MN-observer wrote on Jan 20, 2008 3:13 PM:
" Healthcare costs and reimbursement: There is no doubt that the cost of health care is high at all levels. The charge incurred for an emergency ambulance “ride” is not cheap. However, think about what you are getting: trained, experienced paramedics who are caregivers in the best sense of the word.
The reimbursement of healthcare is not equal by payor (Medicare, Medicaid, HMOs: Kaiser, Blue Cross, Medica, Health Partners, etc.), but the reimbursement is always less than the actual charge. Unfortunately the reality of healthcare costs is that the price assigned to the service has sky-rocketed because the payment is so much less than that billed.
Non-profit businesses, such as Tri-State, put any profit they make back into the company, usually with equipment upgrades, personnel, training, and as witnessed by Tri-State’s actions back into the community itself!! You are blessed!! "
MN-observer wrote on Jan 20, 2008 3:10 PM:
" As fire prevention has become more and more successful it has become the trend across the nation that fire departments are looking to augment their sustainability as full-time paid departments by becoming involved in the ambulance business.
The reality is that many fire fighters do not want to become paramedics; their focus is not patient care. Whereas those individuals who work for private ambulance services believe in providing the best patient care possible, and trust me, they are not in it for the money. Private industry does not have the pensions that exist in city, county, and state positions.
Running a business is not without its costs. Starting up a paramedic service by the city is not going to come without a significant cost to the public (medical supplies and equipment, ambulances, paramedic training, liability insurance, medical direction, maintenance, continuing education, etc). "
MN-observer wrote on Jan 20, 2008 3:08 PM:
" With regard to who should provide ambulance service to the city of La Crosse it has been interesting to watch this debate as an unbiased medical professional. As citizens of the city, you should ask yourselves, how is it going to benefit me for the Fire Department to become the ambulance provider? Will they hire more staff? How will the response to fire alarms or actual fires be impacted? Who is taking care of the current building inspections (fire personnel or other city employees)? What do they do right now anyway?
Has the Fire Department provided a detailed report and analysis to the citizens regarding their current duties and finances?
Cont’d… "
MN-observer wrote on Jan 20, 2008 3:01 PM:
" The agreement between the county of La Crosse and Gunderson Lutheran / Tri-State Ambulance to provide Emergency Medical Dispatch (EMD) is fantastic news and will be a blessing to all of the citizens in the area.
As residents of the county you will have the benefit of a uniformed process for the 911 system. Two components of EMD are: 1) prioritizing if the patient is critical or not and requires a lights and sirens response (which in turn protects the public and crew) and 2) providing pre-arrival instructions to the caller (choking, CPR, bleeding control, childbirth, etc.).
The implementation of the EMD system is a gift to all of you and long overdue!!
"
anon wrote on Jan 20, 2008 10:50 AM:
" Yes, you have done some good things as you stated. However, it seems to me that tri-state has been proactive in response to the FD wanting the service. If they did not wanted the ambulance service then tri-state would not be at calls before the first responders 36% of the time. "
MZavadsky wrote on Jan 19, 2008 7:49 PM:
" PS: One more correction on your blog - we have yet to find any fire-based ambulance service, (even of the 4 the La X FD suggested we visit together as "models") whose revenues offset their costs of providing ambulance services. They are ALL costing more to the taxpayer than they are bringing in... I have those figures from those departments if you'd like to review them as well... Thanks, Matt "
MZavadsky wrote on Jan 19, 2008 7:43 PM:
" To Anaon...
Continued - Finally, as far as going from city-to-city "causing trouble"; did I strike a nerve with you? Why the personal attack?
Is "trouble" helping our outstanding workforce promote patient centered healthcare decisions through a physician represented EMS Commission, improve our response times to the point we arrive at the scene before the First Responders on 36% of the emergency calls, helping bring emergency medical dispatch to the community, bringing flu shots to home-bound patients, providing courtesy "Home for the Holidays" transportation for local nursing home residents? Is that trouble??
If you care to, I'll take you to lunch anytime abd be more happy to review my career offers and decisions with you...
To take me up on any of these offers, feel free e-mail me at MZavadsky@tristateambulance.org. The truth will set you free. "
MZavadsky wrote on Jan 19, 2008 7:35 PM:
" To Anon - You, and any member of our community, are more than welcome to come and see our books. I assure you they are accurate, but come see for yourself...
Why do you feel the turnover is high? As a % of the workforce, it is not much different than 2, 3 or 10 years ago?? Come and I'll show you those statistics as well.
As for causing trouble, I did not start the current controversy - seems it is others who are trying to destroy a clinically, operationally and fiscally high performing EMS system for reasons they have been unable to publicly articulate(or privately articulate for that matter)? Am I incorrect?
More to follow... "
anon wrote on Jan 19, 2008 1:03 PM:
" Also, why dont you go to another city and stir up some problems. Seems you like to go from city to city and cause problems- then get fired or quit for unknown reasons same thing. Why has there been such a big turn over on tri-state since you showed up? "
anon wrote on Jan 19, 2008 12:47 PM:
" To Matt Z. $13 per call profit...after you cook the books. Yeah the city will not make any money, but they will offset costs and the money will pay for ambulances, wages, and benefits of some of the firefighters. "
MZavadsky wrote on Jan 17, 2008 9:31 PM:
" Meximan: One more thing about the "City Run" ambulance. The cost of providing the service through a public agency is always more. The "charge" can be less since they ae using tax dollars to subsidize it. I previously stated what our cost and revenue per call was. If the community wanted lower rates, the government could subsidize the cost of the 50% of bills that are uncollectible. That would allow us to "charge" $315 to the user. The public policy decision is; do you want the USER to pay for the service, or do you want your tax dollar to be paid for the service, regardless of whether or not you use the service? Thanks, Matt "
MZavadsky wrote on Jan 17, 2008 9:24 PM:
" To Meximan: Our basic rate for a dual paramedic mbulance transport from one La Crosse hospital to another is $603 plus $10/mile for a total cost of $623. Only about 50% of money actually billed for any EMS service, anywhere in the country is received as revenue. Some people don't have insurance, Medicare only pays about 50% of the bill, etc. This is true regardless of who the provider is. If everyone paid, the rate would be half what it is now, just like all healthcare. For 2007, our fully allocated cost per call (as a private, non-profit, efficient, non-governmental agency) was $520.90 and our net revenue per call was $534.20, so we "made" $13 per call. The fire department's cost per call (including medical) was $1,917. If you'd like more information, feel free to e-mail me at MZavadsky@tristateambulance.org. "
2Hoots wrote on Jan 17, 2008 9:19 PM:
" Is there something wrong with the ambulance service now? If not, then why does it have to be fixed? The 1st Responder service was started so the FD could give their FF's something to do. Nothing says you must provide 1st Responder service. LaCrosse FD sunk a few hundred thousand dollars into starting up a "free service" and the taxpayers agreed. How about ending the free 1st Responders, sell the vehicles/equipment and laying off firefighters. Fire departments across the country use EMS calls to pad their call volumes when they go to city hall at budget time. Get rid of 1st Responders and have TSA buy more ambulances and hire more personnel. That won't cost the city a dime and they'd get rid of a big chunk of FD budget money every year. Instead of hiring more FF's and buying 3 vehicles, get rid of 24 FF's and vehicles. "
MZavadsky wrote on Jan 17, 2008 9:11 PM:
" Money to be made? Tri-State is not tax subsidized, but rather relies on user fees to pay for having up to 6 dual paramedic ambulances available to respond calls in the La Crosse area. Our monthly and annuallly trended operatonal and fiscal performance reports are available for public view by clicking on the "Performance Indicators" link at www.tristateambulance.org. You will find that we are more transparent with operational and fiscal information than most any of the public agencies. Thanks, Matt "
MEXIMAN wrote on Jan 17, 2008 8:51 PM:
" I say ditch Tri state..!!! A friend of mine 3 years ago took a ambulance ride from Cass St/ Third to Gunderson..the bill was almost $ 1,000 dollars for a fractured leg. I Several years before that was back home and needed a ambulance for a more serious treatment issue...i traveled almost 24 miles to the hospital and my bill was $570. The reason being was that the ambulance service that i took was CITY OPERATED...!!!! It's like watching a Legal (MONOPOLY) being operated in this town....there seems to be alot of that going around..!! (DUMP TRI STATE) "
Darwinism wrote on Jan 17, 2008 8:17 PM:
" It costs about $1100 for an ambulance ride from one La Crosse local hospital ER to the other not including any medical supplies or treatments. La Crosse PD will only do it with Guaranteed payment of $54/hour at a minimum of 3 hours equalling $162 for the same local hospital transfer. It costs $10 for a cab with tip. There IS significant money to be made from the provider of this service. Follow the money....Follow the laws/ordinances that require certian types of transport.... "
La Crosse TaxPayer wrote on Jan 17, 2008 8:00 PM:
" The clowns at City Hall have lost all credibility with the taxpayers because of their wasteful spending and mismanagement of taxpayers’ money! The last thing these morons at City Hall need is more responsibility; it is quite obvious they cannot handle what they have now. Government in La Crosse has become corrupt and nobody trusts anything City Hall tries to do because of their track record of trying to hide and slide deals behind closed doors for the good old boys under the table. I may be supportive of this city owned ambulance service with a different governing board but what we have in City Hall at this time cannot be trusted and are not competent to handle this responsibility!! "
ollie wrote on Jan 17, 2008 6:34 PM:
" I wouldn't trust the current City officials to run a hot dog stand. "
The Real Deal wrote on Jan 17, 2008 5:06 PM:
" La Crosse residents, bite the bullet,fill your car with gas and drive(gasp)outside La Crosse county. 90% of cities the size of La Crosse provide fire department paramedic service. Get your heads out of the sand, 70 to 80% of LCFD emergency calls are EMS. Are these departments wrong or is La Crosse right? "
Krusty wrote on Jan 17, 2008 3:35 PM:
" This is one of the worst ideas the city has had lately. If johnsrud and his pack of idiots get involved with the ambulance service you'd be better off calling a cab to get to the hospital "
random annoying bozo wrote on Jan 17, 2008 1:08 PM:
" all i have to say is, i'm glad as heck i don't live in the City of Lacrosse. but i do enjoy watching the goings on. it's like watching Monty Pythons Flying Circus, i can just see your Mayor right now doing a goofy walk, with the Council vying for the 'twit' of the year. "
JS wrote on Jan 17, 2008 12:31 PM:
" This agreement would be simple if Johnsrud did not want every dime from us. Drop the city ambulance idea. The taxpayers are already overtaxed and clearly there is no need to replace a service that is not broken. "
ollie wrote on Jan 17, 2008 9:45 AM:
" Simple Solution, Is the County or City RESPONSIVE to your need and complaints? You know the answer. This is a dumb idea and it will probably cost lives. "
medic wrote on Jan 17, 2008 9:09 AM:
" This is a mistake. TSA operates very well right now along side LCFD. Nothing more needs to be done. "
joeemt wrote on Jan 17, 2008 8:49 AM:
" By the way skidmark, Please explain to the people of La Crosse why they should have to pay for the Ambulance service with tax money and again if they need a ride should you and the fire chief get your way. A city ambulance service will not make a profit for the city. Maybe you two should look at not filling slots on the F D as guys retire and save money that way. "
joeemt wrote on Jan 17, 2008 8:43 AM:
" To skidmark, please leave the ambulance service alone. You need to focus on fixing Bliss Rd. and other things that are broken in the city. The ambulance service is not broken. I just can't wait until you have to tell a tourist that wants to go up to see the view from the bluff "sorry, you can't get there from here so go to the river if you can still get there." "
North Sider wrote on Jan 17, 2008 7:55 AM:
" Taking it in as fast as they can, as it is going out the back door faster. Any source of money. Go look at the Audit specifics they are asking Pettibone Campground, see what you think? (WIZM Website, Forums). They have their nose to the ground for cash and deals. Temporary fix, and quite a long shot. "
juco48 wrote on Jan 17, 2008 7:50 AM:
" let's see. lhi cannot have a ballroom as it could possibly cut into the LaCrosse Center "profits". But the city of LaCrosse can go into business and cut into one of the cities businesses.????????? "
North Sider wrote on Jan 17, 2008 7:05 AM:
" Of course it is not done. Not until certain entities shave off a little unearned income for there presently empty coffers. Shameful. "
Krusty wrote on Jan 17, 2008 6:49 AM:
" z9qoo!! "
The Moderate wrote on Jan 17, 2008 4:25 AM:
" z9qoo to you to LaX TaxPayer! "
La Crosse TaxPayer wrote on Jan 17, 2008 12:46 AM:
" Just what the public needs, is a bunch of bozos in cityhall running an emergency service that our lives depend on!! These clowns at cityhall can’t even enforce ordinances requiring sidewalks tobe shoveled within 24 hours after a snowfall. When a complaint is called in to the engineering department and the mayors office they say it will be 2 weeks before they can do anything because there to busy with there own snow. An excuse is no what I need if I need medical treatment fast, and I can hear the excuses now, were busy taking a coffee break we’ll be there in a hour or were busy watching drunks kill themselves will be there tomorrow, any thing lacrosse government gets into they screw up!!! Leave this alone, it aint broke so don’t try to fix it!! Or in this case screw it up!!z9qoo "
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