Guest guest Posted September 13, 2004 Report Share Posted September 13, 2004 ... I'd have to totaly agree with you. I like what you had to say. I absolutley love EMS, I can't think of a better job. But because I only make $8/hr when I'm on the truck and a measley $2.50 / hour when I'm on call... I have been forced to go back to college in order to obtain the all mighty bachelor's degree that so many people find invaluble. I am currently going for a sports medicine degree and to be honest with you... I cud care less about the Exercise/Sports sciene field but because of the EMS pay today I can't afford to like EMS enough. I work for a company (Which I will not name) that is great. The owner is a paramedic and they treat us nice... however the pay sucks. I know the owner is a millionare time and time again because i have seen/heard his type of living. So if he has soo much why is it that he only pays the paramedics and other staff below him a very small pitance? Why is it that we are the ones who take the long distance BS... excuse me... I meant the BLS transfers, the 4AM dialysis transports, and then we get volunteered to travel to dallas - san antonio - austin at all hours of the night? How come for as much money as we are making our bosses that we aren't seeing it? Why do they live like kings while we a struggling to make rent and car payments? I know that the world sucks sometimes and we can't fix everything. Is it too much to ask for an hourly wage that prevents us from having to work 96hrs a week? I'm in it with you ... this EMS pay is rediculous. I wish I cud afford to stay in the field full time... because it would make my life so much better and then I might be able to wake up with a smile instead the ringing of a bill collector in my ear. ......... Any comments? -Txbasic > How many times have I heard this, after asking a " patient " to sign a > billing form..... " What do you mean bill? What do I pay taxes for? " > > > sigh.......... > > > > > > Excellent point Barry. One way I heard it described before > (potentially on this list) is that our taxes should provide for its > availability...but the end user's should provide for its use. > > > > Such as a water department. The city taxes pay for the water mains, > wells, treatment plants, etc. But if I water my yard once a month and > you re-fill your 10,000 gallon swimming pool twice a week, why should I > have to pay for your usage? The same really holds in this entitlement > vs. service argument. > > > > Dudley > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2004 Report Share Posted September 13, 2004 Here's a problem with that Mike...some people call an ambulance simply because they don't have money for a cab...or friends to give them a ride.... Meredith Re: EMS Pay Way to stir the pot Dudley..... Just kidding. This thread takes a turn to Paramedic Initiated Refusals, a thread that has in the past brought up many good points, not the least of which is the need for training on the paramedics part. Many studies have shown that Paramedics are not the best in the world at defining what necessitates emergency room treatment, or hospital admission. That said, the training would have to improve to the point where field technicians could effectively evaluate which patients require the ER and which ones require their doctors office, and transport them accordingly. We spend a lot of time trying to figure out how to increase our reenue, which I will agree is imperative. But another thing to look at, is reduction of expenses. One of the ways to do this, is to reduce the number of unnecassary transports by MICU buses. Alternative transportation could be a med-assist van, or even a taxi. The expense is less on the service, and if the patient only needs trasnport to thier physicians office, it aides in reducing strain on the ER. We shouldn't have to do more with less, but we should have the opportunity to do more with what we have right now. Same revenue, lower expenses. Just my humble opinion, Mike > > Danny, > > Not a bad can of worms to open...as our rates (on average-fully loaded) are higher than $600. This is another factor in my argument. If we could get everyone to pay the $600 (or even $450 in a lot of locations) we would be much better off...but M'care, M'caid, Tricare (notice the theme: All gov't provided healthcare) won't pay even close to the real cost so we shift the cost to all others. Some insurance will pay but it continues to be the non-insured and the ones with private insurance that only pays a portion that then subsidize our payments. > > Others have hit the nail on the head too...we pay for plumbers, AC repair, and electricians because if we don't...they don't provide the service. " EMS can't do this " is so very often quoted...BUT (To really open a can of worms)...I ask WHY NOT? > > Wait a second...let me finish. In the " Mother, Jugs, and Speed " days everyone paid or they didn't ride...that swung to the totally opposite end of the scale after that where we don't even talk about the payment end (let alone get a signature or insurance information) because " money shouldn't be a factor in it " . Neither of these extremes are appropriate...but like so many other issues in EMS, instead of having the pendulum at one extreme or the other...how about stopping it somewhere near the middle??? I know...I am speaking blasphemy here...but hear me out. > > We respond to all requests from 911 just like we do today. We evaluate and begin treatment of the patient. We recognize it as a medical emergency, we treat them, load'em up, and transport, gathering billing information when we can....BUT IF, after the evaluation, it truly appears as if the patient does not need EMERGENCY medical treatment, we then determine from them the method of payment. We should also have other means of transport (such as med-assist vans, wheelchair transport, taxi, etc) and we transport them according to their means of payment...again, only after we have determined that ambulance transport is not needed (by any stretch of the imagination)...We then, through credit card, check, cash, etc take payment for the trip from the patient (at a lower cost than having to bill it) and perform the transport. > > AAAAARRRRRRGGGGHHHHHH!!!!! blasphemy, burn him at the stake, ridicule him and his mother.....healthcare is a RIGHT!!!!! Give it to us...give it to us..... > > Now, we have that out of our system. Those who know me will think I have somehow suffered a head injury because this is not something I advocate right now...but as we move forward, the issue will continue to be how we get paid for it...not for the " suit's " profit margins....but so that you, joe & jane paramedic, can buy your house in the suburbs, 3 cars, boat, 2.3 kids, 1.2 cats, etc..... > > Speak up...why not? What would it entail to make it happen (better trained medics again??? Seems that keeps coming up)...better oversight? More physician involvement? > > Just sharing on a blah Monday!!! > > Dudley > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 13, 2004 Report Share Posted September 13, 2004 Here's a problem with that Mike...some people call an ambulance simply because they don't have money for a cab...or friends to give them a ride.... Meredith Re: EMS Pay Way to stir the pot Dudley..... Just kidding. This thread takes a turn to Paramedic Initiated Refusals, a thread that has in the past brought up many good points, not the least of which is the need for training on the paramedics part. Many studies have shown that Paramedics are not the best in the world at defining what necessitates emergency room treatment, or hospital admission. That said, the training would have to improve to the point where field technicians could effectively evaluate which patients require the ER and which ones require their doctors office, and transport them accordingly. We spend a lot of time trying to figure out how to increase our reenue, which I will agree is imperative. But another thing to look at, is reduction of expenses. One of the ways to do this, is to reduce the number of unnecassary transports by MICU buses. Alternative transportation could be a med-assist van, or even a taxi. The expense is less on the service, and if the patient only needs trasnport to thier physicians office, it aides in reducing strain on the ER. We shouldn't have to do more with less, but we should have the opportunity to do more with what we have right now. Same revenue, lower expenses. Just my humble opinion, Mike > > Danny, > > Not a bad can of worms to open...as our rates (on average-fully loaded) are higher than $600. This is another factor in my argument. If we could get everyone to pay the $600 (or even $450 in a lot of locations) we would be much better off...but M'care, M'caid, Tricare (notice the theme: All gov't provided healthcare) won't pay even close to the real cost so we shift the cost to all others. Some insurance will pay but it continues to be the non-insured and the ones with private insurance that only pays a portion that then subsidize our payments. > > Others have hit the nail on the head too...we pay for plumbers, AC repair, and electricians because if we don't...they don't provide the service. " EMS can't do this " is so very often quoted...BUT (To really open a can of worms)...I ask WHY NOT? > > Wait a second...let me finish. In the " Mother, Jugs, and Speed " days everyone paid or they didn't ride...that swung to the totally opposite end of the scale after that where we don't even talk about the payment end (let alone get a signature or insurance information) because " money shouldn't be a factor in it " . Neither of these extremes are appropriate...but like so many other issues in EMS, instead of having the pendulum at one extreme or the other...how about stopping it somewhere near the middle??? I know...I am speaking blasphemy here...but hear me out. > > We respond to all requests from 911 just like we do today. We evaluate and begin treatment of the patient. We recognize it as a medical emergency, we treat them, load'em up, and transport, gathering billing information when we can....BUT IF, after the evaluation, it truly appears as if the patient does not need EMERGENCY medical treatment, we then determine from them the method of payment. We should also have other means of transport (such as med-assist vans, wheelchair transport, taxi, etc) and we transport them according to their means of payment...again, only after we have determined that ambulance transport is not needed (by any stretch of the imagination)...We then, through credit card, check, cash, etc take payment for the trip from the patient (at a lower cost than having to bill it) and perform the transport. > > AAAAARRRRRRGGGGHHHHHH!!!!! blasphemy, burn him at the stake, ridicule him and his mother.....healthcare is a RIGHT!!!!! Give it to us...give it to us..... > > Now, we have that out of our system. Those who know me will think I have somehow suffered a head injury because this is not something I advocate right now...but as we move forward, the issue will continue to be how we get paid for it...not for the " suit's " profit margins....but so that you, joe & jane paramedic, can buy your house in the suburbs, 3 cars, boat, 2.3 kids, 1.2 cats, etc..... > > Speak up...why not? What would it entail to make it happen (better trained medics again??? Seems that keeps coming up)...better oversight? More physician involvement? > > Just sharing on a blah Monday!!! > > Dudley > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 14, 2004 Report Share Posted September 14, 2004 The problem withj pay and many other things in EMS are related to preception. Who and What are. You listen to the colleges, and health care workers, they will tell you that we are health care workers. You listen to fire service and Police services , they will tell you that we are Public Safety. You cannot wear 2 hats and be respected for 1 Person. WEe either have to be Public Safety or WEe have to be health care. That is one of the things that has us ion a pickle with the DSHS disheavel. Until we define whbo we are then we will have no one Place to demand that ourt pay be raised. We must be in control of our own future or we will forever be controlled by those who actualy care nothing about what you want. Off My soap Box. Re: EMS Pay > Dudley; > OK then lets open this can. How do you get the government to up what they > will pay? Where do you go to get the ball rolling? Surely the hospitals are > having the same problem but how have they overcome it? > > I do agree with the don't ride if you don't pay routine. I think for those > that are " frequent fliers " there needs to be some type of set up for on going > payment. I also hear that the subscription plan works with some agencies. I > am curious to know how the new legislation on putting liens on those that owe > EMS bills is doing. > > I think maybe more work needs to be done on our legislature. If people are > expecting Health Care then EMS needs to be as highly funded as Hospital funding. > > Danny L. > Owner/NREMT-P > Panhandle Emergency Training Services And Response > (PETSAR) > Office > FAX > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 14, 2004 Report Share Posted September 14, 2004 The problem withj pay and many other things in EMS are related to preception. Who and What are. You listen to the colleges, and health care workers, they will tell you that we are health care workers. You listen to fire service and Police services , they will tell you that we are Public Safety. You cannot wear 2 hats and be respected for 1 Person. WEe either have to be Public Safety or WEe have to be health care. That is one of the things that has us ion a pickle with the DSHS disheavel. Until we define whbo we are then we will have no one Place to demand that ourt pay be raised. We must be in control of our own future or we will forever be controlled by those who actualy care nothing about what you want. Off My soap Box. Re: EMS Pay > Dudley; > OK then lets open this can. How do you get the government to up what they > will pay? Where do you go to get the ball rolling? Surely the hospitals are > having the same problem but how have they overcome it? > > I do agree with the don't ride if you don't pay routine. I think for those > that are " frequent fliers " there needs to be some type of set up for on going > payment. I also hear that the subscription plan works with some agencies. I > am curious to know how the new legislation on putting liens on those that owe > EMS bills is doing. > > I think maybe more work needs to be done on our legislature. If people are > expecting Health Care then EMS needs to be as highly funded as Hospital funding. > > Danny L. > Owner/NREMT-P > Panhandle Emergency Training Services And Response > (PETSAR) > Office > FAX > > > Quote Link to comment Share on other sites More sharing options...
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