As an IFT EMT it is absolutely integral to patient care to understand how Medicare patients (your biggest demographic) are affected by your documentation and interaction with all parties involved.
For example, ERs want to clear out beds, and if an ambulance ETA beats a wheelchair van by a number of hours, you can bet your *** an MD will sign a bull **** Physician's Certification Statement for Medical Necessity form in a heartbeat. I had that happen last night, and I'm sure it'll happen again within a week. If there's no supporting evidence in the chart or your PCR, that's a technical denial on a Tx granny didn't need. Without your advocacy, she may never be told it won't be covered. Read: a surprise bill for thousands of dollars for someone's elderly family member because you didn't act as a patient advocate. Again, as an IFT EMT, preventing unnecessary financial hardship is absolutely patient care.
As for your employer not getting paid for a Tx, do you think that could possibly have an effect on your wages? It is absolutely your problem. That's the way business works.
EMS personnel not understanding the long term implications of their actions doesn't just apply to clinical decisions. You can screw up a patient medically and financially.
Remember those bigger fish to fry before worrying about unions?
I would hope anyone proclaiming to be a professional and discussing the financial aspects of EMS would have at least a working knowledge of how Medicare affects their industry and their patients.
By the way, as a data point, I'm a Basic at an IFT only company and have the option of medical, vision, dental with decent premiums and 401(k) without a union. Also, I would say that for the 160 hours of education I have, as well as how easy, enjoyable, and low stress IFT is, and the glut of unemployed EMTs in my area, I have absolutely no gripes with being paid minimum wage. I'd pay me minimum wage too.