How will Trump effect EMS?

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Remi said:
How do you know socialized medicine works in Cuba? The accounts I've read all describe long wait times, run down facilities and old equipment, and chronic shortages of both qualified providers and basic medications.

I think socialized medicine appears on the surface to work well, but is fraught with all the problems that accompany any "free" program; namely, demand that outstrips supply. From what I understand, private healthcare is a rapidly growing industry in western Europe for those who can afford it.
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Sounds just like good old fashioned American capitalist medicine.


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Let's just call a spade a spade here and cut to the chase.

It's economics.

People with money, for a variety of reasons, have access to better things than people without money have.

EMS is the front line safety net for people without money.

Unfortunately, Ain't nobody gonna pay for that. Cheap bread and circuses have been the tonic for the masses for ages.

Let them eat cake.


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I don't agree with it, but it's what it is.


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Refer to my signature, if you'd like a modern quote on how to deal with this problem


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Arovetli said:
EMS is the front line safety net for people without money.
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No we aren't.
We don't function that way.
We weren't designed that way.
And we are terrible at it.
 
Summit said:
No we aren't.
We don't function that way.
We weren't designed that way.
And we are terrible at it.
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Agree with the last 3 statements, not the first.

Tragedy of the Commons.


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Let me put it like this. People who make big decisions in business in policy come from schools of thought steeped in game theory and behavioral economics.

You have a gigantic case of the tragedy of the commons right here. We're committed to provided free access healthcare by virtue of law, policy and of course, ethics.

Something with massively high demand is offered for free in a world of finite resources. Challenging paradox. To resolve it, do we try more broad control of the markets or back off and let the markets run loose.

Loose markets creates inequality and instability.

Whatever shall we do?




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Summit said:
No we aren't.
We don't function that way.
We weren't designed that way.
And we are terrible at it.
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I would respectfully disagree - I think we should not be functioning as the safety net, nor were we designed for safety-net purposes, but we are, in many places, functioning as the safety net. That being said, we are bad at it!
 
EpiEMS said:
Demography is destiny, as they say.

Aside from the demographics, though, I don't think we can be very confident in politicians fixing health care, one way or the other.

The ACA (with attendant Medicaid expansion) isn't to blame for heavy use, but it sure as heck didn't help - as we know from a piece of a wonderful study/natural experiment. We've committed as a society to pay for care for the indigent forever, and really put it on paper with the EMTALA for some 30 years (as an unfunded mandate). Clearly, insuring people doesn't help. Will the putative economic benefits of Mr. Trump's policy platform make things better? I give it a qualified yes. Yes insofar as that we will have more tax revenue to make good on our unfunded mandates, but no insofar as that the economy being better overall doesn't necessarily reduce overutilization of emergency services.
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A good bit of trump supporters lacked a college education. A good bit of EMS providers lack college educations.

It's a correlation. Don't read too much into it.


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Arovetli said:
A good bit of trump supporters lacked a college education. A good bit of EMS providers lack college educations.

It's a correlation. Don't read too much into it.
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I know, I was half joking (mostly being snide) there. I do think that any expectation of a quick fix by any party (and certainly by any individual) is unrealistic.
 
@epi I meant to quote the post you quoted not your post, sorry!


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Arovetli said:
A good bit of trump supporters lacked a college education. A good bit of EMS providers lack college educations.

It's a correlation. Don't read too much into it.


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There's no correlation there. If you really want to correlate, consider a total % of college-educated or above people, then break it down by ethnics & residency, and finally, their party affiliation. What you just said is an ole 'all blacks voted Obama, and a good bit of them are welfare queens/gangbangers'.

But yeah, don't read too much into it.
 
No. what I inferred was the demographics of EMS mirror the demographics of Trump voters.

And I did not, in no such way, make any references to race, gender sexuality or any other minority groups or any type of offensive imagery that you've chosen to use.


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Of course you didn't. But this is formal logic vs your figurative language, and am showing you what it looks like.
 
Sigh.

I pointed out one thing matched another and it should not be read into in precisely the fashion you read into it.

I apologize if that was not clear.

I also pointed out that for many thousands of years the problem of poverty, social welfare, class mobility, etc. haven't been solved and were often, by leaders, neglected in quite a gregarious fashion, as evidenced by several quotes from world leaders.

I also apologize if that was not clear. I hope that clarifies.



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Also,

EMS is not on anyone's radar in a policy making or business sense. There's a high amount of fraud in the industry, so from a policy standpoint increasing funding exacerbates a fraud problem.

Behavioral economics of EMS are a hot mess, and having multiple services in close proximity drain resources that could be more appropriately allocated in the aggregate. Yet, much resistance to broad regionalization.

Most of the scientific literature is undoing many of the sacred cows we have built the profession on.

The ACO/MACRA models offered EMS a window to change business models / now, many uncertainties.


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Arovetli said:
There's a high amount of fraud in the industry, so from a policy standpoint increasing funding exacerbates a fraud problem.
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100%. And this is one of the many things that people neglect to think about when they claim that government-run services are cheaper to run: They sure are, because there is less motivation to detect waste/abuse/misused services (or to find cheaper alternatives to [insert expensive thing here]) than private insurers (since there's no profit motive)...
 
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