New policies needed for civilian air medevac transportation
Lawmakers should evaluate billing issues and insurance company procedure to guide healthcare policy and protect patients
By Allison G. S. Knox, EMT-B, faculty member at American Military University
Universal healthcare, medical bills and insurance coverage have been at the forefront of public policy issues in the United States for the past few decades. Congress has tried to correct some of these truly incredible problems, not always with success.
Considering the serious healthcare issues concerning Medicare, Medicaid and increasing medical bills, it is no wonder that the civilian medevac program has become another public health policy problem.
Recently, the media have spotlighted the astronomical medical bills patients receive from ambulance helicopter services for being flown to a healthcare facility for a serious medical condition or traumatic injury.
In some cases, insurance companies will not pay for this service, leaving patients with medical bills costing thousands of dollars. According to NBC, the “costs of these flights can range from $12,000 to $25,000 per flight.”
States working on new medevac policies
The situation has become so dire that a few states have begun working to implement new medevac policies. In the future, some patients may need to give written consent to an emergency medical technician or paramedic before a medevac helicopter transports a patient.
In Virginia, for example, the Emergency Air Medical Transportation – Informed Decision Bill (HB 777) is currently under consideration. This bill requires emergency medical technicians or paramedics to obtain patient consent before they request an air ambulance or helicopter. The bill further stipulates that EMTs or paramedics can still ask for the air ambulance if a patient is unable to consent.
Can patients without medical training give informed consent?
While an established policy would make patients feel more comfortable about the potential costs of air transportation, most patients do not have advanced medical training to make proper decisions. In many cases, it is difficult for patients to make a truly informed decision about when an air ambulance was necessary.
More important, patients fearful of a large medical bill might not give their consent to such expensive transportation. Based on their medical condition, that fear could affect their very survival.
Lawmakers need to create sensible medevac policies
The concept of asking for patients’ consent before they’re flown makes sense on paper. Why shouldn’t someone have the ability to decide whether or not they should be flown and potentially get stuck with an astronomical medical bill? Ambulance transportation is decidedly cheaper and usually covered by insurance.
Ideally, lawmakers should not put in place any law that would make it difficult to fly a patient who really needs urgent medical care. But that law would need to be carefully written to make sure it works in the way it is intended.
Lawmakers should look specifically at billing issues and insurance company policies. They could restructure how insurance companies write their policies, making a better case for patient care. Ultimately, lawmakers could ensure that insurance companies cover air ambulance bills, so patients would not be faced with the unpleasant choice of a high medical bill or a life-threatening delay in proper medical care.
State legislatures should look at other players in the medical treatment equation and write tighter laws that get to the root of outrageously high medical bills. Making the patient decide whether or not to be transported by air ambulance is a slippery slope toward less effective healthcare policies.
About the Author
Allison G. S. Knox is a faculty member at American Military University in the Emergency and Disaster Management Department. Her research interests are comprised of emergency management and emergency medical services policy issues. Prior to teaching, Allison worked in a level one trauma center emergency department and for a Member of Congress in Washington, D.C. She holds four Master of Arts degrees in emergency management, international relations, national security studies and history. She is a certified lifeguard and emergency medical technician and is also trained in technical large animal emergency rescue. Allison currently serves advocacy coordinator of Virginia for the National Association of Emergency Medical Technicians, chapter sponsor for the West Virginia Iota Chapter of Pi Gamma Mu International Honor Society and faculty advisor for the Political Science Scholars. She is also on the Board of Trustees and serves as chancellor of the Southeast Region for Pi Gamma Mu International Honor Society in the Social Sciences. She can be reached at IPSauthor@apus.edu. For more articles featuring insight from industry experts, subscribe to In Public Safety’s bi-monthly newsletter.