Ratcheting Down the Financial Waste in Healthcare

Related Resource: The EMS1 2008 Year in Review special coverage

This past year, the presidential election and the economic disaster dominated the news headlines. As bad and contentious as some of this has been, I don’t think we know how it will impact EMS — at least, not yet. That will surely be a major subject for 2009’s year-end recap.

For me, the biggest on-going saga in EMS has been the air ambulance crashes and the resulting fatalities. Indeed, 2008 was the worst year in both the number of incidents, as well as number of deaths. The fix will have to be multi-faceted, requiring enhanced safety equipment, as well as a reemphasis on a culture of safety for air crews.

However, it also mandates consideration of standardized activation criteria for air ambulance requests and the strengthening of ground-based EMS agencies to better care for patients in lieu of air resources.

In a broader sense, the air ambulance mess also has far-reaching implications for the rest of health care because it raises the question of high costs associated with air transport versus measurable patient benefit. In fact, all of EMS and medicine may soon be subjected to the same financial scrutiny.

A connection does exist between the air industry troubles and our changing political picture. Major health care reforms may indeed be coming sooner or later, but no thorough, responsible reform can happen without ratcheting down the wasteful, out of control costs in our health care “system.”

When you consider the “benefit” of much of what we spend our money on, you realize that the cost-effectiveness of our health care expenditures is weak, at best. While reevaluating the air medical industry has been particularly focused on lately, it will not be the only area of EMS and heath care that will be facing big potential changes in the near future.