Thursday, August 14, 2014

A TBT repost... Our Cup of Good-Will...

This is the kind of story that goes viral. It smacks of greedy helicopter companies sticking it to people at their worst and weakest point of life, and if the word gets out that this is the way our industry is, that good will I was mentioning earlier will be...Gone!

A year ago, Jeanne (wife, friend, flight nurse) and I went on a Cool Jazz Cruise for a week. We had a great time going to the big shows each night, hanging with cool people, and soaking up the tropical vibe. The best part of the ride took place the night before we stopped in Key West. We went to the early evening show in which Marcus Miller did things with a bass guitar that were mind and eardrum blowing, and were then walking back toward our stateroom. We passed by a small, almost empty piano bar and I suggested we stop in for a drink. The room was dark, and the ships piano player was tickling the ivories. I stood there for a minute and as my eyes adjusted I noticed Jonathan Butler - one of the featured musicians on board - sitting at a table with his family. "Hey Jeanne, that's Jonathan Butler. Let's sit at the piano for minute..."

I sat down and exchanged pleasantries with the piano player, an older fellow with a slightly tired grin and a vast talent, and ordered drinks. After a few minutes, in this dark little nearly-empty space, J.B. got up from his table and walked over to the piano.

"Holy Shit, he's gonna play..."

The house player gave up his seat at the piano and then Rick Braun, walked in with his horn in his hand. He and J.B. started talking and smiling. Then the fellow who had chartered the boat, the entire boat with 2000 passengers, came in and sat down. Then a couple more performers bellied up to the piano, and the cruise host... Someone said, "close the doors."

Now I don't know what your favorite music is, but imagine if you had the chance to sit in a dark little bar with the people who make it, and listen to them talk, and play for each other. We sat there quietly, and soaked it up - obviously not part of this group - and loving every minute of it.

Then it happened. Someone from across the piano didn't recognize us and asked "what do you do?"

I sipped my Jameson, put down the glass, and said "I take sick people to the hospital in helicopters." 

"Wow." "Cool man." "That must be really something..."  We were made to feel welcome, and J.B. played Jeanne a love song for her birthday. J.B. and Rick Braun tore into a couple of songs, and then the others took turns performing a song or two, and it was a really good time... A once in a lifetime kind of thing. Jeanne and I were welcomed because of what we do. She takes care of sick people and I fly. 

Society - today - looks up to us, literally and figuratively. We enjoy significant good-will and support from the communities we serve, and will continue to do so unless we lose our way and get out of touch with the "service" aspect of our endeavors.

I know that operating a HEMs business is challenging. The risks are significant. The amount of capital required is staggering. There is no guarantee of success. The old joke about making a small fortune -by starting with a big one and buying a helicopter - has played itself out time and again. It is understandable, indeed rational, that as business people in the business of transporting ill and injured persons for profit, we should attempt to maximize our profits, and perform as many transports as possible.

We don't check for insurance before flying someone, and some people don't pay anything - that money is lost. We also don't get paid for airborne-standby flights that get cancelled, or other community-services we provide, but obviously, there is money to be made because the number of EMS helicopters has quadrupled in just over a decade.

Occasionally, profit-motive can run over caring and compassion like a squirrel in the road and leave the caring aspect a little flat.

An anecdote:  A rural hospital employee suffered a stroke and was transported by helicopter to definitive care at a stroke-center. She recovered, and got a bill approaching $20,000 for a 15 minute flight. She was contacted by the transport service's billing department and the discussion went like this:

"Well ma'am, your insurance has authorized payment of $5000.00 for this transport which leaves you with a balance of $15,000.00. How do you intend to pay this?"

"Sir, I don't have $15,000.00 to pay this bill. I work in a country hospital and don't make much. I can come up with another $5,000 and hope that can be acceptable to settle my bill."

"No ma'am that will not settle your account. Do you thing you might get your church to have a fund-raiser? Or perhaps you could have your husband come out of retirement and get another job..."

This actually happened. The thing that makes it so indefensible is that if this patient had been a Medicare beneficiary, whatever Medicare paid would have amounted to 80% of the total allowable charge (much less than the straight-billed rate), and this woman's obligation would been only 20% of that allowable amountAnd the company would have been satisfied. But she wasn't old enough to be under Medicare, or poor enough to be under Medicaid,  and she was stuck by balance-billing.

This is the kind of story that goes viral. It smacks of greedy helicopter companies sticking it to people at their worst and weakest point of life, and if the word gets out that this is the way our industry is, that good-will I was mentioning earlier will be...


Perhaps the Government should dictate that the most money a person with no healthcare insurance can be required to pay is equal to what the provider would accept under Medicare rules...The self-pay amounts are jacked up today to provide for greater write-offs against profits, thereby reducing tax liability. But the patient's credit, and perhaps life, is still ruined. And frequently, in the case of air medical transport, that patient has no idea what's going on, or even if air transport is really required. 

Courtesy AP
If the companies don't cotton to the fact that one aw-shit wipes out a thousand atta-boys, and use some common sense regarding business development and utilization-review, the friendly folks in government are going to be flooded with irate emails and phone calls and in addition to not getting paid there will be hell to pay. 

May wiser heads prevail.        

So that our cup of good-will never runs empty...

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