HEMS under Obama

[ATPMBA]

Any ideas how HEMS will be under Obama's new healthcare plan? I hear some rides in the states now cost 14,000 USD.

[Gomer Pylot]

It should be better for the HEMS companies than the present system. Currently Medicare pays for those covered, and if everyone were covered, the reimbursement rate would be much better than now, where a large percentage of patients have no insurance and no money, so their transports are simply written off as losses. The present healthcare system is badly broken, and I see no downside to universal coverage.

[alouette3]

I agree with Gomer. With a better reimbursement rate , there will be incentives for the companies to either, reduce their rate per loaded mile, or, upgrade to better equipment.The only downside I see is the reduction in overall numbers of flight programs as HEMS might get re regulated. Proponents of re regulation argue that the Airline Deregulation Act of 1977 was not intended for HEMS ops.Some logic to that,IMO, as, in 1977, HEMS was still a little gleam in someone's eye.
With re regulation will come tighter control over where and when companies can put a base in. This might spur the overall health care cost reduction which is President Obama's long term goal, but it will put a lot of pilots out of work. :{
Other than that , Mrs Lincoln, how did you enjoy the play?:)

Alt3.

[Revolutionary]

A reduction in overall numbers of flight programs won't be a downside in my opinion. One of the main reasons for the depressing regularity of US HEMS accidents is the sheer number of (often unnecessary) patient flights being carried out daily. The bitter irony of the current HEMS system in many parts of the country is that EMS helicopters are over-utilized and under-utilized at the same time, wasting both money and lives.

They are over-utilized by the for-profit operators who, under the current system, must fly as many customers as possible in hopes of having the insured patients cover the cost of flying the uninsured patients. As it is, there is no incentive for anybody in the decision-making chain (doctors; dispatchers; flight crews) to question why a patient with a simple leg fracture must be airlifted from a rural hospital, through the mountains, to a level 1 trauma center in the city at 2 AM in the morning. It makes good business sense for all involved even if it makes no sense at all from a patient care or flight safety point of view.

At the same time, the free-for-all nature of the system encourages companies to place helicopters in close proximity to the competition and to do battle over territory. As a result, many EMS helicopters have to share their potential flight volume with other aircraft in the area, depressing the number of flights per helicopter. This under-utilization of resources in turn often causes a reduction in readiness and currency for the pilots involved. Many US HEMS bases subsist on a flight volume of under 40 flights a month; they could easily handle double the workload.

HEMS is just a small part of the health care system but from what I've seen it's pretty emblematic of the whole: There is lots of money involved, which means lots of companies will throw lots of equipment at it in hopes of snagging a piece of the pie. But the lack of regulation causes a huge waste of these (admittedly impressive) resources. America's healthcare system is probably on a par with most other industrialized nations; only at twice the cost. Sadly, that often includes the cost of lives lost in HEMS accidents.

[Gomer Pylot]

Well, that's capitalism in action. That's exactly the way it works, and is designed to work. Removing the profit motive is usually called socialism. Oh, the horror!!