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Calling 911 in New Jersey Dangerous to Wallets

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  • #16
    I had no idea ther was or is a "law" about that ....... what a mess that services cant be consolidated or managed better. Sorry George, that's outrageous. !
    IACOJ both divisions and PROUD OF IT !
    Pardon me sir.. .....but I believe we are all over here !
    ATTENTION ALL SHOPPERS: Will the dead horse please report to the forums.(thanks Motown)
    RAY WAS HERE 08/28/05
    LETHA' FOREVA' ! 010607
    I'm sorry, I haven't been paying much attention for the last 3 hours.....what were we discussing?
    "but I guarentee you I will FF your arse off" from>
    http://www.firehouse.com/forums/show...60#post1137060post 115

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    • #17
      Down here it's Atlantic Health Systems. (I sure you knew that George.) I just think it's weird that in our town if someone has a heart attack, the paramedics come from the emergency room 2 towns over. Granted their is a BLS service in our town but still I work and live in a very populated area. Sometimes MICU units are very busy or too tied up to even respond. To top it all off, my fire department used to do 1st responder. They gave it up in the 70's. Now that we are trying to get it back, our 1st aid squad does not want us. It's a very long story.
      This space for rent

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      • #18
        The service I work for is about $385 for us to show up, about $11 per mile, $50 for oxygen, Monitor costs $110, IV is about $75, I can't recall what the drugs cost.

        Think about this though;

        Average ambulance call is about an hour of time - Two medic's salary for that hour is about $35 - $40.

        Life Pak 12 - $25,000. Ambulance - $85,000.

        Add up the cost of salary for dispatcher, billing, sepervisors, oxygen delivery, maintenance, fuel, wear and tear on a truck, and, lest we forget - the HUGE cost of vehicle insurance AND liability insurance for the company.

        Now, most of these companies / services have to charge this to cover their costs, plan for capital expenditures and improvements to their vehicles and structures, pay benefits for crews, and make a profit.

        Add to this the fact that medicare and medicaid only reimburses about 50% - 65% of the actual cost of treating a patient and the high cost of the variety of medications we use - Amiodorone $65 per vial, need to use 2 - 3. Narcan multi-dose vial - $36. Adenosine - $35 - $60 depending upon the dose. Glucagon - $50. The reimbursements for these meds is no where near the cost of them.

        When you break it all down I'll bet the service is still not making as much as you might think. I'm not saying that this isn't gouging, but think about all of the incidentals involved that you don't even realize.
        "Too many people spend money they haven't earned, to buy things they don't want, to impress people they don't like." Will Rogers

        The borrower is slave to the lender. Proverbs 22:7 - Debt free since 10/5/2009.

        "No man's life, liberty, or property are safe while the legislature is in session." - New York Judge Gideon Tucker

        "As Americans we must always remember that we all have a common enemy, an enemy that is dangerous, powerful and relentless. I refer, of course, to the federal government." - Dave Barry

        www.daveramsey.com www.clarkhoward.com www.heritage.org

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        • #19
          Ontario it's $48.00 a trip whether it's a taxi ride or the pump every drug in the bus and use every piece of equipment. Also doesn't matter what City or Town you are in it's the same everywhere. Problem is sometimes it's too cheap
          IACOJ

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          • #20
            C'mon LadyCapn, don't rub it in to our American Neighbours.

            It is a flat rate here in BC as well, although it is closer to $400 per trip. $1300 is ludicrous. Let me bleed out, it will be less painfull than getting that bill.

            I'm going to print off that NJ story and post it here in our little clinic for the next time some complains about the cost of non-resident care.
            Never argue with an Idiot. They drag you down to their level, and then beat you with experience!

            IACOJ

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            • #21
              Originally posted by GeorgeWendtCFI
              Here is a trivia question for you old time NJ folks: When it was proposed to start paramedic service in NJ, who was the most vocal group against it?
              George hit the nail on the head.



              The New Jersey State First Aid Council
              Dedicated to serving New Jersey's Volunteer EMS Community


              Or should that read...."Dedicated to SAVING New Jersey's Volunteer EMS Community?" They fought tooth and nail to oppose the establishment of ALS units...yes, a skewed priority. It was all about them...not the patient.

              New Jersey and You....Perfect Together!
              Last edited by NJFFSA16; 07-10-2003, 03:05 AM.
              Proudly serving as the IACOJ Minister of Information & Propoganda!
              Be Safe! Lookouts-Awareness-Communications-Escape Routes-Safety Zones

              *Gathering Crust Since 1968*
              On the web at www.section2wildfire.com

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              • #22
                How could a charge of $11.00-13.00 per mile be even near justified? IT simply doesn't cost that much to operate a vehicle. And they are certainly not paying medics an outrageous salary, either. A medic's pay is a fraction of the pay for a Police Officer here.

                My other rhetorical question would be if the reimbursement rate is so low and the hospitals are borderline poverty stricken, how come it costs so much less in other places?

                The way to bring the costs down overnight in NJ is to allow, like the rest of country, EMS agencies to run ALS.

                BTW; that's $48.00 CANADIAN, Lady
                PROUD, HONORED AND HUMBLED RECIPIENT OF THE PURPLE HYDRANT AWARD - 10/2007.

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                • #23
                  Exactly George, which makes it even cheaper!!!!
                  IACOJ

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                  • #24
                    I haven't noticed this problem in Camden County...Thank God!
                    Firefighter, Volunteering since Oct 2001

                    CCFA 05-04, best overall class for 2005
                    "GOOD GAME!"

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                    • #25
                      The way to bring the costs down overnight in NJ is to allow, like the rest of country, EMS agencies to run ALS.
                      good idea, in concept. and i think it would be interesting. however, thers is a slight problem with that... well three problems: first, current laws say that all medic units must be hospital based (monoc being the lone exception). secondly, the majority of the BLS squads in NJ are volunteer. requiring them to all be ALS compliant would require them to hire full time paramedics to ensure ALS coverage 24/7, which would cause financial problems, which would lead to problem #3. in NJ, the moment you start charging for servcies, you are no longer considered volunteer. even if you don't have paid staff members, and no members receive compensation for their work, the moment you bill, you are no longer considered volunteer by the state of new jersey. i don't agree with it, nor do i think it makes any sense, but that is what it is.
                      I just think it's weird that in our town if someone has a heart attack, the paramedics come from the emergency room 2 towns over. Granted their is a BLS service in our town but still I work and live in a very populated area. Sometimes MICU units are very busy or too tied up to even respond. To top it all off, my fire department used to do 1st responder. They gave it up in the 70's. Now that we are trying to get it back, our 1st aid squad does not want us. It's a very long story.
                      been there, done that. ever worked a cardiac arrest BLS since no ALS unit were available? it sucks. some paid FDs do first response, but I don't know of many volunteer ones in NJ that do.

                      for those of you unfamiliar with NJ's EMS system, it pretty much goes like this: every town has one EMS/Rescue/First Aid/whever squad in it, traditionally run by volunteers. some of the busier towns have more than one squad. BLS transports everything. cardiac arrests, major traumas, breathing problems, stubbed toes, everyting. this is the law of NJ. the only exception to this is where the ALS provider and the BLS provider are the same organization (IE, UMDNJ-EMS newark, MONOC, etc), and this is only in full time paid EMS organizations. ALS is all run out of the hospitals (which MONOC being the exception), and is dispatched and covered regionally. this means in most areas, there are 3-5 paramedic units for more than 10 towns. they get sent, along with the BLS squad, to all life threatening emergencies. but BLS will always do the transport, with ALS assessing and treating the patient in the BLS ambulance, with the ALS vehicle (either ambulance or flycar depending on the organization) following behind.

                      i don't think it's a great system, but that's what we are stuck with
                      If my basic HazMat training has taught me nothing else, it's that if you see a glowing green monkey running away from something, follow that monkey!

                      FF/EMT/DBP

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                      • #26
                        They fought tooth and nail to oppose the establishment of ALS units...yes, a skewed priority. It was all about them...not the patient.
                        they weren't the only ones. the hospital nurses all over the country (not just in NJ) also opposed the creation of paramedics. medics were to be able to do so much more, and yet didn't need a doctor looking over their shoulder the entire time. they were worried the paramedics were going to make the nurses jobs obsolete and unneccessary. maybe the EMTs thought the same thing would happen.
                        If my basic HazMat training has taught me nothing else, it's that if you see a glowing green monkey running away from something, follow that monkey!

                        FF/EMT/DBP

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                        • #27
                          MONOC is based out of Meridian Health, which includes a group of hospitals. That is how they get their Hospital Basing. It's kind of gray in that respect. Also, MONOC does provide BLS coverage and does do BLS transports in some areas, although very few. They have worked out an agreement with a few areas to provide this coverage due to excessive response times by the local BLS squad. Also, every town does not have to have a BLS squad, they only have to provide the service/coverage for the town. My Squad covers 3 towns as an example. And Yes, NJ's setup is what we are stuck with as the FAC dinosaurs will never change it.

                          Vince Robbins, CEO MONOC: "We need to get that money."

                          Vince Robbins: "It's our money, we need to have it to finance our operation."
                          These two statements by Vince say it all. Met him, know him, have dealt with him in the past.

                          And DrP, I agree wholeheartedly with your 3 problems.
                          "This thread is being closed as it is off-topic and not related to the fire industry." - Isn't that what the Off Duty forum was for?

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                          • #28
                            ?

                            Is New Jersey a home rule state, by that I mean can the local goverment make laws to do what is in the best interest of the locals. This could be a way of overriding this crazy system, which sounds like it needs to be....... Also this sound like a form of rationed health care.
                            IACOJ Membership 2002
                            {15}

                            Mike IAFF

                            The beatings will continue until the morale improves

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                            • #29
                              good idea, in concept. and i think it would be interesting. however, thers is a slight problem with that... well three problems: first, current laws say that all medic units must be hospital based (monoc being the lone exception). secondly, the majority of the BLS squads in NJ are volunteer. requiring them to all be ALS compliant would require them to hire full time paramedics to ensure ALS coverage 24/7, which would cause financial problems, which would lead to problem #3. in NJ, the moment you start charging for servcies, you are no longer considered volunteer. even if you don't have paid staff members, and no members receive compensation for their work, the moment you bill, you are no longer considered volunteer by the state of new jersey. i don't agree with it, nor do i think it makes any sense, but that is what it is.
                              The one problem with your post is I never said most of what you are implying. I never said that the law said anything other than a hospital based ALS Unit is the only Unit allowed. I never said that ALL volunteer squads would be required to provide ALS service on a 24/7 basis. AND I never said that billing for care wouldn't change a squads' status.

                              The point of my post was that, by allowing an EMS agency to provide ALS if they so desire, would create a competitive atmosphere which would drive costs down.

                              i don't think it's a great system, but that's what we are stuck with
                              We are only stuck with it because the legislators havenb't been pushed to change it. Perhaps this story will be the impetus behind changing it.
                              PROUD, HONORED AND HUMBLED RECIPIENT OF THE PURPLE HYDRANT AWARD - 10/2007.

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                              • #30
                                Perhaps this story will be the impetus behind changing it.
                                Unfortunately, this is far from the first we have heard/dealt with complaints about MONOC. An article in the Press and an article on Firehouse.com won't come close to doing it. The one's who need to do the pushing are the BLS Squads and I'm betting most in this area are too busy working on finding more members than to challenge MONOC for coverage. Basic mentality - "It's not hurting my Squad to have people complain about MONOC's bill." I don't agree with that mentality, but you can only squeeze so much from a stone. In MONOC's area, very very few FD's do any type of First Responder/EMS coverage, and most do not want to do that, mine included. Heck, we still have EMS Squads doing extrication around here.

                                Also, in Ocean County, MONOC does have a little competition, at least in the Dover Township area, Life Medics out of Community Hospital. Life will come up into the southern end of our area on calls that MONOC is not available.
                                "This thread is being closed as it is off-topic and not related to the fire industry." - Isn't that what the Off Duty forum was for?

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