# Are you Volunteer or Paid?



## resq330 (Oct 22, 2009)

Being new here, I just wanted to get a feel for how many people were volunteer -vs- paid.  With only being on here for one day, it seems like a lot of people are on the paid side of things.

I've stated this in a few places already but I've been a member (now a Life Member) of my local volunteer rescue squad for 13 years now.  And I've been an EMT-B for roughly 7 years.


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## reaper (Oct 22, 2009)

You can check the search area. I think this poll has been done recently.


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## resq330 (Oct 22, 2009)

reaper said:


> You can check the search area. I think this poll has been done recently.



i saw one from back in 2005 and it looked like it was short lived.


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## SA_Medic (Oct 22, 2009)

Started off as a volunteer, became paid and now I am both. Paid by my service and volunteering at another.


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## WolfmanHarris (Oct 22, 2009)

Only paid EMS in this Province aside from the most remote areas served by EMR's who still receive pay, just not a lot. Those remote areas are then backed up by paid Paramedic land Ambulance or by Air depending on whether they're the sort of place you can drive to or have to take a train/fly.


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## Mountain Res-Q (Oct 22, 2009)

resq330 said:


> Being new here, I just wanted to get a feel for how many people were volunteer -vs- paid.  With only being on here for one day, it seems like a lot of people are on the paid side of things.



Paid or volunteer Ambo?  Fire?  Rescue?  Disaster Services?  Other?

What aspect of EMS are you looking at?  All various apects of EMS ranging from Ambo and Fire to Military and Tactical to Disaster Services and Rescue and Public Service to Private non-ambo facilities?  or just the "EMS is only Ambo" side of things?

I will hold off on answering as I am no longer working ambo (currently... fingers crossed) but have my hand in several non-ambo related aspects of EMS.


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## resq330 (Oct 22, 2009)

Mountain Res-Q said:


> Paid or volunteer Ambo?  Fire?  Rescue?  Disaster Services?  Other?
> 
> What aspect of EMS are you looking at?  All various apects of EMS ranging from Ambo and Fire to Military and Tactical to Disaster Services and Rescue and Public Service to Private non-ambo facilities?  or just the "EMS is only Ambo" side of things?
> 
> I will hold off on answering as I am no longer working ambo (currently... fingers crossed) but have my hand in several non-ambo related aspects of EMS.





My Bad...I was really referring to Rescue.  But, since I didn't specify (and can't edit my post :huh then I guess that leaves it wide open


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## WolfmanHarris (Oct 22, 2009)

Mountain Res-Q said:


> Paid or volunteer Ambo?  Fire?  Rescue?  Disaster Services?  Other?
> 
> What aspect of EMS are you looking at?  All various apects of EMS ranging from Ambo and Fire to Military and Tactical to Disaster Services and Rescue and Public Service to Private non-ambo facilities?  or just the "EMS is only Ambo" side of things?
> 
> I will hold off on answering as I am no longer working ambo (currently... fingers crossed) but have my hand in several non-ambo related aspects of EMS.



Very good point, I assumed Ambulance. We don't have any fire-medics here and SAR is all done by the military, where their SAR techs are PCP's. The rest are first responder or EMR trained only.


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## tydek07 (Oct 22, 2009)

Volunteered as a basic for a year... went to medic school, now working at a paid service.


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## downunderwunda (Oct 22, 2009)

If we want EMS to be a genuine profession there is no place for volly organisations.

End of story


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## Lifeguards For Life (Oct 22, 2009)

downunderwunda said:


> If we want EMS to be a genuine profession there is no place for volly organisations.
> 
> End of story



why can't "professional" EMS providers advance,  and vollies keep providing first response?


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## downunderwunda (Oct 22, 2009)

Lifeguards For Life said:


> why can't "professional" EMS providers advance,  and vollies keep providing first response?



If there is enough need for first responders, there is enough need for a paid service to cover the area. 

The more reliance we, as a profession, place on First Responders, the less chance there is of expanding paid services. 

Remove First Responders, take EMS from the Fire Brigade, make them look after their core business of fighting fires & lifting heavy things & allow us to have our own profession.


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## eveningsky339 (Oct 22, 2009)

Worked as a volunteer EMT-B for a year, now work per diem for the same company I volunteered for as a I continue my education.



downunderwunda said:


> If we want EMS to be a genuine profession there is no place for volly organisations.
> 
> End of story



I'm sure the people who voluntarily give up their free time to run 911 calls don't appreciate this blanket statement.


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## scottyb (Oct 22, 2009)

downunderwunda said:


> If we want EMS to be a genuine profession there is no place for volly organisations.
> 
> End of story



Here we go again.  Another fight coming.  We get it, some paid guys despise the volly, and this volly thinks that those paid guys need to get off their high horse.

From a dedicated volunteer, stop bashing the volunteer.  you are ousting a large percentage of the ems community.  paid or volunteer, our goals are the same.  There is something special about a group of people that get together to do something in their community without expecting a paycheck in return.  Just thank us/them for the willingness to help and move on.


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## downunderwunda (Oct 22, 2009)

eveningsky339 said:


> Worked as a volunteer EMT-B for a year, now work per diem for the same company I volunteered for as a I continue my education.
> 
> 
> 
> I'm sure the people who voluntarily give up their free time to run 911 calls don't appreciate this blanket statement.




I am positive they dont. However, lets look at reality.

If you run a service on too many vollies, then this happens http://www.abc.net.au/4corners/content/2009/s2615353.htm.

It is harder to regulate vollies.

I hear regularly that people want a 'career' in EMS, they want to make it their 'career' but how can they when there is an over reliance on vollies to pick up the slack so no one has to pay for it???????????

Force the mongrels to provide a proper serveice that is available for all, run by professionals & gives the option of a career.


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## MrBrown (Oct 22, 2009)

70% of our workforce (ambulance) here is volunteer but they only cover about 20% of the workload.

I do not have a *"problem"* with volunteers per-se as they willingly give up thier free time or work time to respond to calls; same with the volunteer firefighters; I do like the firefighters, they are bloody fantastic when you need them to turn a car into a convertible.

The issue with volunteers is there will always be a "compromise" between the people who go and seek to make paramedicine a career, put in thier 3 years to get the Bachelors Degree and work up to ALS level and the volunteers who are unable to commit to the same level of education.  It's not because they don't want to outright but becaue they have other lives, jobs, families etc and can't spent the time required to learn in-depth anatomy and physiology, pharmacology, cardiology etc.  They tend to operate at a lower clinical competency level and generally have fewer patient encounters.

New Zealand is branching out to seperate qualifications between volunteer and paid staff; those who want to make it a career will be expected to complete a Bachelors Degree (3 years) and a Post Grad Certificate in Intensive Care Paramedicine (Advanced Life Support - 12 months).  The volunteer ambulance officers will be expected to complete a post-secondary, community college style, in-house Diploma in Ambulance Practice which is generally run over 12 months part-time.  

This course contains substantially less theory in anatomy and physiology, cardiology and pharmacology than the old Certificate in Ambulance qualification it replaced. We used to do 6 assignments and two block courses of 6 days in class based mainly around A&P and cardio etc then a large on-road session to put theory into practice and be signed off as competent. This content was argued (by the volunteers mostly) to be too "theoretical" and "not relevant when crewing an ambulance" so a good portion of the micro-level stuff was taken out.

There is a vast disparity between what the Bachelors Degree staff and what the volunteers learn both in terms of theory and practical; the Degree core content is based around the common first semester cirricula for nurses, paramedics, physiotherapists etc whereas what the volunteers get (while I am impressed with it) is still inadequate and at a level that is "achievable" for them.

The US doesn't seem to have this problem as the education standards are the same, volunteer or paid, and they are inadequate as it is.


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## Mountain Res-Q (Oct 22, 2009)

If you feel the need to hijack this thread and start another pointless vollie versus paid debate… check out these threads and knock it off here.  No one wants it anymore; it is pointless.  All you are doing is trying to start another fight.  The OP had a question as to if you are vollie or paid.  Answer that if you wish or don’t, but to quote FFEMT:  “We don't need another paid vs. vollie debate.”

http://www.emtlife.com/showthread.php?t=14473

http://www.emtlife.com/showthread.php?t=9454

You will notice a common theme here… all debates that ensure in regards to vollie service (funny how in your mind EMS always means Ambo… never minding the vollie Fire Departments, SAR Teams, and Disaster Relief Services that provide EMS, but not transport by ambulance, are also “bad”) get closed… KNOCK IT OFF…

--------------------------------------------

To the OP… my EMS highlights:

Was paid Ambulance EMT (trying to get back on after several years off)

Was paid Correctional Facility EMT 

Am a Paid EMT Supervisor at a local Winter Recreational Facility

Am the Volunteer Medical Unit Leader for a High Sierra Sheriff’s Search and Rescue Team… of course, this makes me a bad person because I provide wilderness medical care and rescue for free… so, based entirely on some posts here on the forums, I will be quitting soon  and I am encouraging the Volunteer SAR Rescuers that make up 98% of SAR in the United States to do the same…  All those tens of thousands of people we rescue (collectively in Wilderness EMS) every yearswill just have to... well... die...


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## medichopeful (Oct 22, 2009)

As of now, I'm a volunteer with my college campus EMS system.  However, there is talk of us becoming paid.

When I get out of college, though, I will be going paid ASAP.


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## atropine (Oct 22, 2009)

Iam $$$$$$ defintley paid, don't give weight in gold for free, dude really are still playing ricky rescue in this country, oh waite we are still using system status so I guess it all adds up.


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## SES4 (Oct 23, 2009)

Both.

Where I work is paid where I live currently is volley.


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## Akulahawk (Oct 23, 2009)

In a way, I look at working as an EMT-Basic as paid volunteer service. IOW: your pay is SO LOW that you're practically volunteering to work... with the bonus of being paid. You don't do it for the $$$. You do it because you love the work. If that's how you really feel... then going for Paramedic or some other position in medicine will certainly continue your professional growth and pay you better and that'll be the gravy part... you'd still be doing what you love to do.


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## JPINFV (Oct 23, 2009)

Volly v paid debate?

I would post something along the lines of "I like where this thread is going," but I won't.


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## mcdonl (Oct 23, 2009)

Mountain Res-Q, as you pointed out the other two threads were closed or I would have chimed in on those threads with my limited knowledge of this debate... most of which I learned here 

For some of us (Higher education, long time careers in Health care Management, IT, logistics and technical writing....) the thought of changing careers to EMS is not even an option; financially or to our current employers who count on us to keep our hospitals running..... So, volunteer is our only viable option, and I like it that way. We get to help our community AND the EMS that serves our community.

I will not get into the quality of Volley vs Paid, because I do not know enough about it but I will say this. One of my new roles, due to my professional background is helping create the documentation for proper training, SOP's and SOG's.... there are plenty of officers in our department who know what, how, why and when to do the varies FF/EMT skills but lack the experience and education to create comprehensive documentation, training materials and various other skill sets that the volunteers can bring to the department.

I guess my point is, if you get the right volunteers with the right background, and combine them with the paid professionals you could end up with an EMS that exceeds the quality of an all paid EMS that lack the expertise that the volunteers bring from their professional life.

mcdonl


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## resq330 (Oct 23, 2009)

mcdonl said:


> For some of us (Higher education, long time careers in Health care Management, IT, logistics and technical writing....) the thought of changing careers to EMS is not even an option; financially or to our current employers who count on us to keep our hospitals running..... So, volunteer is our only viable option, and I like it that way. We get to help our community AND the EMS that serves our community.mcdonl





Couldn't agree with you more on this one.


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## eveningsky339 (Oct 23, 2009)

resq330 said:


> Couldn't agree with you more on this one.



I concur.

My ambulance service utilizes Americorps volunteers to keep our most rural base open; otherwise people in that area would have insufficient emergency medical coverage.  A volunteer EMT can be put on any ambulance at any time, creating a team of three, which is really an ideal number of EMTs for any type of emergency.  Sometimes, two just doesn't cut it, and we end up having to call a flycar or another ambulance.


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## Dwindlin (Oct 23, 2009)

Was paid up until I started Med School.  Now I volunteer couple nights a week.


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## reaper (Oct 23, 2009)

I am paid, when I volunteer to go to work!


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## Miss Xina (Oct 23, 2009)

well, i'm not hired nor volunteer. i mean, i do ride time and help out cos i am licensed but i don't know if that's volunteer per se.

so, i am "other"


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## downunderwunda (Oct 23, 2009)

I think what should determine if a service is volly or paid should be:

If the service sends an account to the patient & expects to get paid, then you should get paid. They are doing this to gain a profit & exploiting you at every turn every time you agree to go out for no charge.


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## EMSLaw (Oct 23, 2009)

downunderwunda said:


> I think what should determine if a service is volly or paid should be:
> 
> If the service sends an account to the patient & expects to get paid, then you should get paid. They are doing this to gain a profit & exploiting you at every turn every time you agree to go out for no charge.



See, my squad operates as a non-profit, and doesn't bill anyone for our services.  We have a fund drive every year, and get a small stipend from the Township (the Squad, not the members), but it's purely a public-service thing.

We have a paid contract service during the daytime hours (5am-6pm), and they bill insurance for the ride.  If you don't have insurance, and are a town resident, you're supposed to not be billed, but they send bills anyway, hoping people will pay.


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## downunderwunda (Oct 23, 2009)

EMSLaw said:


> See, my squad operates as a non-profit, and doesn't bill anyone for our services.  We have a fund drive every year, and get a small stipend from the Township (the Squad, not the members), but it's purely a public-service thing.
> 
> We have a paid contract service during the daytime hours (5am-6pm), and they bill insurance for the ride.  If you don't have insurance, and are a town resident, you're supposed to not be billed, but they send bills anyway, hoping people will pay.



If they send a bill, they are relying on the income to keep them running. This means they are working for profit. To claim otherwise cheapens the profession & shows a lack of respect for what we do. 

EMS should not be run for profit. 

EMS should be properly funded& as a primary healthcare provided be free for all. 

Since this is what you consider fantasy, as a private providor, that, by your admission sends bills, claims from insurance, are a for profit organisation & as such should be paying you.


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## DrParasite (Oct 24, 2009)

downunderwunda said:


> If they send a bill, they are relying on the income to keep them running. This means they are working for profit. To claim otherwise cheapens the profession & shows a lack of respect for what we do.


ummmm, no.  what do you think a non-profit organization is? 

I work full time as an EMT/Dispatcher for one of the busiest EMS systems in NJ.  I also work per diem as a road EMT for another trauma center, and also am per diem at a suburban EMS service (one or twice a month at most).

and I'm an active volunteer EMT/Heavy Rescue technician for an EMS based Rescue Squad in the next county from where I used to live.

and I think all ambulances should be billing, and the days of begging for money to continue operations should be OVER


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## downunderwunda (Oct 24, 2009)

DrParasite said:


> ummmm, no.  what do you think a non-profit organization is?
> 
> I work full time as an EMT/Dispatcher for one of the busiest EMS systems in NJ.  I also work per diem as a road EMT for another trauma center, and also am per diem at a suburban EMS service (one or twice a month at most).
> 
> ...



I disagree. I think that ALL ems should be paid. How it is funded is another matter. 

One service here charge a levy on all electricity accounts that fully funds their operations of a fully paid service, without the need for billing each individual. It also negates the need for insurances.

EMS is a profession. The service we provide is an essential service, a service that is provided to the community in their time of need. Why should those who choose to be a pert of it not be fairly & adequatley remunerated? The generation of a bill indicated there is income, if there is income then they should be prepared to pay for the people who staff, either on a permanent or a call basis retainer. To expect people to train to an appropriate level of care & provide it on a volly basis is obscene & should not be allowed.


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## Dwindlin (Oct 24, 2009)

downunderwunda said:


> I disagree. I think that ALL ems should be paid. How it is funded is another matter.
> 
> One service here charge a levy on all electricity accounts that fully funds their operations of a fully paid service, without the need for billing each individual. It also negates the need for insurances.
> 
> EMS is a profession. The service we provide is an essential service, a service that is provided to the community in their time of need. Why should those who choose to be a pert of it not be fairly & adequatley remunerated? The generation of a bill indicated there is income, if there is income then they should be prepared to pay for the people who staff, either on a permanent or a call basis retainer. *To expect people to train to an appropriate level of care & provide it on a volly basis is obscene & should not be allowed.*



This is a pretty extreme statement and I would think many people would disagree.  I think alot of volunteer's probably work other EMS related jobs (at least in my area they do), so saying your getting sub-standard care from volunteers is just false in this area.  I myself volunteered for a small rural dept. that ran less than 500 calls a year.  It doesn't make since for them to have a paid dept. running that small number of calls a year.  Also in this area, many physicians volunteer on dept. like that.  Why?  Because they can continue to be active in pre-hospital treatment without having to join a busy system.  You really believe those people are getting sub-standard care?  

I'm not saying there doesn't exist poor volunteer dept.  but to make blanket statements like that is just wrong, because after all there are pretty poor full time services too.


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## karaya (Oct 24, 2009)

downunderwunda said:


> ... To expect people to train to an appropriate level of care & provide it on a volly basis is obscene & should not be allowed.


 
You must be smoking kangaroo dung down there to make such ridiculous statement. The very foundation of these United States was established on volunteers. Our dedication to duty and community defined to the world the word "volunteer".

As a photojournalist and filmmaker, I have the advantage to travel throughout the United States and spend time riding with dozens of EMS providers both paid and volunteer. I have seen many EMS volunteer providers that could easily put to shame their paid counterparts, both in equipment and training. I have documented where volunteers have made the difference between life and death within their community.

Look at next month's issue of JEMS magazine in the Call To Action two page spread. There I photographed volunteer paramedics and firefighters working to save a woman's life while trapped in an MVA. Their skills in EMS and extrication was extraordinarily to say the least. I would have never known they were volunteers. And yet, I've been on hundreds of similar MVAs with highly paid union paramedics and firefighters where I was appalled at the horrible patient care. I was so disgusted with one in particular that I threw my cameras back in the truck and waited for the call to conclude. I wasn't going to film anymore bad EMS. And again, these were $100,000 a year paramedics!

I don't know the problems you are have down-under with your volunteers and I can't offer any response to that. But, if your going to keep slam dunking our volunteer systems in my country, then at least have the intelligence to support your statements with some credible facts.


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## scottyb (Oct 24, 2009)

karaya said:


> You must be smoking kangaroo dung down there to make such ridiculous statement. The very foundation of these United States was established on volunteers. Our dedication to duty and community defined to the world the word "volunteer".
> 
> As a photojournalist and filmmaker, I have the advantage to travel throughout the United States and spend time riding with dozens of EMS providers both paid and volunteer. I have seen many EMS volunteer providers that could easily put to shame their paid counterparts, both in equipment and training. I have documented where volunteers have made the difference between life and death within their community.
> 
> ...



Thank you, Karaya.  

I have had the pleasure of working with amazing volunteer EMT's and FF's.  One thing I noticed is that volunteers don't seem to fall into the trap of it being a job.  They are doing it because they want to, not because they need to to pay the bills.  They, at least at my ambulance corps, seems to translate into a true sense of wanting to help the patient.  The patients see that, people within their own community helping them and actually care.  

I am not saying that paid personal don't care.  I am saying that, in my experience, people in a community appreciate the volunteers and the volunteers are doing it because they want to.


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## scottyb (Oct 24, 2009)

By the way, I went to your site.  Nice photos.  Keep up the good work.  I had to bookmark it.


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## atropine (Oct 24, 2009)

downunderwunda said:


> I disagree. I think that ALL ems should be paid. How it is funded is another matter.
> 
> One service here charge a levy on all electricity accounts that fully funds their operations of a fully paid service, without the need for billing each individual. It also negates the need for insurances.
> 
> EMS is a profession. The service we provide is an essential service, a service that is provided to the community in their time of need. Why should those who choose to be a pert of it not be fairly & adequatley remunerated? The generation of a bill indicated there is income, if there is income then they should be prepared to pay for the people who staff, either on a permanent or a call basis retainer. To expect people to train to an appropriate level of care & provide it on a volly basis is obscene & should not be allowed.



I agree, but unfortunitly here in America people have the right to give there service away for free. It may substandard, who knows, some say we in Los Angeles provide substandard care, but we start IV's give meds and follow the direction of the Medical Director just like any other paramedic would go figure. but people around the country want to play ricky rescue I say let them, If you choose to live in an area with little to no ems, well you chose to live there thats all.


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## VentMedic (Oct 24, 2009)

atkinsje said:


> I think alot of volunteer's probably work other EMS related jobs (at least in my area they do),


 
Bad, bad, bad idea.

If there is a disaster where your paid EMS job needs you, that is your priority. Whatever community is relying on those EMT(P)s will be left without much coverage. 

We make this point very clear to our Paramedics and RNs who area also working at the hospital. They have their obligation to us and that should be pointed out up front when hurricane season approaches and duty assignments are posted. The same goes with the FD. Those who think they can hold down two FT jobs must disclose both to each employer. This does make it unfair to others who may have to do double duty when the disaster strikes. 

It doesn't even have to be a FT EMS job that will create a problem. If the boss at your paid employer says you come to work or lose your job, I doubt if very many are going to risk their paycheck for a volunteer job.

I also seriously doubt if some will be so gungho for an EMS volunteer job once the education requirements are raised. However, maybe then the states and communities will see how important EMS is and find a way to have an all paid ALS 911 service for every citizen in their state. This "not my real job" stuff isn't cutting it.


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## VentMedic (Oct 24, 2009)

atropine said:


> I but we start IV's give meds and follow the direction of the Medical Director just like any other paramedic would go figure.


 
The difference is there are Paramedics who actually want to do EMS in other services and who have Medical Directors that allow them to do much more than what your area allows or would ever trust the Paramedics to do.  

So no, your FD is not like any other Paramedic service by a long shot.


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## Dwindlin (Oct 24, 2009)

VentMedic said:


> Bad, bad, bad idea.



Say what you like, but its hard to justify doing it any other way when the service runs less than 500 calls/year.  Beside this isn't LA or Miami or New York.  This entire county probably has a smaller population than any one of those cities.  If we have a disaster somewhere in this county there is a county wide response.  So you're argument is moot here.


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## scottyb (Oct 24, 2009)

VentMedic said:


> I also seriously doubt if some will be so gungho for an EMS volunteer job once the education requirements are raised.



I think you may be seriously underestimating the dedication of some volunteers.  Educational standards are raised and the training can be achieved with the only cost to the volunteer being time to do the classes, I think you would be seriously impressed with the number of volunteers that will stick it out.  That, I will admit, is based on my experience within my company and could be very different in others.  Volunteers, just based on the fact that they are volunteers, do not have some objection to becoming better providers and more knowledgeable.  

I just went to a conference that was about 50/50 volly/paid, you could not tell a difference between them.  My company has EMT-B's to paramedic's and everything in between.  There was no noticeable difference between us and the paid. 

Also, I did not get this anti volunteer feeling either.  It is accepted, mainly because there are some very rural areas and running a paid service with the number of calls we/they receive is not feasible.  In a state that is already taxed to the max, it would be a hard sell to rural residents that they need to pay more for a service that is going to sit on its *** most of the time.


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## VentMedic (Oct 24, 2009)

atkinsje said:


> Say what you like, but its hard to justify doing it any other way when the service runs less than 500 calls/year. Beside this isn't LA or Miami or New York. This entire county probably has a smaller population than any one of those cities. If we have a disaster somewhere in this county there is a county wide response. So you're argument is moot here.


 

So in a county response, are you obligated to your paid EMS employer or the volunteer? 

It is called resource management and any paid EMS employer would be foolish to allow their employees do volunteer during a disaster response where their units are needed at max capabililty.


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## Dwindlin (Oct 24, 2009)

VentMedic said:


> So in a county response, are you obligated to your paid EMS employer or the volunteer?
> 
> It is called resource management and any paid EMS employer would be foolish to allow their employees do volunteer during a disaster response where their units are needed at max capabililty.



Again, you didn't read what I posted. In a disaster there is a COUNTY response.  We're all lumped under one chain of command.  Doesn't matter what service you work for at that point.


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## VentMedic (Oct 24, 2009)

scottyb said:


> I just went to a conference that was about 50/50 volly/paid, you could not tell a difference between them. My company has EMT-B's to paramedic's and everything in between. There was no noticeable difference between us and the paid.


 
At this time neither the EMT or the Paramedic requires that much time spent on education so that is not a valid argument. 

How many other health care professionals spend  2 - 4 years in college only to volunteer at a hospital?


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## VentMedic (Oct 24, 2009)

atkinsje said:


> Again, you didn't read what I posted. In a disaster there is a COUNTY response. We're all lumped under one chain of command. Doesn't matter what service you work for at that point.


 

Again, whose truck are you on?  Whose patch is on your shirt?


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## Dwindlin (Oct 24, 2009)

VentMedic said:


> Again, whose truck are you on?  Whose patch is on your shirt?



For someone who claims to so educated you need to work on some reading comprehension.  

Though I fail to see why this matters to you, to answer your question, which ever one I can put on faster.  If the county disaster plan is activated THERE IS NO INDIVIDUAL SERVICE.  We are all lumped together, and then assigned to specific MCI duties (triage, treatment, transport, etc..).


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## scottyb (Oct 24, 2009)

VentMedic said:


> At this time neither the EMT or the Paramedic requires that much time spent on education so that is not a valid argument.
> 
> How many other health care professionals spend  2 - 4 years in college only to volunteer at a hospital?



One of the paramedics in my squad did go to school, has a degree, is a certified paramedic and a school teacher.  I doubt her day job will interfere with a disaster response as school will probably be canceled.   Yet another one is a retired navy medic and a paramedic, has his degree and owns a car shop, again not going to get in the way.


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## VentMedic (Oct 24, 2009)

atkinsje said:


> For someone who claims to so educated you need to work on some reading comprehension.
> 
> Though I fail to see why this matters to you, to answer your question, which ever one I can put on faster. If the county disaster plan is activated THERE IS NO INDIVIDUAL SERVICE. We are all lumped together, and then assigned to specific MCI duties (triage, treatment, transport, etc..).


 
If you are a paid FF/Paramedic, the FD will not be happy to have you run off to represent a volley EMT squad if their equipment is needed.  

A disaster response doesn't just require a bunch of warm bodies but rather it requires those that are needed to get the job done.  If you are hauling patients on a volley ambulance rather than doing your paid job with rescue, you are doing your FD a disservice.  Part of a disaster response is knowing what people you have for what jobs that must be done and that includes those with special training.    Not everyone gets to ride the volley ambulance.  There are multiple jobs that must be done in any one disaster.   Those with the paid services will more than likely be doing what they are paid to do.   You will BE ON THEIR CLOCK for pay.  You will be covered under their insurance during a disaster response.  Thus, you can call yourself a "volunteer" but you are now a highly paid volunteer.   I have yet to work any disaster response where I did not get disaster pay from my paid job and it was really nice pay.


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## VentMedic (Oct 24, 2009)

scottyb said:


> One of the paramedics in my squad did go to school, has a degree, is a certified paramedic and a school teacher. I doubt her day job will interfere with a disaster response as school will probably be canceled. Yet another one is a retired navy medic and a paramedic, has his degree and owns a car shop, again not going to get in the way.


 
Are any of those degrees in EMS?

The topic was about those being with a paid and a volunteer EMS service.     A 9-5 job with an EMS hobby on the side is another matter.


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## Dwindlin (Oct 24, 2009)

VentMedic said:


> If you are a paid FF/Paramedic, the FD will not be happy to have you run off to represent a volley EMT squad if their equipment is needed.
> 
> A disaster response doesn't just require a bunch of warm bodies but rather it requires those that are needed to get the job done.  If you are hauling patients on a volley ambulance rather than doing your paid job with rescue, you are doing your FD a disservice.  Part of a disaster response is knowing what people you have for what jobs that must be done and that includes those with special training.    Not everyone gets to ride the volley ambulance.  There are multiple jobs that must be done in any one disaster.   Those with the paid services will more than likely be doing what they are paid to do.   You will BE ON THEIR CLOCK for pay.  You will be covered under their insurance during a disaster response.  Thus, you can call yourself a "volunteer" but you are now a highly paid volunteer.   I have yet to work any disaster response where I did not get disaster pay from my paid job and it was really nice pay.



Again.  You're arguing with me for no reason....this is how it is done here, I'm not presenting you with a hypothetical.  Would this work in a huge metropolitan area? Probably not.  The reason I brought it up is because of the ignorant blanket statements that people are making on here.  There is no one good or correct way to do things.  Things that work in a large metropolitan area WOULD NOT fly in a small rural area.  Again, you can argue till you pass out, but I am telling you, it is how we do it here, and guess what...it works.


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## JPINFV (Oct 24, 2009)

atkinsje said:


> For someone who claims to so educated you need to work on some reading comprehension.
> 
> Though I fail to see why this matters to you, to answer your question, which ever one I can put on faster.  If the county disaster plan is activated THERE IS NO INDIVIDUAL SERVICE.  We are all lumped together, and then assigned to specific MCI duties (triage, treatment, transport, etc..).



So a county wide response is required. The paid service says "I can provide A amount of units immediately and another B amount of units in 10 minutes as they call crews in.

The volunteer service tells the county that they can send C number of units immediately and another D number of units in 10 minutes as they call crews in.

You're off duty and get called by both your paid and volunteer service, who do you go to? This is important because both services are counting on you being available to staff _their_ trucks. Since there's only one of you, then one of the services might not be able to reach their commitment due to lack of staffing. Even under a unified command structure, you can only staff one apparatus from one company and now the incident command might not get the amount of ambulances that they've been promised.


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## VentMedic (Oct 24, 2009)

atkinsje said:


> Again. You're arguing with me for no reason....this is how it is done here, I'm not presenting you with a hypothetical. Would this work in a huge metropolitan area? Probably not. The reason I brought it up is because of the ignorant blanket statements that people are making on here. There is no one good or correct way to do things. Things that work in a large metropolitan area WOULD NOT fly in a small rural area. Again, you can argue till you pass out, but I am telling you, it is how we do it here, and guess what...it works.


 
Are you saying you will not be paid by your paid employer for time spent at a disaster? I would seriously find another employer. 

Once you are paid by your paid employer, you are NOT a volunteer ambulance EMT. 

This doesn't matter if your county has 10 people or 10 million people.

As JP points out, counting the warm bodies twice will do a disservice to that county if both services need you.


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## Dwindlin (Oct 24, 2009)

JPINFV said:


> So a county wide response is required. The paid service says "I can provide A amount of units immediately and another B amount of units in 10 minutes as they call crews in.
> 
> The volunteer service tells the county that they can send C number of units immediately and another D number of units in 10 minutes as they call crews in.
> 
> You're off duty and get called by both your paid and volunteer service, who do you go to? This is important because both services are counting on you being available to staff _their_ trucks. Since there's only one of you, then one of the services might not be able to reach their commitment due to lack of staffing. Even under a unified command structure, you can only staff one apparatus from one company and now the incident command might not get the amount of ambulances that they've been promised.



Command staff is all predetermined.  As is where the apparatus will come from.  It is not as simple as I've laid out here.  But I didn't feel like typing a book.  Everyone is paid during a disaster response (comes from county budget not local).  So generally most of the personnel actually working the disaster area are off duty if they are from paid services.  Paid service personnel are left on trucks that aren't taken for disaster purposes to cover for normal normal 911 calls.  

Now it also staggers based on disaster size.  Would a full county respose be made for a bus accident? Of course not, most local jurisdictions have local plans in place for stuff like this.  I'm talking huge disasters (tornado/major storms being most common in this area).


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## scottyb (Oct 24, 2009)

VentMedic said:


> Are any of those degrees in EMS?
> 
> The topic was about those being with a paid and a volunteer EMS service.     A 9-5 job with an EMS hobby on the side is another matter.



Yes. I guess I did not make it clear. I believe they both went through a paramedic degree program at local colleges.  I think that neither one had out of pocket expense for school though, based on benefits of there previous employer, Uncle Sam, but I am not sure.  

I was just saying that volunteer does not always mean less dedicated or less educated. Or, resistant to more education for that matter. Volunteer works well for my rural area, and I agree that not all models with work in all areas. Each area needs to do what works for them. I also don't think, for better or worse, that we will see all paid EMS in either of our lifetimes.


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## JPINFV (Oct 24, 2009)

atkinsje said:


> Command staff is all predetermined.  As is where the apparatus will come from.




It's not as simple as that though and this isn't about command staff. This is about resource management. Those ambulances won't drive themselves or treat the patients themselves, correct?


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## Dwindlin (Oct 24, 2009)

JPINFV said:


> It's not as simple as that though and this isn't about command staff. This is about resource management. Those ambulances won't drive themselves or treat the patients themselves, correct?



No of course not.  I think people under estimate the prevalence of volunteer services in rural portions of the country.  There are very, very few paid service in Preble county Ohio.  So the overwhelming majority of providers (both fire and ems) are volunteer.  So, as I said, when the county plan goes into effect it relies heavily on volunteer's, which in this region is easy to do, people WILL show up.  

Again, you can't compare metro areas to rural areas.  There is a different mind set (I assume since people seem so shocked by some of this).  For example people who have non-ems jobs are usually completely free and clear to leave their job in response to a call (because again there aren't many calls so its not like an everyday thing).  And if it were a disaster or MCI situation, I think employers would urge their staff who was part of a dept. to leave.  I someone think this wouldn't fly in large metro areas, but it is expected here.

Again, my only point is there is more than one way to skin a cat.  And these blanket statements being tossed around are ignorant.


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## VentMedic (Oct 24, 2009)

Well you definitely hit all the points as to why states like Florida do not depend volunteer ambulance services.  When a disaster strikes, even in our tiniest little towns, people want to know there will be someone showing up.  They don't want the possibility that some will take their other "real" job more seriously or that they will realize they have little obligation and focus on their family.   We even have this issue with hurricanes when some want to stay with their homes and families to protect them but they know as a paid public employee they do have an obligation to the public as well.   Thus, Florida had the initiative to provide all paid ALS 911 service to its citizens and to provide enough coverage from paid FDs throughout the state.  This includes big cities and tiny little towns.  It also includes the rich neighborhoods and the very poor as well the black, white or brown neighborhoods.    We don't say you're poor so you don't deserve ALS and BLS volley is all you get.    States have resources but usually it is those in the volunteer services that don't want to change.   They usually attempt to prevent any of those "paid strangers" comin' to their town.


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## daedalus (Oct 24, 2009)

scottyb said:


> I think you may be seriously underestimating the dedication of some volunteers.  Educational standards are raised and the training can be achieved with the only cost to the volunteer being time to do the classes, I think you would be seriously impressed with the number of volunteers that will stick it out.



See, I don't think you understand that part of the reason EMS educational standards are so low is because of the volunteer folks fight it tooth and nail.

Also, how dedicated would volunteers be if they had to staff IFT rigs? Discharging patients from the ER is just as vital as bringing them in because if frees up beds and resources.


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## scottyb (Oct 24, 2009)

daedalus said:


> See, I don't think you understand that part of the reason EMS educational standards are so low is because of the volunteer folks fight it tooth and nail.
> 
> Also, how dedicated would volunteers be if they had to staff IFT rigs? Discharging patients from the ER is just as vital as bringing them in because if frees up beds and resources.



My company does bring discharges home if they live in our area of operation.  We do not have a hospital in my town and the closest is 25-30 minutes away.  This is vital for some of our elderly residents and residents of the nursing home.  

I do understand that volunteers fight raising educational standards.  I am unsure as to whether or not those are mostly Fire Departments that wish to maintain there EMS personnel and how many are actual Ambulance only volunteer organizations.  I don't have answer for that yet and I have not had a chance to research it.  

Again, in my Ambulance Squad, I do not see the resistance to the new upcoming standards.  We had a taste of them in the conference we just attended, and I am for one excited to learn more.  I guess my opinion is bias based on my experiences with my squad.  I can not speak on others.  Maybe those with a little more time in EMS and have been on a few different squads would know better.


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## HCEMS (Oct 24, 2009)

Technically I work on a volunteer service right now.  Its kinda messed up how it works.  Our service covers a rural county that has about 20,000 people in it but its a 32 mile by 30 mile county so its fairly large.  We have a small hospital located centrally within our county where they employ the ALS paid side of our county ems service.  Then within the towns in the county we have "volunteer" BLS units.  When I say volunteer though I say it loosely because we only volunteer our call time so if the rig never goes out noone get paid.  However, if we are dispatched to a call we get paid $12 an hour for every hour that we are out on that run.  I guess it works out because its more or less an incentive for people to volunteer their time, but it definitely takes away from really being volunteer.


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## downunderwunda (Oct 24, 2009)

> You must be smoking kangaroo dung down there to make such ridiculous statement. The very foundation of these United States was established on volunteers. Our dedication to duty and community defined to the world the word "volunteer".



So does this mean we continue to live in the past & not look to the furure?? 

Just because it was the right thing to do yesterday does not make it appropriate for today or into the future. 



> I'm not saying there doesn't exist poor volunteer dept. but to make blanket statements like that is just wrong, because after all there are pretty poor full time services too.



I agree, however it is easier to regulate a professional service than a volly service.



> I think alot of volunteer's probably work other EMS related jobs (at least in my area they do), so saying your getting sub-standard care from volunteers is just false in this area.



Where did I say the patients receive substandard care, you did not read what I said properly.



> I have had the pleasure of working with amazing volunteer EMT's and FF's. One thing I noticed is that volunteers don't seem to fall into the trap of it being a job.



I have seen enough Vollys who are doing it because they are self serving look at me type people. That is just as bad as the paid who do it 'as a job'.




> Again, you didn't read what I posted. In a disaster there is a COUNTY response. We're all lumped under one chain of command. Doesn't matter what service you work for at that point.



This makes a farce of the system you hold so near & dear to your heart. IF is can be done at a time of crisis, why not do it all the time, as a PAID service?



> Technically I work on a volunteer service right now. Its kinda messed up how it works. Our service covers a rural county that has about 20,000 people in it but its a 32 mile by 30 mile county so its fairly large. We have a small hospital located centrally within our county where they employ the ALS paid side of our county ems service. Then within the towns in the county we have "volunteer" BLS units. When I say volunteer though I say it loosely because we only volunteer our call time so if the rig never goes out noone get paid. However, if we are dispatched to a call we get paid $12 an hour for every hour that we are out on that run. I guess it works out because its more or less an incentive for people to volunteer their time, but it definitely takes away from really being volunteer.



Large? in population not in area. I work at a PAID station that covers 15000 acres. Population approx 4000. WE ARE FULLY PAID, FULLY FUNDED.

I still love the job I do, I get the same if not more respect from my community because I am called on when I am off duty to assist & rarly if ever say no. 

Dont tell me it cant be done. I know it can be. Maybe it needs people to open their minds to other ways of thinking & as I said before, to move our thinking forward to what CAN BE DONE, not living in the past thinking 'we always did it this way so we will always do it this way'


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## ChicagolandIFT (Oct 24, 2009)

I really really really really like getting my pay check every two weeks, it might be small, but it pays the rent, and there is enough behind to put in my paramedic school fund.


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## atropine (Oct 24, 2009)

VentMedic said:


> The difference is there are Paramedics who actually want to do EMS in other services and who have Medical Directors that allow them to do much more than what your area allows or would ever trust the Paramedics to do.
> 
> So no, your FD is not like any other Paramedic service by a long shot.



so your saying there are medical directors who let there medics do whatever they want like the wild west, man I gots to go there, they probably get to suture and do chest tubes in the ield if there that progressive, silly me man I just lucky to get a big, big pay check.


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## reaper (Oct 24, 2009)

Shining example of LA EMS at it's finest!


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## JPINFV (Oct 24, 2009)

reaper said:


> Shining example of LA EMS at it's finest!



Huh? All I get is...



> atropine
> This message is hidden because atropine is on your ignore list.


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## VentMedic (Oct 24, 2009)

atropine said:


> so your saying there are medical directors who let there medics do whatever they want like the wild west, man I gots to go there, they probably get to suture and do chest tubes in the ield if there that progressive, silly me man I just lucky to get a big, big pay check.


 
The medical directors write the protocols which in most states are much more extensive than California.    

Read the protocols from just about any EMS service outside of California and you will find out what you are missing.  

Yes your paycheck is big since you work over 3000 hours just to make a decent paycheck in Southern CA.   

Yes there are Paramedics that can suture, do chest tubes, central lines, pericardiocentesis, manage IABPs, manage ventilators and even get to titrate actual medication drips.     

Are you really this oblivious to the world of EMS that you have absolutely no clue what goes on anywhere but at your fire station?  Have you even read the little EMS magazine called JEMS?   That even has articles featuring what other services are doing.  Have you ever heard of places like Seattle or Wake County?


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## MMiz (Oct 24, 2009)

Lets keep this thread appropriate and on track.  Thanks.


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## mycrofft (Oct 24, 2009)

*I'm not oblivious, I don't read JEMS, and I'm ignorant.*

Less so after reading and asking questions here.
The aspects of volunteer EMS I am unhappy about are twofold:
1. Civil autority ("guvernmint") forgets vollie is ony to be used because paid EMS is too expensive and EMS is needed; they then use it to continue to fill areas where money could be made available. They also use it as a club to keep pay rates down.
2. EMS will always tend to attract "cowboys", and the control promoted by paid professional positions in stable formal structure tends to either train them up, or weed them out, potentially raising the level of care and provider satisfaction.

I am afraid I and others will denigrate the fine history of volunteerism, but when able, it needs to be thanked kindly then replaced by paid professional and controlled/structured service.


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## downunderwunda (Oct 24, 2009)

mycrofft said:


> 1. Civil autority ("guvernmint") forgets vollie is ony to be used because paid EMS is too expensive and EMS is needed; they then use it to continue to fill areas where money could be made available. They also use it as a club to keep pay rates down.
> 2. EMS will always tend to attract "cowboys", and the control promoted by paid professional positions in stable formal structure tends to either train them up, or weed them out, potentially raising the level of care and provider satisfaction.
> 
> I am afraid I and others will denigrate the fine history of volunteerism, but when able, it needs to be thanked kindly then replaced by paid professional and controlled/structured service.



Just a brief sideline, if EMS is to expensive & propped up by vollies, why dont they do the same with fire, there is more core EMS work than core fire work.......


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## eveningsky339 (Oct 24, 2009)

downunderwunda said:


> Just a brief sideline, if EMS is to expensive & propped up by vollies, why dont they do the same with fire, there is more core EMS work than core fire work.......



There isn't a paid fire department within 100 miles where I live.

Rural communities need the support of volunteers.  I like the way my community works-- EMS is provided by a semi-private, semi-hospital based ambulance company which covers the entire county, employing over 100 EMTs.  However, it is also supported by vollies in various aspects.


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## downunderwunda (Oct 24, 2009)

eveningsky339 said:


> There isn't a paid fire department within 100 miles where I live.
> 
> Rural communities need the support of volunteers.  I like the way my community works-- EMS is provided by a semi-private, semi-hospital based ambulance company which covers the entire county, employing over 100 EMTs.  However, it is also supported by vollies in various aspects.



So who determines who is paid & who is volly??

They are doing the same job, the 'semi-private' company is doing it for profit, so they should pay for their workforce. 

I dont see too many people with a fantastic sense of patriotism being vollies for the army, navy or airforce to serve without pay, why should EMS be any different?


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## mycrofft (Oct 25, 2009)

*Apples and handgrenades*

There are vollie soldiers, but the FBI and ATF shut them down.

Oh, wait, the draft ended in 1975!

Don't know about now, but as of the late Seventies, about 90% of fire depts were vollie; I don't know how that compares in firefighter hours, but the number of communities served had to be that high. 

Get out into rural Nebraska or the Dakotas, a Native American reservation, into the hills of the Sierra Nevadas (how about upstate New York?) and there are towns that can't even afford their own fire house much less paid EMS.


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## DrParasite (Oct 25, 2009)

downunderwunda said:


> I disagree. I think that ALL ems should be paid. How it is funded is another matter.


ok, I think we are getting into a language barrier here between US and Australia.

Just because a company bills doesn't mean they are for profit.  there are many non-profit semi-governmental agencies that bill for services, but at the end of the year, their expenses and their income end up zeroing out.  hence the term, non-profit.  So a 100% career agency that bills for services can still be non-profit.  a company that has more money being brought in than it costing would be for profit (like many private ambulance services).

I think all EMS should bill.  I think most should be paid as well.  I think all EMS should provide the majority of their coverage by staffing in house, whether by paid or volunteer staff.  training should be equal for paid and volunteer staff.  smaller agencies should be eliminated in favor of merging to form larger agencies, possibly with a local first responder (that is tax based, whether volunteer FD or paid PD)

oh, and for the whole paid and volunteer thing, it's a moot point.  if my career agency calls me for a MCI and I am unavailable (for whatever reason, on a volunteer ambulance, fire truck, part time job, vacation, just don't feel like dealing with the chaos), then that is my choice.  they have no right to get mad, and can't punish me for not coming in on my day off (unless my job description requires me to be available 24/7 for off duty recalls).  so again, what i do in my spare time is my bussiness, and what my paid boss thinks is moot.


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## downunderwunda (Oct 25, 2009)

I find it amazing that you do not believe that EMS is a basic human right, not a luxury in 21st century, first world countries.  Aussie isnt the only country that does, Canada, the UK, most of the EU, all have free or nominal cost EMS as a basic right. They are paid employees, not private companies, but government agencies.

But God forbid that any other country might be able to do something better than the USA.


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## Miss Xina (Oct 25, 2009)

downunderwunda said:


> I find it amazing that you do not believe that EMS is a basic human right, not a luxury in 21st century, first world countries.  Aussie isnt the only country that does, Canada, the UK, most of the EU, all have free or nominal cost EMS as a basic right. They are paid employees, not private companies, but government agencies.
> 
> But God forbid that any other country might be able to do something better than the USA.



I know!!

I am british living in the US and just got my EMT-B license. It is SHOCKING that people die because they can't afford healthcare. Some of the houses I see is just appalling. They work hard but have to live in squalor because their medication costs them a more than they earn.

But, many americans confuse socialist healthcare with communism. A "christian" country that places a price on a person's life. And it's ALWAYS christians that are opposed to universal healthcare. 

When I ask them how they would feel about their child being allowed to die because they don't earn enough to warrant their child a life, they tell me to go back to where I came from.

I really hope that Obama manages to ignore the republicans and improve the health care situation.

I would be happy if only the children got free healthcare, you know? I mean, a child's life shouldn't be dependant on the parents' income.

I doubt even EMS employees would earn enough to fund a child's cancer treatment in this country. 

It truly saddens me.


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## JPINFV (Oct 25, 2009)

Miss Xina said:


> I really hope that Obama manages to ignore the republicans and improve the health care situation.



Here's the funny thing, and this isn't directed at you, but directed at the vast majority of Americans who apparently failed US Government during high school. The presidency has, essentially, the least impact on the bills working their way through Congress. He can't submit laws. He can't amend laws. He can't vote on laws. Want to affect health care? Talk with your senators and congressmen. They have more power over this than Obama. 


Downunderwunda, "God forbid that any other country might be able to do something better than the USA?" God forbid that the US does anything different either apparently. Sorry, but socialized health care isn't some sort of panacea to access problems. Plenty of other countries with this awesome idealized government run health care still have access problems because the government won't pay enough to ensure access. You can give everyone "free" health care, but that isn't going to force people to work for peanuts to ensure that demand is met. Hence the waiting lists that are prevalent in so many other countries with "ideal" health care systems.

This also ignores the completely different sizes of the countries involved. The US has almost 1 million more square miles of land than Australia and over 10 times the population of Australia. The US has around 40 times the land area of the UK and 5 times the population of the UK. A much better comparison would be if, somehow, the EU developed a single unified medical payment system for all of their member states together. That's a much closer approximation to the issues facing developing a national plan in the US than seen in countries with a fraction of the population and land area that we have.

Also I guess if we pull our military out of all of our commitments (Africa, Middle East, boarders alongside the former USSR, Korea, Japan, and other such locations) we'd have the money to do so. Now think about that for a minute. How much money in direct payments and income from the economy would Germany lose if we, say, closed Ramstein? Now I'm not saying that Ramstein is the only thing keeping Germany afloat, but I'm sure that we pay a pretty penny to be there and we benefit the local economy.  Similarly, does anyone really want to see what would happen if we pulled out of the DMZ in Korea? I bet we could save a ton of money if we pulled our 28k troops out of Korea tomorrow.


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## Miss Xina (Oct 25, 2009)

JPINFV said:


> Here's the funny thing, and this isn't directed at you, but directed at the vast majority of Americans who apparently failed US Government during high school. The presidency has, essentially, the least impact on the bills working their way through Congress. He can't submit laws. He can't amend laws. He can't vote on laws. Want to affect health care? Talk with your senators and congressmen. They have more power over this than Obama.
> 
> 
> Downunderwunda, "God forbid that any other country might be able to do something better than the USA?" God forbid that the US does anything different either apparently. Sorry, but socialized health care isn't some sort of panacea to access problems. Plenty of other countries with this awesome idealized government run health care still have access problems because the government won't pay enough to ensure access. You can give everyone "free" health care, but that isn't going to force people to work for peanuts to ensure that demand is met. Hence the waiting lists that are prevalent in so many other countries with "ideal" health care systems.
> ...



Oh, well,... I'm sure he directs the whole...you know, political thing...

But, why not have it run state by state?

And no.. you talk of waiting lists being terribly long, but it's on a who needs it most basis.

If you're needing Knee Replacement Surgery because your knee is sore, but you can still walk on it and get by, but someone else needs the same surgery, but is in agonizing pain and can't even get out of bed and is high on pain medication, then the latter will get it first.

Coming from a socialist country, I would rather WAIT knowing I will get it sooner or later, than have to deal with insurance companies who can refuse to pay for your treatment or simply be told "no, you're not covered. Now get out"

If states can have their own laws and their own tax legislature (sp?) then they can run their own Healthcare system.

Those are not valid reasons for letting people die unnecessarily.

Also, the military can provide healthcare to all of their active duty, reserve and prior/retired personnel in all countries around the world.. so the government can't really be as bad at this than some people can.

Why can the country run a socialised fire department, police department, education system.. practically EVERYTHING else, but not healthcare?

There is no excuse. Everything else is socialized, healthcare should be too


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## DrParasite (Oct 25, 2009)

downunderwunda said:


> I find it amazing that you do not believe that EMS is a basic human right, not a luxury in 21st century, first world countries.  Aussie isnt the only country that does, Canada, the UK, most of the EU, all have free or nominal cost EMS as a basic right. They are paid employees, not private companies, but government agencies.
> 
> But God forbid that any other country might be able to do something better than the USA.


ok, that's it, I give up.  Maybe it's the language barrier.  maybe its your reading comprehension.  maybe you are delusional.  or maybe you aren't even responding to my post.

either way, I'm totally lost in what you are talking about, where you are getting your information, or why you seem to think that I said anything about healthcare in the US being any better than anywhere else.

So I walk away, you win.  I'm lost


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## JPINFV (Oct 25, 2009)

Miss Xina said:


> If states can have their own laws and their own tax legislature (sp?) then they can run their own Healthcare system.


There's a major problem with that. State X has socialized health care. Well, if I don't have health care, I can just move their and get covered under their system. On the other hand, such systems requires funding and who's going to pay? The rich, also known as the people with the best means to move. New York State just increased their top tax rates and their tax receipts are falling because the rich are moving out of the state. There have been cases in the past where states have put luxury taxes on items such as yachts where the end result was the collapse of the ship building industry in that state.  



> Also, the military can provide healthcare to all of their active duty, reserve and prior/retired personnel in all countries around the world.. so the government can't really be as bad at this than some people can.


1. VA hospitals are generally not nice places.

2. The government can print money. Ask the Weimar Republic how printing money to cover debts worked. 

3. I akin the military to a very large company that provides health insurance to their workers. In essence, soldiers are workers for the US military. It's like saying if Kaiser can provide their employees health coverage than every company should be able to.


> Why can the country run a socialised fire department, police department, education system.. practically EVERYTHING else, but not healthcare?


Last time I checked, the public education system for primary and secondary education is pretty weak compared to other countries. Not all fire departments are government run. Also the police via powers of arrest can't really be compared to the other emergency services. Outside of universities and railroads (which are special circumstances) you don't really see private police forces with full police powers in the US.


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## Miss Xina (Oct 25, 2009)

DrParasite said:


> ok, that's it, I give up.  Maybe it's the language barrier.  maybe its your reading comprehension.  maybe you are delusional.  or maybe you aren't even responding to my post.
> 
> either way, I'm totally lost in what you are talking about, where you are getting your information, or why you seem to think that I said anything about healthcare in the US being any better than anywhere else.
> 
> So I walk away, you win.  I'm lost



The American reputation on a global scale is that Americans believe that they are the superior country in the world and MUST, just GOTTA be considered the best over everything else.

Your reputation has improved since Obama has been elected, but the way  the American media represents the american culture is that it is rather arrogant and prideful.

That is probably what he is referring to. The American news always refers to the US health care as being the best in the world, but realistically, when you look at the WHO website, you will find it's not number one. Don't worry, the UK isn't either.

I think he was just referring to American culture needing to feel that it's the best.

I could be wrong though


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## resq330 (Oct 25, 2009)

Miss Xina said:


> The American reputation on a global scale is that Americans believe that they are the superior country in the world and MUST, just GOTTA be considered the best over everything else.
> 
> Your reputation has improved since Obama has been elected, but the way  the American media represents the american culture is that it is rather arrogant and prideful.
> 
> ...





I thought this thread was about being volly or paid?  :unsure:


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## Miss Xina (Oct 25, 2009)

JPINFV said:


> There's a major problem with that. State X has socialized health care. Well, if I don't have health care, I can just move their and get covered under their system. On the other hand, such systems requires funding and who's going to pay? The rich, also known as the people with the best means to move. New York State just increased their top tax rates and their tax receipts are falling because the rich are moving out of the state. There have been cases in the past where states have put luxury taxes on items such as yachts where the end result was the collapse of the ship building industry in that state.
> 
> 
> 1. VA hospitals are generally not nice places.
> ...



Thank you for your in-depth response.

And you're right. if one state has universal healthcare and the one next door doesn't then that will happen. But that's why they all should have tax funded healthcare.

And everyone pays for healthcare. the way it works in the UK is that it is taken from your wages in National Insurance... much like Social Security, and extra tax is added on to food, cigarettes etc Just like it is in Illinois.

They recently increased the tax on Sugar items like candy, soda, tea, etc but not in MO.

I fully support this move. it might stop parents from feeding their kids crap and it will help fund the healthcare system with obesity problems.

Everyone pays for healthcare when it is taxed. And it is done by a % scale. So everyone pays the same % of what they earn.

In France, they have semi socialized and semi private insurance. So, you pay for treatment with your tax money and then you can pay for luxuries with private.

I think that's a good way to go.

I also think that if you smoke then you should have to pay for your treatment for lung related issues, if you eat a poor diet which results in diabetes, then you should pay.

People should have access to healthcare BUT they should also be penalized if they poison themselves with crap by having to subsidize their treatments.

And the education system here is pretty good. Better than some other countries!

Oh, and I go to VA hospitals. I'm a military spouse. I am NOT complaining about it at all. You guys don't appreciate what you have!!

I really worry about having children in this country. I would fear my children's lives if we had children and my husband got out of the military. 

And that's what puts me off having kids. I wouldn't want to have to become bankrupt if they ever got sick...


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## Miss Xina (Oct 25, 2009)

resq330 said:


> I thought this thread was about being volly or paid?  :unsure:



It is  I was merely translating


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## resq330 (Oct 25, 2009)

Miss Xina said:


> It is  I was merely translating



Just pickin


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## downunderwunda (Oct 25, 2009)

Well translated Miss Xina!!!!!!


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## Miss Xina (Oct 25, 2009)

downunderwunda said:


> Well translated Miss Xina!!!!!!



I have the privilege of being an immigrant in the US of A. I love it. I have more patriotism for the US of A than some Americans!!!

And that is why I am so passionate about American politics, health care, you name it, I am passionate about it!

Still gotta represent England though, cos it is the motherland, but I do love America more.


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## DrParasite (Oct 25, 2009)

Miss Xina said:


> The American reputation on a global scale is that Americans believe that they are the superior country in the world and MUST, just GOTTA be considered the best over everything else.
> 
> Your reputation has improved since Obama has been elected, but the way  the American media represents the american culture is that it is rather arrogant and prideful.
> 
> ...


while I don't disagree with what you are saying, I still have no idea where I mentioned anything remotely related to it in an early post.  all I said was that non-profit companies do bill.  and he went off on something totally unrelated.

and for the record, Obama has been the worst thing for the US in a long time.  and I am pretty sure he won't we reelected.  he talks a good game, but make a lot of promises and actually following through are two very different tasks.  but that's a different topic.

and if healthcare is so good elsewhere, why do so many people come from UK and Europe an elsewhere to the US to have procedures done?


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## Miss Xina (Oct 25, 2009)

DrParasite said:


> while I don't disagree with what you are saying, I still have no idea where I mentioned anything remotely related to it in an early post.  all I said was that non-profit companies do bill.  and he went off on something totally unrelated.
> 
> and for the record, Obama has been the worst thing for the US in a long time.  and I am pretty sure he won't we reelected.  he talks a good game, but make a lot of promises and actually following through are two very different tasks.  but that's a different topic.
> 
> and if healthcare is so good elsewhere, why do so many people come from UK and Europe an elsewhere to the US to have procedures done?



Because we don't give away plastic surgery. And I don't know one person who has chosen to come to america for treatment.

And, Obama worst thing ever? Come on.. he's been in less than a year and you're saying he's WORSE than bush?

I really hope you're not one of those people that think he's a muslim immigrant that has been planted by some people to become president LOL

Give him a chance, he's only human! Although I feel bad for him. No matter what he does, he'll fail. Supporters have put him on such a high pedestal that he can never fulfil their expectations and the opposition are quick to jump on his back over.. what? anything and everything.

I do not envy him!


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## DrParasite (Oct 25, 2009)

ok, now we are really getting off topic but...





Miss Xina said:


> And, Obama worst thing ever? Come on.. he's been in less than a year and you're saying he's WORSE than bush?


Bust was an idiot.  still is.  Obama isn't stupid.  But are we really in a better position now than we were last year?  if you read the news reports, you will find much of the same problem, as well as some problems that our kids and grand kids will have to deal with.





Miss Xina said:


> I really hope you're not one of those people that think he's a muslim immigrant that has been planted by some people to become president LOL


absolutely not.  but I am also not one of the ignorant voters who only voted for him because he was black.  and if you think certain people only voted for him because he was black, well, then I have a bridge to sell you....


Miss Xina said:


> Give him a chance, he's only human! Although I feel bad for him. No matter what he does, he'll fail. Supporters have put him on such a high pedestal that he can never fulfil their expectations and the opposition are quick to jump on his back over.. what? anything and everything.


the man decided he was running for president after being a US senator for under a year.  he has no executive experience in politics.  he has minimal political experience.  he is an amazing orator, very charismatic, and made a lot of big promises, many that he isn't going to be able to keep.  his supporters didn't' put him on a high pedestal.  he wanted to be on it, and made sure everyone knew he was standing on this pedestal.  That was how he got elected, as the voice of change, as the hero, as the man with all the answers, as the man who would save the day.

I have always said, getting elected president is easy.  anyone can do it, assuming you have enough money and make a lot of promises.  

the trick is to get relected, after you have made all those promises, after the public sees if you can actually put your money where your mouth is.  personally, I don't think obama will be reeleced for that simple reason.  and if he does, well, I guess I will owe my old partner a steak dinner.

but waaaay off topic, if you want to discuss politics, and the healthcare systems worldwide, might be a better idea to start a new thread.


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## karaya (Oct 25, 2009)

This thread  is way, way off topic and from my point has run it's course.  I hoping a mod will shut this one down.


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## scottyb (Oct 25, 2009)

karaya said:


> This thread  is way, way off topic and from my point has run it's course.  I hoping a mod will shut this one down.



I agree that this thread is way off topic, but I am still interested in seeing the full poll results.  There are a lot of members that haven't voted, only 59.  I guess if we have gotten a representative sample, we are about even.


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## Dwindlin (Oct 25, 2009)

I love it when people try to compare health care systems with the WHO statistics.  They are meaningless.  You want to compare health care systems?  Compare treatment of disease processes that are similar no matter the county (cancer for example).  You can't compare US to any other county in infant mortality because we attempt to resuscitate babies we probably shouldn't, skews the numbers in a negative way.  Same with life expectancy.  We have the worst lifestyle in the world (which isn't considered in the WHO statistics) its a miracle our life expectancy is where it's at period.  Altering the health care system may correct the infant mortality rate (though in reality the same number of babies would be dieing they just wouldn't get included in the numbers like other countries), but more access to health care is not going to correct lifestyle.  People change because they want to, not because a doctor tells them too (anyone care to look at successful number of smoking cessation because the doctor says to? it isn't a good number).


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## downunderwunda (Oct 25, 2009)

atkinsje said:


> I love it when people try to compare health care systems with the WHO statistics.  They are meaningless.  You want to compare health care systems?  Compare treatment of disease processes that are similar no matter the county (cancer for example).  You can't compare US to any other county in infant mortality because we attempt to resuscitate babies we probably shouldn't, skews the numbers in a negative way.  Same with life expectancy.  We have the worst lifestyle in the world (which isn't considered in the WHO statistics) its a miracle our life expectancy is where it's at period.  Altering the health care system may correct the infant mortality rate (though in reality the same number of babies would be dieing they just wouldn't get included in the numbers like other countries), but more access to health care is not going to correct lifestyle.  People change because they want to, not because a doctor tells them too (anyone care to look at successful number of smoking cessation because the doctor says to? it isn't a good number).



Are you for real? lets just break down what you have said here for a minute.



> I love it when people try to compare health care systems with the WHO statistics.  They are meaningless.



They are only meaningless because they do not fit your argument.



> You want to compare health care systems? Compare treatment of disease processes that are similar no matter the county (cancer for example).



I think you will find the process for disease treatment to be very similar in all first world countries & the US does not have a monopoly on the provision of expertise in the treatment of patients, there are many leaders in their field in countries such as England (and the broader UK) Scandinavia, Australia, South Africa, The UAE, Israel, just to name a few. (Interestingly much of the research & practice for trauma is based on studies from Israel).



> You can't compare US to any other county in infant mortality because we attempt to resuscitate babies we probably shouldn't, skews the numbers in a negative way.



The US isnt a martyr in this area. All first world countries try when it isnt realistic. But to make a statment as rediculous as this, when the statistics _include_ US stats.



> Same with life expectancy. We have the worst lifestyle in the world (which isn't considered in the WHO statistics) its a miracle our life expectancy is where it's at period. Altering the health care system may correct the infant mortality rate (though in reality the same number of babies would be dieing they just wouldn't get included in the numbers like other countries), but more access to health care is not going to correct lifestyle. People change because they want to, not because a doctor tells them too (anyone care to look at successful number of smoking cessation because the doctor says to? it isn't a good number).



Consideration of lifestyle is not relevant in raw statistics. What it tells us is that there are trends in some countries, not others, further analyisis of these numbers show lifestyle issues as the root cause. 

Lifestyle is similar acress the free world. The problems the US have are Obesity, smoking etc, the same as the UK, Europe, Australia etc. 

The information provided by WHO is an acurate record, because _all_ countries report on the same thing.

There would be concers if, on analysis of the data they found that 45% of child mortality in the US came from malnutrition, but this number from a country such as Sudan, where they are currently again in famine, is not unrealistic.

Stop pretending the US is a special case for everything. It isnt. Just because you want to think that you should be above WHO reporting so it doesnt offend you, so you can think you are superior (





> You can't compare US to any other county in infant mortality because we attempt to resuscitate babies we probably shouldn't, skews the numbers in a negative way.


 I, & my colleagues worldwide have all worked on many that we probably shouldnt have, but, we do it so we can say we tried & gave it every opportunity). 

Grow up.


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## VentMedic (Oct 25, 2009)

atkinsje said:


> You can't compare US to any other county in infant mortality because we attempt to resuscitate babies we probably shouldn't, skews the numbers in a negative way.


 
Have you ever actually looked up for a fact what WHO compares for infant mortality? 

What neonatal experience do you have that makes you an expert on neonates? How much do you know about neonatal resuscitation in this country and others? Do you know where the U.S. actually gets some of its own guidelines? Which babies would you like to see die first? How about all born in the field? How about all born to those that you don't believe should have babies? 



> People change because they want to, not because a doctor tells them too (anyone care to look at successful number of smoking cessation because the doctor says to? it isn't a good number).


And, how much do you know about smoking cessation? Do you have any training in it? Are you qualified to counsel patients? Hust being a smoker or once smoked to look cool in high school doesn't count. Can you prove what numbers you are suggesting? 

Put up some scientific data to backup your claims.


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## Dwindlin (Oct 25, 2009)

downunderwunda said:


> Are you for real? lets just break down what you have said here for a minute.
> 
> 
> 
> ...



My responses are bolded.  Also more generally my post may have been misleading as I didn't mean to make the US a special case (but as the US health care system was the shifting topic why would I talk about others?).  I think the WHO statics are poor for comparisons of any country (they are good for seeing progress in that country).  When comparing the effectiveness of medical care you have to be on even playing ground (how seriously would you take medical research that didn't have a similar patient base?), I used cancer because as I said it eliminates some of the lifestyle factors. Three of top five causes of death in the US are lifestyle induced for the most part.  Do you really not believe this alters life expectancy figures?  No where did I mention that the US is superior to anyone, my only point was that the effectiveness of US health care is not as bad as the WHO stats make it out to be.  This all becomes a problem when people try to make the case for a national health care system by comparing us to the rest of world using WHO stats because what works there may not work here.


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## VentMedic (Oct 25, 2009)

atkinsje said:


> No where did I mention that the US is superior to anyone, my only point was that the effectiveness of* US health care is not as bad as the WHO stats make it out to be*.


 
Have you actually looked at the factors and the statistics?    

Have you actually looked at the statistics for the people in this country that do not have insurance and in some places little to no sources for health and dental care of any type? 

Open your eyes to what is happening in your country and not just in your own cozy little living room.


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## Dwindlin (Oct 25, 2009)

VentMedic said:


> Have you actually looked at the factors and the statistics?
> *
> Have you actually looked at the statistics for the people in this country that do not have insurance and in some places little to no sources for health and dental care of any type? *
> 
> Open your eyes to what is happening in your country and not just in your own cozy little living room.



Access to health care and effectiveness of said health care are 2 entirely separate issues.  No where did I mention access.


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## Dwindlin (Oct 25, 2009)

VentMedic said:


> Have you ever actually looked up for a fact what WHO compares for infant mortality?
> 
> What neonatal experience do you have that makes you an expert on neonates? How much do you know about neonatal resuscitation in this country and others? Do you know where the U.S. actually gets some of its own guidelines? Which babies would you like to see die first? How about all born in the field? How about all born to those that you don't believe should have babies?
> 
> ...



Not sure what your getting at in your first paragraph.  I said nothing about any of this.  I'm talking about what countries currently do.  I'm at home and don't have access to the online journals right now (I refuse to pay for them, and I get them free from school).  So if you want my actual sources PM me and I'll be more than happy to PM or e-mail you PDF copies.  For now The Journal of Medical Ethics in 2006 had an article about IMR reporting worldwide, and not everyone reported based on the WHO standards.  Example if an infant born in Germany has a birth weight less than 500 grams and doesn't survive 24 hours this was recorded as still birth and does not count against them in IMR.  Other countries had similar policies with gestation age (France and Belgium).

Smoking cessation rates based on physician encouragement were in the single digits (from Journal of Family medicine).  People who ultimately decide to quit smoking typically have other motives.  Does this mean physicians can't help? Of course it doesn't.  But what it does mean is that unless that person truly wants to change they probably won't.  The same can be said for weight loss.

Edit:  Admittedly the data I have on IMR reporting is 3 years old, I tried a MESH and google search but didn't find anything more recent.  If someone has something more recent please post it (or PM/e-mail me) and I will of course yield.


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## Dwindlin (Oct 25, 2009)

As an aside to the mods, instead of just closing this as this has went off topic admittedly.  Any chance posts relavent to health care debate be moved?  Thanks.

And on that note if anyone wants to further discuss this, by all means make a thread.  But (as others have said as well) if we continue here it will likely get locked.


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## VFFforpeople (Oct 25, 2009)

I am a vollie, about to start medic on wed. I am working in to getting into the paid system, but will never leave my vollie station until forced to. We all are trying to do the same job with the same goal. Paid or vollie. Some areas can't afford full time or paid people. My area has 12 paid SAR (already hired SO, just expanded duties). The rest all vollies. It just depends on your tax base that is decide if you have more paid or vollie (yes I know there are other factors). Like for profit hospitals, ect. In relation to SAR it is tax based.


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## Miss Xina (Oct 25, 2009)

VFFforpeople said:


> I am a vollie, about to start medic on wed. I am working in to getting into the paid system, but will never leave my vollie station until forced to. We all are trying to do the same job with the same goal. Paid or vollie. Some areas can't afford full time or paid people. My area has 12 paid SAR (already hired SO, just expanded duties). The rest all vollies. It just depends on your tax base that is decide if you have more paid or vollie (yes I know there are other factors). Like for profit hospitals, ect. In relation to SAR it is tax based.



Would you consider me a volunteer seeing as I am fully licensed but doing ride time for experience?


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## downunderwunda (Oct 26, 2009)

atkinsje, 

I find your responses disturbing, ill informed & poorly considered. I will address them in your summary.



> Also more generally my post may have been misleading as I didn't mean to make the US a special case (but as the US health care system was the shifting topic why would I talk about others?).



How can you say that when you stated 





> We have the worst lifestyle in the world (which isn't considered in the WHO statistics) its a miracle our life expectancy is where it's at period. Altering the health care system may correct the infant mortality rate (though in reality the same number of babies would be dieing they just wouldn't get included in the numbers like other countries), but more access to health care is not going to correct lifestyle.


 in your original post?



> I think the WHO statics are poor for comparisons of any country (they are good for seeing progress in that country).



So how do you suggest we get comparisons, trends & projections? Like it or not there are similarities between all first world countries, & those trends can be seen through WHO reporting.



> When comparing the effectiveness of medical care you have to be on even playing ground (how seriously would you take medical research that didn't have a similar patient base?),



I am assuming from this that you believe that the pathophysiology of illness/disease is different for the US than any other country. Why is it that _*many*_ medical research projects, regardless of the country of origin, collaberate to conduct sampling worldwide? Could it be that the pathophys is the same worldwide????????



> I used cancer because as I said it eliminates some of the lifestyle factors.



Most cancer treatments are similar worldwide, because they follow evidence based practice. Early detection of cancer is shown to be the most important factor in sucessful treatment.



> Three of top five causes of death in the US are lifestyle induced for the most part.



Interestingly the top 5 include trauma, however that aside, the per capita numbers are surprisingly similar for most first world countries, Heart Disease, Stroke, Cancer & respiritory disease. So why should the US be discounted?



> Do you really not believe this alters life expectancy figures?



No, I dont, however WHO in conjunction with federal health departments worldwide can see trends & look at what stratergies for better education can be implemented to help reduce the problem.



> No where did I mention that the US is superior to anyone, my only point was that the effectiveness of US health care is not as bad as the WHO stats make it out to be.



WHO set baseline standards for reporting of figures. These are the same for all countries. Where there are studies & trials being conducted, statistical allowances are made & notes are made in the statistical tables explaining the anomoly.



> This all becomes a problem when people try to make the case for a national health care system by comparing us to the rest of world using WHO stats because what works there may not work here.



How do you know a nationalised socialised healthcare system wont work? Oddly enough it works in countries such as France, The UK, Aussie & many, many others. It can work. The provision of healthcare that is the same for all regardles of sociaoeconomic status will always be open for debate, but to make comments like you have, without entering into proper, considered debate, with irrational statments like you have made, is a nonsense.


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## VentMedic (Oct 26, 2009)

> Originally Posted by *VentMedic*
> 
> 
> _Have you ever actually looked up for a fact what WHO compares for infant mortality? _


 


atkinsje said:


> Not sure what your getting at in your first paragraph. I said nothing about any of this. I'm talking about what countries currently do.


 
I made that statement after reading the post below.  You should familarize yourself with how the factors are determined and what statistical significane means in the studies. 



atkinsje said:


> I love it when people try to compare health care systems with the WHO statistics. They are meaningless. You want to compare health care systems? Compare treatment of disease processes that are similar no matter the county (cancer for example). You can't compare US to any other county in infant mortality because we attempt to resuscitate babies we probably shouldn't, skews the numbers in a negative way. Same with life expectancy. We have the worst lifestyle in the world (which isn't considered in the WHO statistics) its a miracle our life expectancy is where it's at period. Altering the health care system may correct the infant mortality rate (though in reality the same number of babies would be dieing they just wouldn't get included in the numbers like other countries), but more access to health care is not going to correct lifestyle. People change because they want to, not because a doctor tells them too (anyone care to look at successful number of smoking cessation because the doctor says to? it isn't a good number).


 
As for the smoking cessation, I would read more journals than just one and you might try those that specialize in Pulmonary medicine or the stats from the ATS. 

Family practice doctors will suggest that a patient quits smoking while they are there to get their BP checked and then refer to a Pulmonologist for a follow up for respiratory issues. The Pulmonologist will then send the patient to a PFT lab where the employees in that lab will initiate counseling during the testing. The physician will then start to hammer it home when he/she has black and white results that paint a picture of the person's lungs. The patient will then be seen to further counseling while starting treatment for pulmonary disease and they will be closely monitored during each visit for followup testing. My CO-OX machine will catch them if they have been smoking during the previous few hours. The Pulmonologist can also tell them they may not be eligible for certain surgeries that are not deemed emergent or even if they are, the patient may be in a high risk group which limits their options. 

So, there are specialists that know how to do smoking cessation and get results. GPs may not want to make like the bad guy and lose a patient.


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## Dwindlin (Oct 27, 2009)

Thread was locked for a short time already.  So downunder if you want to continue this conversation checks your PMs.


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## downunderwunda (Oct 28, 2009)

atkinsje said:


> Thread was locked for a short time already.  So downunder if you want to continue this conversation checks your PMs.



Negative.

Maybe this should be split into another tread to continue the discussion. 

I am still to see a reasonable argument from you other than inane ramblings.

Wunda

PS, why are you only addressing this to me, it would appear Vent has issue with some of the things you are dribbling as well.


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## Miss Xina (Oct 28, 2009)

downunderwunda said:


> Negative.
> 
> Maybe this should be split into another tread to continue the discussion.
> 
> ...



I have toothache :sad:


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## Medic One (Oct 29, 2009)

Paid for 20yrs but did have a short 4 or 5 year run as a volunteer but with working 40+ hrs a week paid and the volly politics/ required time I dropped vol side of my life.

Volunteering is good tho...helps communities that are less fortunate financially and give a good feeling in the heart.


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