peterjmag
Member
EMSA Services To Be Paid Through Utilities
http://www.kotv.com/news/topstory/?id=123256
Any thoughts?
P.J.
http://www.kotv.com/news/topstory/?id=123256
Any thoughts?
P.J.
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EMSA Services To Paid Through Utilities
- Thread starter peterjmag
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Chaos703
Member
HT600 said:
I have the same thought each time I hear TFD dispatched to "difficulty breathing" call. Especially when they add, "EMSA is responding." I understand why they send both, but it still seems like a waste of resources. Maybe consolidation would solve this.
As far as paying on the water bill, I think that does sound like a good idea. Since many of the service abusers are either too ignorant or too lazy to opt out, it will at least help collecting something from them.
Why? I have insurance. I can pay my own bill if the insurance won't (for whatever reason). I'm in good health and not accident prone. I'm paying taxes. That means I'm likely ALREADY paying for ambulance service 2 or 3 times over (taxes, car insurance, med insurance). I see no reason to pay a 4th time to subsidize some loser who won't pay.
HT600 said:
I would hate to see the figures on how much $$ it would take to get it off the ground. I'm sorry to drag this OT, but I think the current setup with the EMSA/TFD dual response is about as perfect as it's gonna get. If I was doubled over in McCrapper (lol, PJ) choking on a Big Mac, I would rather lose consciousness knowing there's a Paramedic Engine AND a Paramedic Ambulance running code to save me instead of just the ambulance. Plus I'd rather be treated by someone that has EMS as their first priority. I'm not saying Firefighter medics aren't good at what they do, but patient care seem to be a secondary thing to them. Just my 2cents.
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Some food for though:
'07 Departmental Budget:
Tulsa Fire Department - $56 million
EMSA - $2.3 million
EMSA pays for itself for the most part by billing the patient and/or insurance, and partly by the taxpayers who the service is offered. The fire department is payed in full by the tax payers. So think about this: You pay a few dollars a month to support a service that when you need it, it will be there for you, and in return you or your insurance will receive a bill (EMSA). For a lot more money, you pay taxes on a service that if you need it, it will be there, but you won't receive a bill (FD).
So now lets think about if the ambulance service is turned over to the fire department. Now you're paying taxes to support a service that will be there if you need it. If you use it, you or your insurance will also receive a bill in addition to the tax money you pay.
The general population isn't aware of EMSA's standings nationwide as far as an EMS system goes. They are led to believe that all EMS services are on the same level, which is very far from the truth. I've run calls where the patient had a family member or friend drive them from the next county over just so EMSA would respond on them and not the service that covers that area. EMSA is one of the top five services in the nation for cardiac arrests saves, and is also one of the cheapest on the tax-payer. There are a handful of other cities (comparable in size to Tulsa) that have cloned EMSA's way of operating and then tweaked it to fit their city/operations. EMSA also has very tight quality improvement/quality assurance, which is generally not the case in a fire-based EMS system. EMSA is required to respond to all medical emergencies, or potential medical emergencies (i.e. man down calls), where as not all fire-based EMS services are. How would you feel if you were the man down and had to wait for PD to respond before anyone realized you needed medical help, and then had to start an ambulance?
'07 Departmental Budget:
Tulsa Fire Department - $56 million
EMSA - $2.3 million
EMSA pays for itself for the most part by billing the patient and/or insurance, and partly by the taxpayers who the service is offered. The fire department is payed in full by the tax payers. So think about this: You pay a few dollars a month to support a service that when you need it, it will be there for you, and in return you or your insurance will receive a bill (EMSA). For a lot more money, you pay taxes on a service that if you need it, it will be there, but you won't receive a bill (FD).
So now lets think about if the ambulance service is turned over to the fire department. Now you're paying taxes to support a service that will be there if you need it. If you use it, you or your insurance will also receive a bill in addition to the tax money you pay.
The general population isn't aware of EMSA's standings nationwide as far as an EMS system goes. They are led to believe that all EMS services are on the same level, which is very far from the truth. I've run calls where the patient had a family member or friend drive them from the next county over just so EMSA would respond on them and not the service that covers that area. EMSA is one of the top five services in the nation for cardiac arrests saves, and is also one of the cheapest on the tax-payer. There are a handful of other cities (comparable in size to Tulsa) that have cloned EMSA's way of operating and then tweaked it to fit their city/operations. EMSA also has very tight quality improvement/quality assurance, which is generally not the case in a fire-based EMS system. EMSA is required to respond to all medical emergencies, or potential medical emergencies (i.e. man down calls), where as not all fire-based EMS services are. How would you feel if you were the man down and had to wait for PD to respond before anyone realized you needed medical help, and then had to start an ambulance?
Secret_Squirrel
Nut Protector Extraordinaire
I think what EMSA wants to do seems like a good idea to me. There are a lot of people out there who DON'T have insurance and it's certainly NOT because they are "losers". Pot, kettle, black, stones, glass houses, etc...those are some words that just floated up on my keyboard.
Besides, if I helped out the less fortunate by paying that $3 or $4 per month on my utility bill then I could claim that it was the "Christain thing to do" and that would make it okay, then I'd be a hero to the masses and....well, you know how it works.
A little unrelated but I just wish that rural volunteer fire departments could tack on $3-4 per month on the water bill for services rather than have 25% of the community pay dues and carry the load for the 75% who don't.
Besides, if I helped out the less fortunate by paying that $3 or $4 per month on my utility bill then I could claim that it was the "Christain thing to do" and that would make it okay, then I'd be a hero to the masses and....well, you know how it works.
A little unrelated but I just wish that rural volunteer fire departments could tack on $3-4 per month on the water bill for services rather than have 25% of the community pay dues and carry the load for the 75% who don't.
freqscout
Member
- Joined
- Jan 21, 2006
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- 700
Maybe they want to build their own 31 million dollar radios system for the Tulsa metro that is provoice and DES encrypted so that they can feel better about relaying patient info.
Or maybe a scam to give Carroll Fisher free rides to the hospital...also ingeniously designed to funnel more money out of a government agency and into his off shore trust funds. Just my 2 cents, okay I'm joking.
Or maybe a scam to give Carroll Fisher free rides to the hospital...also ingeniously designed to funnel more money out of a government agency and into his off shore trust funds. Just my 2 cents, okay I'm joking.
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SS,
I know where you're coming from - but for the record... I DON'T have insurance - by choice. Insurance is a bet, and I'm not a gambler. But I can afford an ambulance ride.
On the other hand, do the math - this is from the "living on tulsa time" blog - there are roughly 180,000 single family residences that get a Tulsa water bill. At $3/month times 12 months times 180,000 is $4.2 million - to supposedly fund a 2.3 mill budget.
Now, the next time some one from the government says "trust me", hang on to your wallet and check their math - they probably went to TPS, too.
I know where you're coming from - but for the record... I DON'T have insurance - by choice. Insurance is a bet, and I'm not a gambler. But I can afford an ambulance ride.
On the other hand, do the math - this is from the "living on tulsa time" blog - there are roughly 180,000 single family residences that get a Tulsa water bill. At $3/month times 12 months times 180,000 is $4.2 million - to supposedly fund a 2.3 mill budget.
Now, the next time some one from the government says "trust me", hang on to your wallet and check their math - they probably went to TPS, too.
Chaos703
Member
One the one hand, Jay is TOTALY right about his choice not to carry insurance. There are two main reasons that insurance and healthcare rates are so high:
1. The general attitude that insurance claim money is free cash the appears out of thin air. In truth, insurance is a community pooling it's money for individual crisis needs. When one user hogs the pool — like the Coweta lawsuit — everyone has to pay more to replenish the pool.
2. The modern notion that we should use our insurance for ever little need (i.e. eye-doctor, dentists, doctor's offices visits, etc.) instead of only using it for crisis (major medical).
So Jay is right in saying, let him worry about paying the ambulance bill out of his own pocket instead of forcing him to pay insurance. It's his right to make that decision. I will however, reiterate that this plan does include an opt-out feature precisely for people like you, Jay. Because it has that feature, I do feel it's a good idea. You're right about doing the math. If they only need 2.3 I'd like to know why they're asking for so much more.
I have to defend Jay again, Squirrel. He may have generalized a little, but clearly the "losers" he's talking about aren't the poor folks who can't afford insurance. He's talking about the pervasive abuse of emergency services. Jay's "losers" are the system-gamers who treat ambulance services like a taxi service, or a free Walgreens with home delivery. He's talking about the people who call EMSA because they need a Band-Aid or some aspirin. These are problems we all know about. And I believe that to extend free resources to them is not an act of Christian charity, it's and act of enablement.
Lastly, I have to say that that was a very, very impressive argument KE5EHI put up on EMSA's behalf. I'm now pretty solidly sold on retaining their services. Thanks for that info.
1. The general attitude that insurance claim money is free cash the appears out of thin air. In truth, insurance is a community pooling it's money for individual crisis needs. When one user hogs the pool — like the Coweta lawsuit — everyone has to pay more to replenish the pool.
2. The modern notion that we should use our insurance for ever little need (i.e. eye-doctor, dentists, doctor's offices visits, etc.) instead of only using it for crisis (major medical).
So Jay is right in saying, let him worry about paying the ambulance bill out of his own pocket instead of forcing him to pay insurance. It's his right to make that decision. I will however, reiterate that this plan does include an opt-out feature precisely for people like you, Jay. Because it has that feature, I do feel it's a good idea. You're right about doing the math. If they only need 2.3 I'd like to know why they're asking for so much more.
I have to defend Jay again, Squirrel. He may have generalized a little, but clearly the "losers" he's talking about aren't the poor folks who can't afford insurance. He's talking about the pervasive abuse of emergency services. Jay's "losers" are the system-gamers who treat ambulance services like a taxi service, or a free Walgreens with home delivery. He's talking about the people who call EMSA because they need a Band-Aid or some aspirin. These are problems we all know about. And I believe that to extend free resources to them is not an act of Christian charity, it's and act of enablement.
Lastly, I have to say that that was a very, very impressive argument KE5EHI put up on EMSA's behalf. I'm now pretty solidly sold on retaining their services. Thanks for that info.
Good! maybe then EMSA willl be able to pay their staff the salary they deserve!KD5WLX said:
The public, atleast in this little corner of the world I've grown up & work in, seem to want something for nothing from the government.
Jay, I see the logic in your math, but there's more to it than a simple multiplication equation. First, you have to take into account how many people will either opt-out of the fee or who may not have or pay water at all. Also, EMSA has stated that was just a good guess at how much would need to be added to water bills to cover the expense (with things like what I just mentioned taken into account). I believe they also said that if the $3/month is generating more money than needed, it will be reduced to fit what is required. Now I know a lot of people would probably say "yeah right, why would they reduce it if they are already getting all of this money?" My answer is: In 30 years, EMSA hasn't asked the city for a subsidy. It supported itself. Now due to the decrease in Medicare/Medicaid payments and the inability to bill for the rest of the charge to the patient, combined with the increase in call volume due to the baby-boomers getting older and more and more people using the ER as primary care and using an ambulance as a taxi to get there, there's just no way EMSA (or any service) can support itself. So it asked the city for a small subsidy to compensate. Now the city doesn't want to pay, so EMSA has to find another source of money to subsidize for the loss. I'm not 100% sure, but I think any extra money is paid back to the city. But with it being a trust with a contractor, I'm not 100% on the finacial details.
I know I already paid a few dollars a month on my water bill in Jenks to support EMSA and it doesn't affect me any more than watering my lawn an extra day and then paying for the gas to mow it. I don't have an option to opt-out. With the new plan, people will have that option, but why would you want to?
Here's some more math. Assuming the numbers stay the same (which they won't), or at least rise at the same rate respectivley.
Opt-out ambulance bill = $1,100
Opt-in on water bill = $3/mo.
$1,100 divided by $3/mo. = 366.6 months
So basically, you can pay this $3/mo. for 30 years before it equals the cost of one ambulance ride. What are the odds in 30 years you will need an ambulance?
I'm younger than 30 and I've already needed one once.
I know I already paid a few dollars a month on my water bill in Jenks to support EMSA and it doesn't affect me any more than watering my lawn an extra day and then paying for the gas to mow it. I don't have an option to opt-out. With the new plan, people will have that option, but why would you want to?
Here's some more math. Assuming the numbers stay the same (which they won't), or at least rise at the same rate respectivley.
Opt-out ambulance bill = $1,100
Opt-in on water bill = $3/mo.
$1,100 divided by $3/mo. = 366.6 months
So basically, you can pay this $3/mo. for 30 years before it equals the cost of one ambulance ride. What are the odds in 30 years you will need an ambulance?
I'm younger than 30 and I've already needed one once.
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Chaos703
Member
Medic32 said:
Why do I have the feeling that no one reads my posts?
1. I know the opt out is in there - but it remains to be seen how many bureaucratic hoops have to be jumped through to actually "get" out. Remember AOL billing people for over a year after they'd canceled service? And that was a Fortune 500 business, not a governmental bureacracy.
2. It's my understanding that the $3 per month came from $50/12 - the current cost of a "total care" subscription. It's actually a bit over $4/month, but they're probably figuring that many "lazy" people who mean to but never actually sign up for Total Care will similarly NOT opt out, increasing their subscriber base and therefore lowering the cost per household slightly.
3. The math IS a straight multiplication. When the numbers were presented to the city council, it was presented as "if every HOUSEHOLD that receives a water bill paid $3/month, it would provide $2.3 Mil to fund EMSA. The point is the math DOES NOT work out that way. City of Tulsa sends 180,000 water bills to single family residences and duplexes. That is JUST the houses, not businesses, churchs, parks, etc. That, times 3, is 540,000 per month or 6.48 mill per year - and that is 4.18 million MORE than what was estimated - not 4.2 mill total, but 4.2 MORE - in other words, nearly triple. In order for the math to actually "work", 64.5% of the "households" would have to opt out - or someone is seriously cooking the books (not unheard of in this town).
4. The "bet". $3/month now pays for an ambulance ride in about 30 years. Will I need an ambulance ride before then? Possibly. Will I need one in the next 10 or 15? Highly unlikely. How about if I join Total Care in about - say, 12 years, and save myself $600? That's the "bet". If I'm wrong and need an ambulance in 11 years, I'm out $500 (not $1100 because it's less the $600 I would have already paid in). But if I'm right, and my "first ride" is in 15 years, I saved that $600 for something else. And considering I'm relatively young and in good health, the odds of me needing an ambulance in the next 25 years or so is astronomically low, barring a car accident - and that I DO have insurance for - it's part of my automobile policy, NOT my medical policy.
In general, I think plans "like" this are a good idea. Fire, Police, EMS, and roads are really about all I think government should be doing with tax dollars. But THIS deal sounds too much like some recent "sweetheart deals" where the "taxpayers" got sold a bill of goods, and some local businessman and/or politician (usually both) walked away with a whole bunch of cash.
2. It's my understanding that the $3 per month came from $50/12 - the current cost of a "total care" subscription. It's actually a bit over $4/month, but they're probably figuring that many "lazy" people who mean to but never actually sign up for Total Care will similarly NOT opt out, increasing their subscriber base and therefore lowering the cost per household slightly.
3. The math IS a straight multiplication. When the numbers were presented to the city council, it was presented as "if every HOUSEHOLD that receives a water bill paid $3/month, it would provide $2.3 Mil to fund EMSA. The point is the math DOES NOT work out that way. City of Tulsa sends 180,000 water bills to single family residences and duplexes. That is JUST the houses, not businesses, churchs, parks, etc. That, times 3, is 540,000 per month or 6.48 mill per year - and that is 4.18 million MORE than what was estimated - not 4.2 mill total, but 4.2 MORE - in other words, nearly triple. In order for the math to actually "work", 64.5% of the "households" would have to opt out - or someone is seriously cooking the books (not unheard of in this town).
4. The "bet". $3/month now pays for an ambulance ride in about 30 years. Will I need an ambulance ride before then? Possibly. Will I need one in the next 10 or 15? Highly unlikely. How about if I join Total Care in about - say, 12 years, and save myself $600? That's the "bet". If I'm wrong and need an ambulance in 11 years, I'm out $500 (not $1100 because it's less the $600 I would have already paid in). But if I'm right, and my "first ride" is in 15 years, I saved that $600 for something else. And considering I'm relatively young and in good health, the odds of me needing an ambulance in the next 25 years or so is astronomically low, barring a car accident - and that I DO have insurance for - it's part of my automobile policy, NOT my medical policy.
In general, I think plans "like" this are a good idea. Fire, Police, EMS, and roads are really about all I think government should be doing with tax dollars. But THIS deal sounds too much like some recent "sweetheart deals" where the "taxpayers" got sold a bill of goods, and some local businessman and/or politician (usually both) walked away with a whole bunch of cash.
We have a similar fee on our utilities for the ambulance service in Skiatook. The way it was described to me is that the monthly fee makes sure there is personnel standing by with functioning and up to date equipment 24/7 in case you need them, but you (or your insurance) will still be billed for the actual cost of transport & patient care. Is that what Tulsa is considering?
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AsstChief
Member
- Joined
- Mar 10, 2005
- Messages
- 65
In the Sand Springs Leader the City is looking at doing the same thing as Tulsa. I wonder about those of us that live in Tulsa County and how they will have us pay?
Just my .02, but EMSA does an outstanding job and the medics really need a raise. I worry about TFD taking over because EMSA will not stick around for those not in the City limits of Tulsa. We would get stuck with some worthless ambulance service and patient care will really suffer. So if TFD wants to run the ambulance so bad, have them run everything EMSA is running and see if they can do it as cheap.
Just my .02, but EMSA does an outstanding job and the medics really need a raise. I worry about TFD taking over because EMSA will not stick around for those not in the City limits of Tulsa. We would get stuck with some worthless ambulance service and patient care will really suffer. So if TFD wants to run the ambulance so bad, have them run everything EMSA is running and see if they can do it as cheap.
Secret_Squirrel
Nut Protector Extraordinaire
EMSA Funding Debated...
Another story that relates to this thread appeared on the KOTV website today.
http://www.kotv.com/news/local/story/?id=123651
Another story that relates to this thread appeared on the KOTV website today.
http://www.kotv.com/news/local/story/?id=123651
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