Recession and EMS

[seshan]

As much as I hate the fact that there is a fear imbedded in peoples minds about a so called "recession"-especially when I believe that media propaganda is responsible for this fear, but it seems today that it is a reality without any sights of improvements.

I would like to know how EMT’s are affected by this recession in the EMS industry?

My general thoughts are that with the amount of aging babyboomers and the increased need for medical attention that the EMS and Medical market will not feel as much of a “recession” than say the automotive and manufacturing industries.

Any thoughts?

 

[VentMedic]

As much as I hate the fact that there is a fear imbedded in peoples minds about a so called "recession"-especially when I believe that media propaganda is responsible for this fear, but it seems today that it is a reality without any sights of improvements.

You have already skewed this conversation.

Fear? Know anyone that is going through foreclosure or know where almost entire neighborhoods with vacant houses? Noticed the differences in backgrounds of people who are now in the homeless shelters? Aware of the many layoffs by industries of all types including health care? See the correlation between employment and insurance? Have kids in school to realize how many schools have been closed and teachers laid off? Noticed the cut in school programs? Tried applying to a state university lately and notice the cut backs for admissions? Own a home to pay property taxes as government agencies are trying to offset the growing deficits? Notice the Tea Party protests on April 15? Watched your retirement funds and stock portfolio shrink to less than 1/3 of what it had been? Yeah, fear.

For EMS, the calls may be different. More stress related illness and injuries will be prevalent. More suicide attempts, although many more will be successful. More violence and more crime has already been noted. Did you also read in the news papers that some of the entire families killed by a member of that family, and then suicide, also had serious financial problems?

There are some of us who are aware of day to day happenings in the community around us and know what happens to our neighbors will have an effect on us as well. I've seen the lay offs at the hospitals. Unfortunately, those being laid off are the ones who can't afford to lose their jobs.

Even the unions for FDs and PDs are asked to take cuts in their contracts. Some fight it and then you end up with a Vallejo, CA situation. Do you know how many other small cities are on the brink of bankruptcy in CA? Even the large cities like SF are struggling with cutback. Heard about the brown-out controversies to save costs? Do you know anything about the costs to operate EMS? It is more then the employees. Do you understand the various budgets? Capital budgets? Long term and short term investments? Other sacrifices may have to be made to keep the same number of trucks on the street?

What about the many services that have been cut by the cities and states? Clinics? Mental health? Prescription assistance? Don't these relate to health care? As well, almost every hospital in the country has cut a few things or will just make do for awhile.

This is a little more involved than just media propoganda when there are so many harsh realities present for too many families.

 

[triemal04]

My general thoughts are that with the amount of aging babyboomers and the increased need for medical attention that the EMS and Medical market will not feel as much of a “recession” than say the automotive and manufacturing industries.

Any thoughts?

Yeah, just one: apparently you have forgot that healthcare is damn near always run as a buisness. And when a buisness is no longer profitable and starts to lose money, what happens? 3 guess's and the first 2 don't count.

It doesn't matter how many people need access to doc's, hospitals, clinics, ambulances, etc if they can't pay for it. Especially when the federal gov't isn't paying as much for it either. Would you like to hear about the hospitals here that are nearing bankrupcy right now? The ones that can't finish their halfdone expansions? The ones looking for infusions of public money so they can continue to operate? Or how about the ambulance services that no longer pay overtime, just take units out of service when people call in sick/take vacation? Or the ones on hiring freezes? The ones cutting service? Cutting pay and benefits?

Heard of any of that? Or do you just want to keep ignoring reality?

 

[VentMedic]

Here is one example of how a recession plays into the demand for jobs. However, this may not be for the reasons one might thing.

Recession Slows Demand for Nurses
http://abclocal.go.com/kgo/story?section=news/health&id=6776151

"The economy has caused people to lose their health insurance -- so hospitals are seeing fewer patients, people are putting off surgeries, they are putting off health care that they need," said Roz Hartman of College of Marin Health Sciences.

Hospitals are also seeing delays in reimbursement for their services leading them to hold off on filling positions that are open. The jobs that are available generally go to experienced nurses.

"What's happened is many nurses have gone back to work because either their spouse has lost a job, they have lost health insurance, or there is a fear that their spouse will lose a job," said Hartman.

As of last summer, there was a nationwide shortage of about 125,000 nurses -- that's gone, as are the dreams of some nursing students.

Those of you wanting to be a nurse or some healthcare professional will still be able to do so and things should get better after the economy stabilizes. However, your first job may not be the one in your dreams.

It is also not just the patients that are putting off surgeries, the physicians are as well. Doctors are reluctant to take call or perform some surgeries that can be postponed until the various insuring agencies can pay. California is particularly familiar with this when MediCal didn't pay its bills to LTC facilities or doctors for a few months.

 

[CAOX3]

My general thoughts are that with the amount of aging babyboomers and the increased need for medical attention that the EMS and Medical market will not feel as much of a “recession” than say the automotive and manufacturing industries.
Any thoughts?

No you might not see cutting of personnel, you wont see them adding any either. The increase in call volume will just be sucked up by the already overworked and underpaid EMS personnel.

Propaganda? Tell that to the homeless and unemployed.

Unemployment and foreclosures are at all time highs.

 

[carpentw]

The recession has hit EMS pretty hard where I live.. They have shut down an ambulance service all together and have diminished services in several areas.

 

[Shishkabob]

It doesn't matter how many people need access to doc's, hospitals, clinics, ambulances, etc if they can't pay for it.

I have yet to hear of anyone being denied emergency services because of their lack at being able to pay.



PS-- CAOX3, they aren't "all time highs" as it's no where near The Great Depression, which is still considered a time =P

 

[triemal04]

I have yet to hear of anyone being denied emergency services because of their lack at being able to pay.



PS-- CAOX3, they aren't "all time highs" as it's no where near The Great Depression, which is still considered a time =P

No, ER's won't (can't actually generally speaking) refuse someone emergent service. But that also doesn't mean that they will be paid for those services. Or that the people providing them will decide to work for free for that pt. Which means that, oh, I don't know, they will be losing money. And as more people can't afford to pay for their own healthcare (either out of pocket or with insurance) this will happen more and more, which means that that hospital/ambulance service/whatever will continue to lose more and more money and then...bet you can guess what comes next.

I wasn't kidding about any of the examples I posted, and that's just up here; try looking nationally and it's much worse.

Edit: when a hospital closes and no longer has an ER, or an ambulance service goes bust and leaves that area in the lurch, I suppose you could call that being denied emergency service. :blink:

 

[Mountain Res-Q]

I have yet to hear of anyone being denied emergency services because of their lack at being able to pay.

PS-- CAOX3, they aren't "all time highs" as it's no where near The Great Depression, which is still considered a time =P

Denied it, no. Fail to seek it for fear of not being able to pay for it (especially after they get fired and don;t have insurance anymore), yes. While this mostly affects Hospital and Clinic Staff: You-know-what always role downhill. Does it mean that EMSers will be losing jobs over teh economy? Probably not, but private companies will be less likely to hire new people out of fear over the current state of affairs. And who is gonna pick up the slack assosiated with decreased Hospital and Clinic Staff and fewer new EMSers?

And if there are less people visiting the hospitals for more "minor" conditions, the amouont of IFTs is likely to drop slghtly, which tends to be the bread and butter of many companies, i.e. AMR, etc... I know of several EMT's that were laid-off becasue of lowering demand for IFT's in my area... a big source of revenue for this particular company.

Cost also go up in an economy like this which means that it is more expensive to run private ambulance companies, another concern that may make EMS organizations panic slightly more than some would think.

 

[medicdan]

It seems to me, at least in the area in which I work, that the privates are doing very well financially. They are being hit hard by gas and supply prices, but cope.
Its the services that are running 911, and may be subject to smaller town or city budgets that I see as having trouble. To quote AMR in MA, "There's no money in 911!"

 

[NorCalMedic]

It seems to me, at least in the area in which I work, that the privates are doing very well financially. They are being hit hard by gas and supply prices, but cope.
Its the services that are running 911, and may be subject to smaller town or city budgets that I see as having trouble. To quote AMR in MA, "There's no money in 911!"

I actually work for a private ambulance company, and they recently have been reporting that they have been getting hit from Medicare and Medical lag days in paying for the actual calls ran. That is a scary thing for them because 95%+ of their earnings come from these insurance companies.

 

[VFFforpeople]

In my small CA town up north about 3 1/2-4hours from SF. We are hit hard, our paid hospital is closing down. and Mercy's ER is flooded. It is ugly here. Medics making 13 an hour, Emts making 10. RNs at 20-22. Lay-offs, FFs,PD being laid off. We are understaffed everywhere with no money to staff. EDD-17%. So to tell me, media propaganda...I will tell you to take a flying leap! My dad just got laid off 15yrs for the same company. I have met people working over 30yrs, here. Blue collar good folks give ya the shirt off their back, out of work..and yet we still donate money to help those that are poorer than us. Yet you think it is only fear..no big deal..You will never understand thinking like that. Half the Dr.s are on call because they can't staff em. Why become a Dr. now? Whats the point? you will be underpaid and never pay off your debt. Our city wants to pull more of us volunteers because thats all thats left. It is a grim view.

 

[VFFforpeople]

I actually work for a private ambulance company, and they recently have been reporting that they have been getting hit from Medicare and Medical lag days in paying for the actual calls ran. That is a scary thing for them because 95%+ of their earnings come from these insurance companies.

Ya like I said, I am a few hours above you, thats all that is here is medicare/cal insurance and even no profits are having trouble opperating off of it. Which is sad, when non profits are having trouble.

 

[NorCalMedic]

Its the worse i have ever seen! I went to Paramedic school spcifically because they were looking for soooo many at one point in time. Unfortunately for me 10,000 dollars later and the down turn of the economy, here I am paying student loans off and working as an EMT making enough money to just skim by. Its a crappy world when we cant hire full time doc's to cure us, and are laying off FF and Police that protect us!

 

[Mountain Res-Q]

To quote AMR in MA, "There's no money in 911!"

Must be a company line. I heard the same thing from AMR out in California. The six IFT cars our divison ran braught in 90% of the money. The other 10% was made by the 25 911 cars. A down turn in the amount of transfers they run now, combined with the lag time in Medi-Care payment (if they pay at all since tehy often denied most of our transports as unwarrented) means that several EMT's I know are now drawing unemployment.

Who here called the fear unfounded? Can I barrow that silver spoon you are eating with in your palace of gold?

 

[SanDiegoEmt7]

ventmedic is correct.

My employer (a private company) was also hit by the medicare/medi-cal issue. They have frozen their hiring for the last six months, as well as taken away our overtime hours, and our ability to pick up overtime shifts. With no other companies hiring currently though, beggars can't be choosers right?

The recession has hit people hard, I have family and friends whose retirement packages were destroyed. Hopefully things turn around in the next couple years.

 

[medicdan]

The impact of the recesion, it seems, is causing other changes within EMS. I have been reading about community hospitals, who are having trouble maintaining staffing and reimbursment levels transforming their ER/EDs into Urgent Care Centers, and in the process, deserting their community (NB some of these ERs were sub-par to start with)...

That adds more volume to the urban centers, who in addition are seeing more patients for previously treatable conditions, brought on by the lack or decrease in primary care. We have chronic patients, who either due to non-compliance, high costs, poor coverage, etc, are flocking to ERs for their primary care, etc. The list goes on...

Boston saw some of this, last summer, when ERs were on divert so much the state had to step in. I aspire to be a helathcare economist, and the American healthcare system facinates and scares me. We need to start treating the roots of our problems, not just put bandaids over the symptoms.... And putting communiy EMS services and hospitals out of busines isnt helping. I am going to stop my rant here, but if interested, I reccomend the recent articles by Stuart Altman (see the recent NEJM and NYT pieces).

 

[remote_medic]

socialized healthcare anyone?

As a Canadian citizen living in the US I have seen the good and the ugly side of socialized medicine.

 

[VFFforpeople]

Its the worse i have ever seen! I went to Paramedic school spcifically because they were looking for soooo many at one point in time. Unfortunately for me 10,000 dollars later and the down turn of the economy, here I am paying student loans off and working as an EMT making enough money to just skim by. Its a crappy world when we cant hire full time doc's to cure us, and are laying off FF and Police that protect us!

Ya, up here in Redding, our council members are cutting 60 PD jobs..Meth capitol of the world and we are losing 60 cops. Talk of cutting more FF jobs..So we will be responding 1 on an engine lol, I mean this is horriable. Medics are still being hired here, just not alot of money. Medic school is 17-20k depending on where you go here. I hear ya man, My family is from the bay, my grandpa was saying it is getting ugly down there. Be safe!

As for socialized healthcare. You can keep it. Canada doesn't have Illegals jumping the borders living on the system. PLus I see more canadian Drs. here working, I ask them why did you leave and come here. "O, I make more money here then in Canada." Now we are back to the same Issue as before, but with even more debt and people leaving to make more money. Anyway thats my thought.

 

[remote_medic]

Ya, up here in Redding, our council members are cutting 60 PD jobs..Meth capitol of the world and we are losing 60 cops. Talk of cutting more FF jobs..So we will be responding 1 on an engine lol, I mean this is horriable. Medics are still being hired here, just not alot of money. Medic school is 17-20k depending on where you go here. I hear ya man, My family is from the bay, my grandpa was saying it is getting ugly down there. Be safe!

As for socialized healthcare. You can keep it. Canada doesn't have Illegals jumping the borders living on the system. PLus I see more canadian Drs. here working, I ask them why did you leave and come here. "O, I make more money here then in Canada." Now we are back to the same Issue as before, but with even more debt and people leaving to make more money. Anyway thats my thought.

HaHaHa. What does "Illegals jumping the borders living on the system" have to do with socialized medicine in Canada? As far as higher salaries in the US...again, what does this have to do with socialized medicine in Canada?