the same. I know Texas didn't want to since it meant a lot of medics wouldn't be medics and felt it would limit what Texas medics could do.

As long as each state has it right to do what it wants this seems like an impossible mission.

[dr-exmedic]

As long as each state has it right to do what it wants this seems like an impossible mission.
Maybe, maybe not. Only 100 years ago, physician education was pretty much the mess we have now in EMS (it's really funny to hear people of the day writing about how so many medical schools are really degree mills, giving an MD to anyone who could pay tuition, then think about the modern medic mills). What we really need is an EMS version of the Flexner Report (http://en.wikipedia.org/wiki/Flexner_report), which led to the medical training we have today: something that would really crystallize the problem in the public's mind and get them demanding that something happen. If it's just us advocating for change, it will take much longer than if a bunch of non-EMS constituents start bombarding Congress with demands for change.

Of course, it's not going to happen overnight either way.

[RyanEMVFD]

It doesn't help us any when some states are dictated by a medical director while some are dictated by Legislature.

[emt161]

And others are dictated by fire unions and fire chiefs.

[fly5650]

Bundled services in EMS is another failed mission of the insurance industry like HMOs. We do not have the same overhead as hospitals and thus our itemized rates for services provided would not come close to a hospital bill for the same itemized services.

This would allow EMS to run as it should run: BLS as first response, ALS intercept when necessary (ahhhh this could be contentious haha). The bundled services under the new fee schedule made intercept services nearly impossible to run.

Before this something even more drastic has to take place, and this has to do more with private services that provided non-emergent and/or inter-facility transfers. Currently, ambulance companies end up having to take the financial hit when a claim is DENIED by Medicare based on medical necessity, but often times services are forced to take this hit to please their customers. The facilities that order transfers which end up being denied based on medical necessity should be responsible for the bill. In other words not only should ambulance companies not have to accept assignment, but they should be able to bill whatever is not paid to the ordering facility.


Obviously this is a pipe dream under this administration.

Anyone agree/disagree??