I received a number of comments on Trumpcare’s First Victim: American Medical Response that indicate I wasn’t clear enough on a few things for people to understand. I want to make a few general clarifications before addressing some of the individual comments I have received.
First, I want to stress that the article from Modern Healthcare originally cited indicates that AMR is for SALE… NOT GOING OUT OF BUSINESS. This is significant because Envision, unlike prior owners Laidlaw (a bus company) and Onex (auto parts/airline manufacturing), Envision is healthcare oriented and for years touted AMR as a cornerstone of its model. During that time AMR has truly been able to grow and improve in many facets, something they previously had been unable to do under ownership who lacked a healthcare focus. The fact Envision is looking to sell it is an indicator of where healthcare is projected to go and leaves the progressiveness that AMR has enjoyed over the last few years in question.
Second, anyone who thinks that EMS can stand alone and apart from the healthcare system is gravely mistaken. We are not an industry unto ourselves as has been illustrated time and time again. Things affecting the healthcare system as a whole (hospitals, clinics, physician practices, etc.) is going to have an impact on EMS either directly or indirectly. The estimated loss of 24,000,000 insured individuals from the population will have an impact on EMS reimbursement and collection for service. As long as EMS remains a fee-for-service industry we will be affected by that which affects the greater whole.
Third, one of the propaganda points made regarding Trumpcare is its “return to a free market” for healthcare. That is absolutely false. I previously illustrated this fallacy citing EMTALA of 1986. Does EMTALA specifically regulate EMS? No, it does not UNLESS you are a hospital based ambulance. Aside from impacting EMS through the hospitals (see my second point above) what EMTALA did was create an environment where healthcare is devalued due to its ease of obtainability through the emergency departments of America, proven true through the increase of emergency department volume over years. EMTALA destroyed any notion of free market healthcare and is the first step towards Socialist medicine, not the ACA. As I noted, EMTALA was signed into law by Republican President Ronald Reagan. Perhaps we should rename EMTALA to Reagancare? If we are to believe the hype of returning healthcare to a free market, then why aren’t we repealing EMTALA?
Lastly, it does not matter who the President of the United States is when the legislation proposed revokes the ability to provide healthcare system reimbursement on services rendered for millions of Americans. Many of those millions use the EMS system to gain access to healthcare. If they can longer reimburse the hospitals for their usage it is safe to say they will not be able to reimburse EMS. I could have just as easily called it Cruzcare, Bushcare, or Ryancare. It was, after all, Republican branding of the Affordable Care Act as Obamacare that started this trend.
I am not “attacking” the President… I am being critical of the legislation he has put forth that will defund what had been, up until the ACA (Obamacare), an unfunded mandate in EMTALA (Reagancare). Honestly, it reminds me of this person I know who claims that they are “attacked” anytime someone disagrees or says something they don’t want to hear. Trust me, it isn’t an attack. Now, had I called it Putincare, then maybe I would agree that it was an attack… but I didn’t. Don’t confuse disagreement with hostility. Don’t become a blind brand defender. The only casualty in those false accusations is your own reputation which undermines your ability to cope with an actual attack when it comes.
I have comment moderation on for this site. That means that all comments are held back from publication unless you have a previously approved comment elsewhere on the site. Needless to say, all the comments had to be approved including those who disagree, both sensibly and disrespectfully, because apparently no one ever felt the need to comment on any of my other 464 posts.
Here is a list of the replies to the individual comments for your perusal:
- Jake‘s comment on EMTALA creating bad debt and whether AMR was ever able to turn a profit and my reply thanking him for proving my point
- Patrick‘s comment as a 16-year veteran of AMR claiming ownership changes won’t change the company and my reply highlighting AMR‘s progress under current ownership and why it does affect everyone at AMR if there is a sale
- Wes‘s comment about tone-deaf leadership at Envision and how we need to stop picking on Trump and my reply spotlighting the forward thinking of Envision leadership to divest now before experiencing bigly losses and explaining the naming convention for
PutincareTrumpcareIt is worthwhile noting that Wes also wrote his own blog post on the topic titled What Really Happened With The Proposed Sale Of AMR. While he makes some very good points regarding the acute lack of political activism from EMS, those points are lost by being ensconced in hyperbole. My General Clarifications above clarify my position on the vast majority of the points in that post which, unlike Wes, I have actually linked to so people can read it and make their own informed decisions.
Recommended Reading: Linking To Other Bloggers
- Ken‘s amazingly bigly inaccurate comment and my reply listing those inaccuracies and chastising him for having a Hotmail e-mail address
Feel free to share your own constructive thoughts in the comments…