• Last modified 1178 days ago (June 1, 2016)


Call it Dallke-care?

Or, perhaps, Holub-care, Lalouette-care or maybe even Debesis-care? None have quite the ring of Obamacare, but whatever you choose to call what the county is trying to do with emergency medical services, it shares one thing in common with what the president tried to do with the nation’s health insurance system.

While laudably addressing serious problems about delivery of health case, both seem to have as their main accomplishments little more than massively increased prices and steadily swelling government payrolls.

The real problem with rural ambulance service may very well be out of the control of county commissioners and EMS directors. Laws detailing precise equipment, staffing, and training — while quite logical in large metropolitan areas — may be inadequate to deal with the challenges of rural areas, especially those where calling an ambulance has become a substitute for a house call by a doctor or a telephone call to a 24-hour nurse.

Look at the Emergency Dispatches column on Page 6 of this week’s paper. Even as the county is increasing what it charges for most ambulance services so that its rate now exceeds what Medicare will cover, in 12 of the 30 times Marion County ambulances were called out this past week, no patient was transferred — and, therefore, none of the county’s costs were recovered.

Simply put, the other 18 calls had to pay for their own, plus the 12. That alone creates a 30 percent markup over actual cost.

Of the 18 times in which patients were in fact transferred, 10 involved transfers from one health care facility to another. So only eight times did a public call for an ambulance actually result in an ambulance transporting someone. And most of those runs involved either vehicular accidents or people collapsing in public places, where trained personnel rather than panicked callers summoned an ambulance.

The vast majority of calls to visit a patient at his or her home were essentially free house calls.

That’s not to say it isn’t important for us, as a society, to have in place some sort of mechanism for helping those who need such assistance. However, sending a full and heavily trained crew — in some cases, as many as three or four different certified EMTs — in vehicles equipped with tens of thousands of equipment means that those who legitimately need ambulance service are subsidizing those who could be served by some other means.

Too often government grows and grows and grows — and increases the prices we citizens pay as a result — because it fails to look for simpler solutions.

Before Marion County emergency medical services becomes yet another unstoppable growing bureaucracy, isn’t it time to see whether some commonsense solutions might also be tried?


Last modified June 1, 2016