The high charges of HEMS in the USA
 

Mick

In Alberta Canada the ground ambulances are run by the provincial gov't and bill to the individual patients at about $300.00 per trip I believe ( Not sure as I haven't had to use them knocking on wood) The air ambulance Stars is ran as a non profit that gets money from the Gov't, Corporations and private individuals plus some in house fund raises that they do.

I count ourselves luck that we have these services at what sounds like bargain prices compared to what your showing.

Roybert

It is a bad situation for sure.....but when you crash helicopters as frequently as some Operators do....you have to find a way to pay for them.

Add in the numbers of un-neccessary helicopter transports and the industry really does look bad.

When Hospitals were willing to underwrite some of the helicopter costs in trade for the expensive healthcare procedures that tended to follow intake....the cost to the patient for the transport was pretty reasonable even if not cheap.

Now with non-hospital based services cropping up with cheap singles and the need to keep the revenue flowing....bad things happen and costs go up.

My State did not operate any EMS aircraft but did tightly control the numbers and types of operations that would be accredited and licensed within the State.

We remain a free capitalist economy pretty much....and prefer government to stick to that business they are allowed by law to get into....and wish they were involved less in less than they are pretty much.

Discussions of changes jn the American way of Healthcare and Health Insurance....two distinctly different things....should we see a shift in control of Congress and the White House does not bode well at all for any of us.

The move is on again by one party to go to a Single Payer System, move 200 Million People into the our Medicare system (now thought to be bankrupt in as few as eight years as it is now without any changes) and about 31 Trillion (with a T) additional cost over Ten Years alone.....and you can see we are headed for a genuine crisis that makes the current situation look almost "Good".

We have far too many States, too large a Federal Government tangled web of Bureaucracies, too powerful a group of special interests and too many legislators on the local, state, and federal level with open palms to see a good and judicious outcome I am afraid.

Somebody has to pay. These things are not free wherever you live. In more socialist countries it is paid for via governmental subsidies obtained by MUCH higher tax rates. Consider that someone making $150K AUS is in something like a 37% tax bracket, while in the US the dollar equivalent puts you in a 28% tax bracket, give or take depending on what year's data you look at, exchange rates, all that sort of thing.

In the US my insurance costs have doubled since the onset of Obamacare. That's because instead of being taxed directly via federal income tax, as a gainfully employed member of society I now have to pay my insurer double so that they can turn around and insure those who are not contributing members of society. It's effectively an indirect federal tax.

Obviously the system is horribly broken. In the US, where health care and insurance are concerned, we now live in this terrible purgatory between outright socialized medicine and the old semi-capitalistic system where those who could not afford it didn't get anything. Like a lot of Ugly Americans, I'm a staunch capitalist and would be happy to go back to the old ways, paying less for taxes and health care. Alas, one cannot buy votes that way, and buying votes is the name of the game with an unrestricted electorate. It's only a matter of time until we are "socialized" to the same degree you mates and chaps are.

Meanwhile, in terms of refusing transport, I was, for some eight years, an EMT on a ground ambulance service. In an urban area I can tell you unequivocally that most air transports are a racket. Not all, but most. By the time you make the decision for air transport, set up the LZ, wait for the bird, wait for it to shut down, do all of their stabilization and packaging procedures, start up and depart, you could have been sitting in a local ED (A&E, whatever you call it in Australia) or even in an OR. Tell you what: you can pick me up at the local hospital pad if you want to transport me that badly, at least I'm within feet of definitive (surgical) care while I'm waiting, not sitting on an LZ waiting. Now that obviously flips on its head in the more rural areas. But because of population densities most air transports in the Northeast happen even though you are within 10 minutes of a perfectly good operating room and often within 10 or 15 minutes of a perfectly good Level II trauma center. So, yeah, it's a racket. Of course, most folks who are so transported are not conscious and alert enough to demand to be taken to the nearest OR equipped ED/trauma center while they wait, so that's a problem!

As a Yank I can say with all certainty,...

My country is run by money grubbing assholes! That's what it is.

If you are wise you purchase a membership from the HEMS company, if it's available. For the high price of $49 a year my entire household is covered by both helicopters (two Bell 429's and I believe 3 407 GX's) & a King Air. They will send a helicopter up to 150 miles, the plane up to 500 miles to get us. There may be minimal charges after that, but certainly not thousands and thousands of dollars.

I live in the middle of England and our air ambulances are operated by charities with no contribution from the Government. Our local air ambulance charity operates three Airbus EC135's, G-OMAA, G-HWAA & G-EMMA. Their website is Midlands Air Ambulance Charity | Saving Lives by Saving Time and will make interesting reading to our American friends.

With all of the excessive costs of EU regulation, twin engine machines etc, etc they say the average cost of a mission is £2,500.

Quote from the website:

"Each year it costs in excess of £9 million to maintain the three aircraft and the provision of a lifesaving service. Each air ambulance mission costs an average of £2,500. The charity receives no funding from the Government or National Lottery so relies entirely on the support and generosity of local people and businesses."

The US system would appear to be spectacularly expensive and unreasonable.

(Just for clarity, I have a capitalist mindset - it would appear to me there is room for great margins between £2,500 - £40,000 per flight respectively).

Slightly out of date Cran, it's 2 x 135s and 1 x 145T2 (GRMAA) now.

Cheers TeeS

Air Methods is a very large player in the US EMS industry.

The Link will take you to an Annual Report that discusses factors that impact their Operation and generally describes one Years business results.

Cran....compare your Charity Operation to Air Methods and see if you are making an Apples to Apples comparison of services and capability.

https://www.airmethods.com/docs/defa...rsn=76819d95_2

I studied and compared different HEMS systems, mostly Europe but USA too - it was part mof my thesis some years ago.
I can only say, that US HEMS is, with some bright but rare exceptions, a complete f....k up. Even many hospital based services.
First: fixed costs for such operation are enormous compared to variable cost (cost per mission) Often, it is way over 80% of total cost of operation.
But, under current payment schemes, revenue is generated only per patient transported - this forces providers to take as much patients as possible and this creates two wrongdoings:
- strange arrangements on picking patients (suspicuous criteria for use of helicopters, forcing patients into helicopters, pushing for heli transport of patients, that most of the time, do not need it etc)
-pushing into bad weather to try and transport the (paying) patient as turn back or empty flight does not create revenue -same goes for sitting on the ground and waiting for the weather to improve. Adding to that, some less responsible companies are trying to lower high burden of fixed cost by use of cheapest possible helicopter. Flying a Long Ranger in marginal weather or at night without basic stabilisation, let alone a decent autopilot and even no NVG is a Russian rulette.

Since health care in U.S. is, compared to services in EU, more or less a commodity, sold same way as other services on the market, free market law apply - but with some exemptions, that forces providers to provide service, without knowing if customer is able to pay for it. This leaves them with many bills unpaid as emergency service most often cannot be declined or better to say, service providers are gambling on balance between able and unable to pay customers.
Effectivelly that means that those, able to pay are covering for those that avoid payment one way or another. and that operators are trying to squezze out as much as possible from unaware customers. Those that protest and become loud are potentially damaging to those businesses and often get away with a settlemet - a massive write-off which is, in reality, a fair price.
Just a hint: in Austria, a 15 min flight from ski resort to hospital with decently equipped and staffed EC-135, operated by a pure commercial company will not cost more than 5000 Eur - and they run for profit.
But, since such transports are free market area in Austria, companies mushroomed and sadly, I see some U.S. HEMS trends coming.

My personal opinion: as long as Americans do not want to accept that there are some common issues that need common solutions in a society (or better to say, accept that there is a thing, called "society"), they have to accept the current situation.
Now, fire back.

Has anyone tried the UK charity model in the US and elsewhere [and presumably failed]?

It seems odd that it works so well here with minimal government money and yet apparently 'copious' amounts of charitable giving. I realise it is partly to do with population density [it is pretty crowded here] but you might expect the 'free at the point of service' to work fairly well in and around cities across the world. It would appear that even the paid for US model has pretty strict boundaries...... so paying your membership dues to an air ambulance in Washington State would have no value if you had a need in DC?

No matter who you are or where you are in the UK if you need an air ambulance doctor brought to you or if you need removing from scene by air you will never get a bill. It is peace of mind all round.

The idea that people without Health Insurance cannot get health care in the USA is a myth.

One of the problems is the un-insured or those who do not qualify for government funded healthcare too often show up at Emergency Rooms/Trauma Centers to obtain what at best would be Urgent Care treatment or Primary Care Treatment.....and of course are unable/unwilling to pay for that treatment which cannot be denied by the facility.

The provider may limit their provision of care to that which is necessary to stabilize the patient then transfer the patient to another facility.

Those with Insurance, the Tax Payer, and those who self fund their healthcare do in fact wind up paying for the indigent who cannot afford or do not otherwise have healthcare insurance or coverage under a government funded source.

In Maryland, the only charge for State Police helicopter extraction/transport is a token fee ($6, I think) that everyone pays each time they register or re-register a vehicle.
https://cimg3.ibsrv.net/gimg/pprune....b66052a38f.jpg

Try that in a country of over 300 Million people with somewheres around 12-15 Million Illegal Immigrants and all of the indigenous poor....it ain't Chicken Feed we are talking about.

Also....recall most of our medical facilities are "For Profit" operations that are privately owned and not government funded and operated.

The one item always missing from these discussions is that US law prevents the possibility of trying to change these issues.

For example, helicopter EMS ops is "protected" by the Airline Deregulation Act of 1978. Believe it or not. Every time a State tries to reel in the EMS costs the operators play their dereg card and win. Until congress legislates these ops out of the Act they will continue.

The lack of insurance... is a misnomer. Everyone in the US has access to healthcare whether they can pay or not. Walk into any hospital emergency room and you will get treated. It's against the law not to treat you. However, in the big picture, if congress would legislate the ability to purchase medical insurance outside the state in which you live... the free market would bring costs down and offer better alternatives, Currently, by law, I can only buy insurance from a company with offices in my state.

And while obamacare was all the talk, it has slowly taken the existing insurance system and buried it. Out of 175M working adults, 120M get insurance from their work. The other 50M were supposed to be taken care by the ACA. What they failed to detail was that 30M of that 50M were going to get free healthcare through an "expansion" of the Medicaid system (low-income). The paying obamacare group never got above 24M. So guess who has to pay for those 30M?

The funny thing is, the hype on the ACA was it was to help "middle-income" folks. But with the current median single income of around $52K per year, how come all ACA subsidies stop at $49K income per year? The insurance company lobbyists are a close second to the defense industry lobbyists. Until that bond can be broken, our healthcare system will remain broken.

Norway- All this is FREE
 

Hi
Here in Norway MEDEVAC is free , hospital free, doctor free( after annual max 300euro)
All education from 6 years to Professor is FREE!
How you say?
We do not piss away the money to the greedy capitalists!

Oh and PS:
Our personal tax are the lowest in Europe.
You all have a healthy day now.
Regards
Cpt B

BluSdUp : while I am all for free healthcare and education don't misrepresent your country to the americans, please. that's intellectually dishonest. you know very well that the cost of living in norway is incredibly high, which prices that are significantly above for many items than in denmark, sweden, germany. it all balances out. the americans here are proclaiming their taxes are lower but in the end they pay just as much, only through different systems and processes. I've lived and worked on both sides of the pond.

In Switzerland we have the REGA. I pay CHF 70 for the whole family and that covers helicopter rescue in Switzerland and repatriation by either airline or their own jets worldwide. Health insurance does cover part of the rescue, too. REGA is now an essential part of the Swiss rescue system, it would not work without it.
REGA is a non profit organization and is very (very, very) well funded, since almost everybody is a patron. There are three other companies doing rescues for profit: Air Glaciers (always whining why they have to use twins and then rolling them), Air Zermatt (very professional) and Lions Air/Alpine Air Ambulance under the cover of TCS (Touring Club Switzerland). The first two are located in the Wallis, whose populations just has to do things different as the rest of Switzerland as a principle and the third seems to have responded to local politicians, who where apparently annoyed with REGA, because there was no helicopter base in their county or something like that (it smells extremely fishy). For a rescue by Air Glaciers or Air Zermatt, patrons of REGA are covered, but not for the Lions Air/Alpine Air Ambulance/TCS.

REGA is in very high regard and known to every child, which is essential to their success. It would be very difficult to build something like that from scratch, since REGA grew up with the helicopter business in general in Switzerland. A time when pioneers were in high regard and new things welcome (well, more than today a least).
I find it funny, when the discussion comes to free market and health care. In case of an emergency, there is no such thing. The customer has no choice, than to take the emergency transportation that is coming to his/her rescue. The US proves every day, that a free market in health care produces the most expensive health system in the world with a declining live expectancy. That is not a success story.

Except your cost of living is monstrous, property is eye watering, don't think about buying a car, you can't order a drink that is more than a double and you'd need to sell a kidney to pay for it. Love the place and the people but it is one of the most expensive places you could ever hope to visit.

I suppose you not read much of what has been said about our Healthcare system here at Rotorheads or elsewhere.

Our system is not "free" due to the States and Federal Government self imposed involvement on the system.

If the government got completely out of it.....then perhaps we would have that "free market" you assume exists.

One example....ACA known as Obama Care....imposed requirements for every Insurance Policy using a "one size fits all" concept as Government so often tries to use.

I am a single, un-married, childless Man yet any healthcare insurance policy I buy (each Policy has set coverages) will cover Maternity costs.

Last time I checked....it is biologically impossible for me to bear offspring.....so why am I required to have that coverage AND PAY for it?

For years Cafeteria style shopping of Health Insurance coverages has been sought by genuine reformers.....and it never happens because the States and the Federal Government refuse to allow it.

Odd thing...I do that for my Home Insurance, Auto Insurance, Boat Insurance, and personal liability Insurance....so why not health insurance?

Answer.....the States and the Federal Government don't get involved in structuring those kinds of insurance policies....the market does.

I live very near saltwater....and recently had some in my ground level rooms due to a Hurricane....my Boat Insurance has paid my Claim for damages, the Wind/Hail Insurance has assessed the damage and made a determination of loss (less than my Deductible), and the Flood Insurance (a Federal Program) has yet to make a decision.....see the trend?

The less involved the Government is in "Insurance" the better.....and the more "free" the market is.

"Free" to the government is defined as "Income Redistribution" where politicians take from some and give to others without any recourse by those whose pockets get picked.

This discussion is really about two separate issues; first government intervention in healthcare and second how healthcare is funded. The US has more political interference than other countries. Working in the US I am often prevented for providing certain care even if the patient is paying cash due to local, state and federal restrictions unheard of elsewhere. At the same time I dispair of incompetent political oversight in Europe as well, but regulation rarely imposes itself between my patient and myself.

Funding is a separate but related topic. The cheapest way to fund health is via national taxation eg income tax, followed by specific national levies followed by insurance policies simply due to the administative costs.

The US has additional issues not least those related to the drug manufacturers but the ACA has undoubtedly reduced healthcare standards. No system is perfect, and most countries are facing increasing costs in relation to GDP. However the US spends over twice what the rest of the developed world spends, the rate of increase is greater, and it is the only developed country where so many of the population are uncovered. Yes you can walk into an ER but you will only get treatment for specific entities. Children still die from asthma in Florida due to not being able to buy inhalers. The US has one of the lowest proportion of HIV sufferers on retrovirals as the cost has been placed on Medicare which is now the financial responsibility of the states. Sadly I see no hope of impending improvement to either HEMS or healthcare in general as the political system is broken. All I would ask is that those Americans who scorn 'socialist medicine' whatever that is reflect when they next pay their property taxes to fund education or argue against privatisation of ATC.

The notion that UK, AUS, NZ and elsewhere are 'socialist' in not allowing an open market competition in EMS is short sighted. With the exception of Queensland, all EMS helicopters in AUS and NZ are run by independent commercial entities (either not-for-profits or for-profit operators such as Babcock, CHC or Japan post). The government simply uses it's purchasing power to tender for the services across the region in an open market to ensure the best deal, and enforce minimum standards.

NZ did this very well recently in enforcing IFR capable, twin engine aircraft to replace the existing singles operating EMS. This benefits operators in providing long term, well funded stable contacts, patients in high-level consistent services and us pilots in providing job stability and safe, capable aircraft.

I would argue this is the evolution of the free market economy. The government does it jobs but legislating the standard and then uses its purchasing power to get a good deal for all citizens. Same as the government getting a contract for dump (rubbish) trucks vs everyone getting their own garbologist to collect their trash (rubbish).

SAS
Even with universal healthcare in Alberta we still have people showing up at Emergency with a bad cold and asking for treatment even though Primary Care centers are free. In the US the Urgent Care and Primary Care centers are For Profit operations that can and I believe do refuse to provide service if you can't pay for it. Feel free to correct me if I'm wrong on my assumption.

Roybert

Emergency/Trauma Centers are required to provide necessary care to stabilize the patient and cannot refuse care.

Thus....the uninsured shows up with the sniffles and ties up the Emergency Room, and utilizes expensive care, and walks out without paying.

Urgentcare and Primary Care facilities are not required to provide services.

I have Medicare (being an old fart) and have purchased Medicare Supplemental Insurance....I can go to any Urgent Care or Primary Care facility and my care is cost free beyond my Insurance Premiums for both Medicare and the Supplemental Insurance.

I also qualify for Medical and Dental care from the Veterans Administration (VA).....if I don't mind all sorts of bureaucratical bull**** and slothfulness.

To add insult to injury....the VA will pass along their costs to your Insurance Provider for services rendered.

Single Payer Healthcare is not a good thing.....as a Canadian you should fully understand that.

For instance.......

https://www.medpagetoday.com/cardiol...syndrome/18279

SASless if you read the article you will see a patient is going to the US because his tiny tiny province doesnt have the expertise. This has nothing to do with systems or money. In the UK we do the complex surgery for Malta - a full member of the EU and a prosperous country that is just too small to provide for an operation that might be needed once a year. Even New Zealand exports its citizens for less common treatments not justifiably covered in a population of 4.5m. Doing these operations locally would be dangerous as the doctors would not have the experience - bit like only flying a couple of hours a year. That was the basis we expanded EMS in the US into interhospital transfers for trauma

You are fortunate to have several layers of insurance. Many of your fellow citizens cant afford any insurance and then have to pay a federal tax penalty of $400!!! ERs and primary care centres do not provide proper care for chronic illness (asthma, diabetes, hypertension) which needs ongoing supervision not occasional emergency salvage.

I am not a US citizen so you are welcome to tell me to stop poking my nose in BUT so many Americans have been fed rubbish about 'socialist medicine' and even death committees that there is no real debate as to how to provide universal healthcare which many would argue should be as much a right as universal education or universal freedoms enshrined in your constitution.

Krautland.
Wooppy Doo , who are You!

So you have lived and worked both side of the pond.Wow!
Well Kraut, so have I , in Canada , another well functioning socialist state.
And as Sweden and Denmark goes they have the same exact system as us.
As for the oil, they both had a shot at it: The Danish in the 60s when the offshore borders was drawn( Danish negotiator got drunk on Norwegian Aquavit!)
And the Sweeds in the 80s when we offered the Volvo/Oil deal!
We are hardworking and honest and would have been more or less at the same spot without the oil, but you wouldnt know anything about that Kraut.
We decided never to suffer like we did from 1940 to 1945 and our system for everything works better then anything in the US.or EU for that matter.
It is that simple!

I have lived and commuted into six different EU countries since 1985 while maintaining HQ in Norway.
Norway works, some lands , not so much.
Enjoy Your money were ever You are.

Radgirl,

Not quite right.....only if you refuse to buy Insurance do you pay a Tax.

The ACA/Obamacare model requires enlarging the pool of insureds and by the Supreme Court Decision penned by the Chief Justice.....the Penalty magically became a Tax.

The Internal Revenue Service (The Tax Man for the Federal Government) collects those Penalties in the form of a Tax Levy.

Thus we have a situation where the Government is requiring you to buy a product it has devised and if you do not.....you are rendered a financial penalty.

The problem is the young and healthy generally need at most....a Catastrophic Event kind of medical insurance and not the ACA style policies.



Yes...far too many folks cannot afford to buy health insurance due to the structuring of the rates and deductibles and the rate increases each year under Obamacare (ACA).

The other problem is how many States are losing Providers due to the ACA's problems and thus access is becoming problematic for those who do have Insurance access.

A quintessentially American response, .... but utter nonsense. 🙄

Care to explain why you thhk that?

Just calling a post nonsense does not advance the discussion at all.

Tell why the Canadian system works well and should be copied by us down south of you.

We hear about "Death Panels" (which is a hyped name for the method that determines what services are provided due to age and physical condition of the patient) that decide if a Patient can have a Medical Procedure.

We see that as being "rationed" healthcare where cost to the system trumps patient needs when the decision is made.

The UK particularly is accused of that.....and I have heard there are long waiting times for some care in Canada.

Are we being mislead about that?

Dear SASless
May I remind you, that the term "death panels" are a invention of your own Sarah Palin, talking about a very important bill in your own country? May I also remind you, that in a famous congressional hearing before the time of Obamacare, US health insurance companies admitted, that they denied life saving treatments to patients due to the cost and as a results these patients died?
The term death panels is a) a horrible choice of words and b) misleading. Under the Canadian system, when the patient can not take a decision, somebody else has to step in. Normally some other family member. If this person does not agree with the doctors, especially, if the doctors want to continue treatment and the next of kin thinks, that palliative care is the way to go, some sort of commission will look at the case and decide, what is best for the patient. This is actually a quite common procedure in many countries, where the will of the patients is decisive for the choice of treatment. Unfortunately your own politicians and press have perverted the discussion to a point, where it is impossible to have an adult and informed discussion about what to do with very ill patients, who can not express their will or even if they can.
Their is no such thing as rationed healthcare either. But anybody with common sense can understand, that the capacity of a health system must not provide every treatment at a moments notice. Sometimes one has to wait a few weeks for treatment. That is for several reasons. Everybody who has ever been in a waiting room of hospital with a common cold knows, that cases are treated due to severity. You came in by helicopter unconscious loosing blood, you are treated immediately, you jogged in with a hurting finger, you grab a coffee and wait. Same goes for more complex treatments.
Many countries have health care systems like Canada. Most of them work pretty well. The whole of Europe does a pretty good job at it (but we are also extremely good at complaining), not perfect, but we do not let people die, due to cost. We have the principle, that a society has to protect the weakest.
Before you come up with isolated cases I will repeat: It does work pretty well, but it isn't perfect. There is lots of room for improvement, but I think everybody around here will agree, that we prefer our system with universal healthcare for everybody at a reasonable price to society, to your system, which is twice as expensive to the society, compared to the second expensive country, but "lets the free market play" and yours does not even provide better care. Live expectancy in the US is way, way lower than in Canada or any European country. Even some second world countries have a higher ones.

I am keen to keep to facts, and agree SASless that one line rubbishers are unhelpful

Death panels were invented by US aspiring politicians during elections. There have never been any in the UK, nor to the best of my knowledge anywhere else.

In the UK certain procedures are not covered because they are considered cosmetic. Examples include breast augmentation. Even these are permitted and paid for if there is a specific reason, be it cancer or mental health issues. This is no different to US insurance policies, which do not cover certain procedures. Only Oregon as far as I know, has a method to allow the public to include new procedures. The UK public are unhappy about suggestions that some operations should be curtailed but this is because research has demonstrated they have no benefit or actually do harm.

New drugs may be refused NHS (state health) approval if the improvement in quality of life cannot be demonstrated to be more than so many years. I and other doctors do not fully approve BUT we can still use these drugs outside the state system. By comparison the US FDA continually refuse or delay equipment and drug approvals granted in the rest of the first world. I undertake several procedures on US citizens in the UK because the procedures are banned in the US even if they pay.

So overall I suspect there is no difference save that every UK citizen has access to all care....And in the main the same applies in other countries

Waiting times are an issue and you can certainly get faster care in the US, although it is difficult to accurately measure the downside of waiting save for those who have pain. What must be remembered is that rapid care in the US is not due to how it is paid for but supply and demand. US hospitals run at much lower bed occupancy levels - there are more medical facilities per head of population and this is another reason why costs are far higher.

My ideal would be the best of US medical research and university based medicine funded by taxation and universally available.

You will note that I am not a fan of the US Health Care system....primarily because of the problems caused by government policies....and therefor plain old politics.

I lost my Mom not so long ago at Age 97 and spent six years taking care of her....and know very well how our system deals with such situations.

She had government Medicare Insurance and a privately funded Medicare Supplemental Insurance Policy that picked up the costs not paid by Medicare.

She spent that last bit of her life in a Nursing Home and had one major surgical. procedure in that time.

While in the Nursing Home and receiving palliative care...we paid lots of money for that.

Her Surgical Procedure and after care that lasted almost three Months cost us nothing due to the Insurance coverages she had.

Big Pharma has far too much power over the Politicians.

The Profit Center concepts used by the Medical Industry is part of the problem.

Our Drug costs are atrocious....as compared to any other Nation.

We have problems....lots of problems....and they are not going to get any better until the Politicians set aside their bitter differences and start doing the people's business.

Sadly....we see them split philosophically today to such a degree that compromise just doesn't happen.

In a free market economy....competition drives prices, competition in quality of service, competition in timeliness of services, competition in costs of services.....but with the government involvement (both State and Federal), we have a very dysfunctional system.

I am in the midst of a struggle with the Veterans Administration (VA) over a second Hip Replacement Procedure.

The first one was done in a non-VA facility (a teaching hospital) but paid for by the VA.

Unfortunately....the other Hip has decided to wear out....and I have been dealing with the bureaucracy since August and am no closer to getting the authorization for the second procedure.

Yesterday....when I informed the Patient Advocate I had contacted one of my US Senator's Office for assistance in unraveling the mess.....I was assured I would have my approval within 24 hours.

Due to the problems with my Single Payer VA provider....I have gone to a non-government provider and have had three Primary Care visits and two Consults with an Orthopedic Surgeon and could have the Surgical Procedure down with a two week notice.

My Medicare and Supplemental. Policy paid all the costs for those visits.

See the difference in timeliness and why most Americans have a dislike for government run anything?

We look to the Postal Service and State DMV Offices for examples why government should not have anything to do with our health care....other than to prevent monopolies, and see to Licensing perhaps.

All one has to do is see the mess we have now and allowing the government to get further involved very much is not the thing that should happen.

SAS

Never claimed that the Canadian System was better or worst than the US system. Our system is sometimes just a flawed as any other system worldwide. Waited 10 years to have my knees replaced due to damage and arthritis. First Doctor I saw was a _____ (you fill in the blank) wouldn't do anything because of my weight. Finally got them replaced two years ago because the Doctor had some compassion and it's been life changing but it also cost me 10 years of my life.
Bottom line is Health Care is an Essential service that All people deserve regardless of there position is life It's not a For Profit business

My two cents worth or half a cent in the USA

Roybert

Roy,

Could you have done like I did....seek some alternate source of care within your system....change of Doctor perhaps and then have a favorable outcome or were you stymied by the decision of that one Doctor (or a review board that made the actual decision based upon the Physican's Notes)?


Canadian EMS has some problems as well.

Let's look back at the Ornge EMS Operation and the turmoil that has taken place there over the past few years to include fatal accidents and wrongful spending and other accusations.

Do a search using the word "Ornge" here at PPRuNe and you will come up with numerous Threads seen here at Rotorheads in the past.

https://www.pprune.org/rotorheads/47...ighlight=Ornge

SAS

In Alberta, hip and knee replacements are funnelled thru one facility to try and keep the costs down. Took me five years to have them assign me a new surgeon. I looked at having the surgery done in the US but at the cost I was quoted and the length of time they wanted me to be there was just unrealistic give that I am still working. Actually thinking about getting on a bird next week and go with one of the company crews instead of sitting at a desk scheduling things.

And like I said never claimed the Canadian system was perfect

it drives those things but usually downwards as we see in the aviation world - a race to the bottom.

Looks like some might be trying to reduce costs