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View Diary: Bain's Black Helicopters (62 comments)

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  •  It certainly varies a lot by state (5+ / 0-)

    Subscriptions are illegal in NY. You can go to any hospital you choose. Rates are set by law. The Centers of Medicare and Medicaid Services (CMS) has a set compensation schedule for ambulance transport.

    It is definitely expensive, but not out of the realm of reasonableness, I think. A single fully equipped ALS ambulance will run upwards of $250k with ongoing costs for labor, fuel, and restocking of used equipment and drugs (which expire), not to mention the overhead for administrative work and ongoing training.

    To tweet or not to tweet. I tweet therefore I am.

    by RadicalParrot on Sun Sep 01, 2013 at 03:50:05 PM PDT

    [ Parent ]

    •  My mother's last trip to the "real" hospital (8+ / 0-)

      45 miles and not 5 minutes away was about $1,250.

      The hospital five minutes away is where you go to die when you have a critical ailment which has happened to her three times there.  So, that's the other "great" thing about the choices in that region because if you are scared that you might not be able to afford the longer trip, you might make a critical decision that could end your life.

      We are fortunate enough not to have to take the financial calculation into the equation, but that town is mostly poor and the people there do take that into consideration which is sad and scary.  Particularly since I can tell you that from our experience if some of the first important events had been treated at the other hospital 45 miles away, my mother might not have had the massive stroke she did and may well have had treatment that would have prevented the brain damage and problems that she lives with today.

      She's a much more expensive Medicare patient than she might have been.  Of course, the Obama Administration says that the medical community is doing "too many expensive tests" and that's the problem - ha - if the medical community had actually done the tests they should have - MRIs with neurologists looking at the results somewhere during the seven years that she was having significant problems - she would be far more self sufficient and probably not brain damaged as she is now.  But they didn't want to test and they wanted to write her off.  So now Medicare pays for nursing, seizure medications, neurologists, hospital stays, and all kinds of shit that a prescription for a blood thinner probably would have prevented - she had a blood clot in her brain building for years that no one found.

      Isn't that awesome?

      •  Sorry to hear that (2+ / 0-)
        Recommended by:
        ColoTim, Dianna

        Where do you think the fault lies? Was it the doctors who wouldn't order the tests, or were they hamstrung by Medicare?

        To tweet or not to tweet. I tweet therefore I am.

        by RadicalParrot on Sun Sep 01, 2013 at 05:12:39 PM PDT

        [ Parent ]

        •  The doctors who did not move her along to (5+ / 0-)

          the hospital that could have done the tests and the doctors who wrote her off as "old" even though she is not really old - and a system that is increasingly putting pressure on docs and healthcare providers to cut down on testing.

          Less and less of our healthcare system is being driven by science.  More and more is being directed by payment whether it is private insurers, government or a person's bank account.  The ACA hasn't really changed that for the average person.  It has helped with people already diagnosed with critical diseases, but it isn't going to help prevention the way that it should.  The Medicare cuts within ACA also deeply affected my Mother and other people who are in her situation.  Those cuts started rolling out early this year.

          I've worked with the healthcare industry for nearly 20 years now and I can tell you that a lot of the wonkery in ACA and the really piss-poor law writing is going to start to become problematic in fairly short order - within the next five years or so.  But it will take the next 20 or so for the studies to be completed and for people to have "science-based" evidence to once again prove that private health insurance and withholding treatment is bad for public health and the economy.  I'll be closer to dead or dead by then, though. I hope for the best for future generations in the quest to get this thing back into the zone of "health" for everyone.

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