I’ve seen as ice chest flown from a hospital on a helicopter, presumably for organ transplant.
Subsidizing hospital helicopters seems to me a great thing for government to do.
I don’t know how far apart that is but 'round here, they very often use helicopters to shuttle critical patients from Milwaukee to Madison. That’s 90 minutes by car, it would probably be 75 if you could do it with lights and a siren, I’d guess it’s probably 60 by helicopter.
What makes you think that? Why would a helicopter be under-equipped for trauma?
Helicopters aren’t always faster. I remember a program on TV where a transplant organ had to be delivered and delivered fast. They had a bit of time to prepare (keeping the donor alive) and a high-speed emergency vehicle was available, and the police blocked all the roads along the way, so the vehicle did 150+ on a blue light pretty much all the way.
You’re from the land of the haggis, so I assume this is kilometers per hour? Works out to about 94 MPH, so I guess that’s at least plausible. It’s slower than a helicopter, but if the trip is short enough - and the ambulance is on-site, but the heli isn’t - then I suppose the total door-to-door time could be faster.
In Nevada they save a lot of time. If someone is out on Highway 6 and needs to get to a trauma center, it can take 3 1/2 hours one way for an ambulance to drive there and 50 minutes for a helicopter.
The bill may have been that much, but the cost to actually operate a helicopter is about $1500/hour…. about $25/minute. That includes the pilot but no medical staff (usually they carry two). My brother is an ER doc and flew in medical helicopters earning about $120/hr, or $2/min.
Seems like the hospital is charging $1000/min for something that costs them $29/min.
Yes, weather is a factor. There are times it simply isn’t safe to fly, in which case a ground vehicle is your better option.
Why would you think that? There’s absolutely no reason a helicopter can’t be equipped as fully as any ambulance.
It depends on your insurance policy, actually. Some will never cover one, some will cover it only when deemed necessary, and other are more generous.
I’m sure that there was plenty of profit built into that $1000 a minute charge. Bit then again, most things medical related seem to have a quite large profit margin built in.
It’s certainly another topic, but it does always amaze me at the expected profit a medical issue has when a private party vs an insurance company is posting the bill. In my wife’s instance had the helicopter ride been by a preferred provider the cost would have been 100% covered, presumingly for $4000. But because her husband had no choice it wasn’t covered and suddenly cost three times the amount. Health care in this country is out of reach to all but the wealthiest citizens without insurance. Why the same rates aren’t applied to individuals as to insurance companies is beyond me.
No insult to you, but weather doesn’t cause accidents, drivers not responding to the weather conditions do. Yes I knew what you meant just one of my pet peaves.
FWIIW I flew Hueys in the Army for five years. Three of those years was on an emergency response team. Had to preflight and run up aircraft everyday to be ready to go with 30 min notice. This included time to airfield if needed. We could pull pitch in 5 minutes if we were there. Fortunately never had to do it.
As for landing near an accident, on might land on an intestate in daylight if traffic was held up but ALL ROADS HAVE WIRES and they will mess up your day. A field or parking lot would be a much better choice. And yes we could set down without putting our full weight on the ground. All in all those medevac pilots do some serious flying.
Lots of roads in Nevada have no wires, but wires were a big concern when my brother was flying as a ER doc in Medical helicopters in Ohio.
Yes but it is a term they drill into you in flight school. I guess I shouldn’t have been so critical of urbanredneck. Had to have it on the cover of our mapbook.
One guy in my unit before I got there was doing unauthorized low level flight hit a guy wire and severed his mast. They were lucky, landed upright from only about 20 feet, everyone walked away.
You got type-faced by the type-faceist!
Maybe OT, but should it be legal for a hospital to be able to charge such an exorbitant markup? I’m beginning to think it should be flat out illegal to charge more than “merely” 3x the actual documented cost or so. The reason free markets don’t need price controls are due to a huge number of assumptions that don’t apply to the medical industry at all.
Insurance company worker here.
Obviously getting a prior authorization is out of the question in most cases, but we do review cases retroactively for medical necessity because of the extreme dollar amount. If it’s a par provider, we either pay the claim at our allowed amount or deny it was provider liability. If it were a nonpar provider we would pay it at 100% of charge amount as non patient driven care, or deny it as member liability since we don’t have a contract with that provider (although I’ve personally never seen it happen). In my state we have a contract with all air ambulance providers.
If you ever need to be medevaced back to the US, it’s covered by a lot of commercial insurance, but tell them you want to go to the closest US hospital, not home. If someone takes a sip of tap water in Mexico, typically they want to go back to Chicago, not be dropped off in El Paso. But we’ll figure out how much farther it is from the closest US hospital and deny that part of the claim;people have ended up paying $20,000 for an airplane ride this way that would cost them $150 on Southwest once they had recovered.
You might want to define “par” and “nonpar” provider for those who have never been in the industry. Outside of insurance those aren’t exactly common terms.
Aside from that - you can ALWAYS try to negotiate better terms. By that I DON’T mean ask for a payment plan and simple accept what they want to saddle you with. Be assertive, or authorize someone to be assertive on your behalf (they’ll try to tell you they can’t possibly discuss it with anyone but you but you most certainly CAN authorize anyone you wish to represent you. You may need to produce a written document saying “I authorize so-and-so to represent me in financial dealings with my medical providers and grant permission for them to have all access to medical records required to to do this”, sign it, and date it. Or consult a lawyer if you want to get fancy. Trust me, the legal fee for drawing up such a document is MUCH lower than the medical bills you’d otherwise be saddled with).
I have successfully negotiated reductions of 40% in medical charges not covered by insurance. More than once. They won’t ever offer negotiating as an option, but you CAN do this.
EMT student checking in. Our protocols here in Alberta call for helicopter evacuation if the trauma meets a severity score criteria, or the mechanism of injury is on a list (head trauma, penetrating chest injury, both femurs fractured, etc) AND using a helicopter can reduce TOTAL transport time by 15 minutes or more.
You have to add in the time it takes to launch the aircraft, to set up an LZ, to move the patient to the LZ, and the transit time for the bird to get to the LZ.
It usually works out that in-the-city traumas are faster by ground ambulance. Anything rural that’s severe will usually warrant a chopper. Rural crews will often put the choppers on stand-by-alert on the way to the scene based on the dispatch information. That gives the pilot a general idea of the destination, and lets them launch in less than 5 minutes.
In terms of level of care, most ambulances with paramedics (ALS) can do pretty much anything an ER can do in the first 15 minutes short of emergency surgery (i.e drugs, fluids, airway, but no chest tubes, no blood transfusions, and no chest surgery). Our helicopters are staffed at a slightly higher level of care than ambulances. Their medics are Critical Care Paramedics, and they also have a flight nurse. Scope of practice includes a few more drugs. I don’t know if they can put in a chest tube, but they don’t carry blood. In EMS circles here, medical flight crews are regarded as very elite.
My only experience with Medevac is that my husband was transported by air after a bad wreck in December 2012. I just checked Google maps, and it’s almost exactly 30 miles by ground between the accident site and the trauma center. The map estimate of travel time is laughably wrong, though - Google says 33 minutes, but I’ve driven those roads. With traffic (and there’s always traffic,) it’s more like 45 minutes at one in the morning, or an hour during most parts of the day. And yes, I know that an emergency vehicle running code gets the right-of-way, but drivers don’t yield, far too often (* and **.) At the time of day that Tony was transported, a ground ambulance could probably have made the trip in a half-hour to 40 minutes.
Instead, by the time first responders had used the Jaws of Life to chop up the car, the helicopter had landed on a nearby church’s parking lot. The flight probably took 10-12 minutes to the trauma center. And, where the ambulance was manned by very professional EMTs, the helicopter’s staff included a flight nurse plus a paramedic. So the benefit wasn’t just that he arrived at the hospital 20 or 30 minutes sooner, but the air ambulance also has a better-trained crew, as trupa described.
As for cost - everything has been covered by insurance, but the helicopter bill was first routed to our house before all of the service providers figured out where to send stuff. $1000 per mile is about right - IIRC, the bill was in the neighborhood of $24,500. Given that the flight path between the wreck and the hospital would have to route around a commercial airport and a military airfield, the flight distance was very likely in the vicinity of 24.5 miles.
*That’s actually the reason for Tony’s wreck. He was running code to a house fire, and a driver just plain stopped in the roadway, after zigging and zagging a bit. Tony hit the ditch, and essentially pole-vaulted a Crown Victoria. Possibly his most athletic achievement since playing high school football!
** Hell, when I was being taken to the trauma center (by one of Tony’s co-workers,) we were running code the entire trip - about 55 miles. Lights-only on the interstate, except for a few moments when people just wouldn’t fucking move over, and lights + sirens once we got into city traffic. Even with David cutting lanes and driving over medians to get past the douchenozzles who refused to yield the left lane, the last 3 or 4 miles took probably 12 minutes.
It depends on the air traffic, actually. Medical flights are top priority and if conditions allow they may not have to route around other airfields, air traffic control might allow them to simply fly on a straight line to their destination.
Interesting! Looking again at the map, it’s entirely possible then, that the chopper flew directly over the local airport - it’s a small one, with maybe 80 total commercial flights arriving and departing daily, plus a handful of private takeoffs and landings, so there wouldn’t have been a major disruption to clear the airspace for the amount of time it takes for one helicopter I suppose. (I can’t imagine what a nightmare that might entail around, say, Hartsfield or O’Hare!) Even if the helicopter diverted around the airport, though, that probably added less than a minute to the flight time.
Coordinating with the local army airfield, however, is probably pretty routine, because the hospital is only about 2 miles from the airfield, and this hospital is the only Level 1 trauma center within about 100 miles, so they get all of the really spectacular car crashes and interhospital transfers. (IIRC, the day of Tony’s wreck, there were seven patients brought in by helicopter, and the staff didn’t find that out of the ordinary.)