Are you Volunteer or Paid?

[HCEMS]

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.

 

[downunderwunda]

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'

 

[ChicagolandIFT]

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.

 

[atropine]

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.

 

[reaper]

Shining example of LA EMS at it's finest!

 

[JPINFV]

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.

 

[VentMedic]

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?

 

[MMiz]

Lets keep this thread appropriate and on track. Thanks.

 

[mycrofft]

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.

 

[downunderwunda]

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.......

 

[eveningsky339]

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.

 

[downunderwunda]

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?

 

[mycrofft]

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.

 

[DrParasite]

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.

 

[downunderwunda]

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.

 

[Miss Xina]

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.

 

[JPINFV]

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.

 

[Miss Xina]

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.

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

 

[DrParasite]

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

 

[JPINFV]

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.