Councilman Proposes Payment Before Ambulance Service

[spenac]

Enjoy your Fosters. I don't think any agency would, no matter the agency or the personnel.

Rich the problem is any patient you are worried would faint would be considered emergent and prepayment or refusal would not be an issue. That is the flaw with the logic so many have about a denial of transport, they think it means saying no to everyone, when in fact it would only eliminate a small percentage of calls but it would require Paramedics become better educated. It would also require knowledge of other services available besides the ER. So in all honesty a denial policy would in the long run improve patient care not hurt it.

[Just Plain Ruff]

I think it's what we would LOVE to do but I'm pretty sure it'll go over like a terd in a punch bowl!

And no matter how you polish a turd, it's still a turd.

[Richard B the EMT]

Gee, spenac, I thought I had put the sarcasm on so thick, you'd be tasting it for days. Yet, I don't dispute what you said.

[Alex Woo]

Until the local, state, & federal govt take control of welfare, low income housing, Medicaid, & all services for the poor; there's no way you can ask someone to pay; if their condition is not life threatening. Duty to Act is there. Plus as PHC providers; you can't put such a demand on the EMT-B/I/CC/Ps; it will open up a lot of law suits.

[Bieber]

I have often wondered why every ambulance seems determined to staff with only Paramedics. not to diss on the top spot, but paramedics where I work make $17 an hour, compared to my measly $12.75 as an EMT I, and 70% of the calls are NOT ALS. As I've had pointed out to me here on the forums many times, EMT B's are just trained first aid providers. Most would be more than capable of handling the 70% that doesn't require any sort of advanced interventions. That would save lots of money and plus, most EMT-P's I know are bored with the BLS stuff anyway. Lots consider it beneath their training, so now we can save a TON of money and still preserve EMS.

A paramedic isn't a paramedic because they can push drugs and intubate and manually defibrillate someone, a paramedic is a paramedic because they have the knowledge and the education. Not to diss EMT's, because until January 5th I'm still an EMT myself, but the truth is that you're right, the majority of patients don't NEED an IV and a monitor, but they DO need a paramedic's knowledge and judgement.

As far as pay-for-transport goes, I will refuse people if I don't think they need to go to the hospital or if I think there is another more appropriate place for them to be seen, such as by their family doctor (if they don't want to go to the hospital, of course), but the day I am asked to get payment before transport or payment as a requisite for transport is the day I'm done. That's not what I signed up for, that's not what I believe in, and that's not what I will ever practice. I'm not a salesman, I take care of people.

Edited December 23, 2010 by Bieber

[paramaximus]

Just have to weigh in here...

I've been a paramedic for the last 16 years. I'm not a volunteer. I only mention the latter because I wonder where some of you get this concept that a service should be rendered without proper payment.

The simple fact of the matter is I expect to be paid. Furthermore, everyone I work with wants paid for their time and effort too. I'm not independently wealthy, so this isn't a hobby for me. Therefore I want the service I work for to do all they can to collect money to make sure they stay in business, and that I get my paltry share.

I'm confident enough in my ability to know what is an emergency and what is not. I would have no problem telling someone with a non-life threatening condition to pay up before we roll a tire. We don't currently do that here, but I'll be glad when the day comes. Just because they "feel" like they're having an emergency means nothing. They can "feel" like the earth is flat and it doesn't make it so. That's where we are supposed to come in. If you can't determine whether or not you're looking at something serious or something ridiculous, and then can't muster the testicular fortitude to tell it like it is... you probably have no business in this business.

If they want a cabulance... let them pay one of the private service memberships... or me. Up front and cash is king.

[zippyRN]

do you take mastercard? Visa? American Express? Just swipe your card and go.

What's next, taking chickens in lieu of payment like the old country docs used to do.

I actually have a physician friend who treated an amish boy for a fractured hip from a fall from the roof of the barn he was helping build. You know, an Amish Barn Raising.

The Amish community pitched in and built the physician a new detached garage. He saved 20K on building costs and the amish family saved the entire cost of the medical procedure.

that's a 'cash equivalent' transaction at the end of the day ...

the issue with pay before ride is as has been pointed out

1. A crew deciding something is minor and it actually being serious , regardless of whether the person travels or not

2. creates a fear of activating the service for calls that are serious incase people are charged

3. public disquiet over what is an isn't considered 'life threatening' i.e. indigestion in an over 35 year old - could be an MI .... and should be getting a 'free' ride' where a broken arm might not be getting a ride especially in an area where BLS has no analgesia options