Tuesday, November 15, 2011

Life Or Debt In The Keys

There is some debate underway in Monroe Country about the value of Trauma Star the county air ambulance service. As usual the debate has descended to the spit balls and school yard level of political discussion but there are real issues at stake here, not least how much ordinary working people pay to ride an air ambulance to Miami.


There are two air ambulance services in Monroe County. Lifenet is the private provider and they charge full fare to any and all passengers. Lest you think you are a one percenter and imagine you can afford a ride to burn or trauma centers in the Big City a Key West resident recently took a ride and ended up on the front page of the paper facing a $27,000 bill that he says he cannot pay. That half the adults in Monroe County have no health insurance should not allow this to be construed as an unusual occurence. When Lifenet won the contract they promised they wouldn't hound customers to get their bills paid. Interestingly if you need an air ambulance in the city of Key West officials are required to call Lifenet first. The customer gets no say. If Lifenet's ambulances are busy they call Trauma Star as the second choice. County dispatchers call Trauma Star first to pick up the patient outside the city. For residents of the Keys the difference is crucial.



Trauma Star service is part of the Monroe County Sheriff's Office and is subsidized by a $50 per parcel tax throughout the county. The agreement here, honored by our public servants, is to charge county residents no more than their insurance will pay, and nothing at all if they lack insurance. Their rates for paying customers, publicly listed are easy to read and decidedly cheaper too: $5500 for call out and $80 per mile.


Here's the problem, in the political environment in which we live, toxic to rational discussion and sensible outcomes the vocal opponents ask loudly why those that don't need an air ambulance should pay for it through something as iniquitous as taxes. As though Lifenet isn't charging those of us with insurance (like me!) to pay for those who can't pay their impossible bills. This ghastly state of affairs came to very public light a few years ago when County Commissioner Mario di Gennaro a member of the notorious Gang of Three suddenly saw the populist light when his daughter got a Lifenet bill for a flight to Miami. He tried to win public support by campaigning for Trauma Star service but his record of dubious public positions lost him his seat anyway. The paper estimated his net worth from his disclosure forms at between 16 and 20 million dollars so I don't suppose his daughter is still dealing with that particular bill, but it should give every resident of the county of the Right or Far Right pause when a one percenter gets shaken awake by an air ambulance bill.
Don't count on it though. The problem with supporting Trauma Star is that it is such a sensible public service that opposing it forces people of the Right to once again lose their political, social, ethical and emotional minds. If one supports the notion of a very modest parcel tax to help pay for a service that saves lives, a service that most of us can't pay individually, you find yourself on the single payer spectrum of public health service. Trauma Star is single payer writ small, Lifenet is what we have now, huge bills paying salaries, stock holders and unrecoverable charges. The recent letter writer in the Citizen whinging about Trauma Star and its tax base of support (she cried: Socialism!) better be ready with a big fat check because Trauma Star is currently reserved for those of us lucky souls who live anywhere in the Keys outside Key West. Lucky me.

3 comments:

Anonymous said...

Conch,
My spouse had surgery two weeks ago. As of yesterday, we are at $102,000 in bills received, with many more to come. 5 hours in pre-op, operatory and post-op, plus 24 hours in-patient = $87,000 hospital charges. Surgeon is a comparatively reasonable $12,000. Pre-op EKG? $688. And so on. We started selling personal belongings two months ago to help pay our share of costs, but I foresee bankruptcy ahead. What was my option? Let my spouse die by foregoing needed surgery? Bring on socialized medicine with all dispatch.

Conchscooter said...

I am so sorry. Don't destroy yourself financially now that you have restored your wife's health. A lawyer could help for a lot less money. Negotiate lowered fees or monthly payments. My wife says when the bills get unbearable we pay five bucks a month forever and keep them at bay. It's all desperation talking in the hope of something changing before that day arrives.

The weird thing is that those of us who have lived with single payer know how good it is. You'll never find a vet, a Medicare recipient a European or a canadian that wants to buy private insurance to replace their health cards.

Anonymous said...

I never thought about a lawyer before, or negotiating a small payment per month. Thanks for the suggestions. Not fishing for sympathy!, just telling a true story of how screwed up our current health care system is. I was, long, long ago, married to a Canadian who, although now having American citizenship, is returning to Canada for the healthcare system after being laid off from a Fortune 100 company after 2 decades... Another true American story! :(