this week has been nice. i've only stayed over at work a cumulative total of about an hour and fifteen minutes. holla. it feels nice actually getting off work on time. lately it seems that the dispatchers have paid more attention to the actual schedules of the people that are actually out there in the thick of the money-making.

i found out the other day that an ambulance ride costs upward of $600. $600 is like a flat fee. after that, it's $7 per mile that we transport. that means that for that patient i took to the border of kentucky the other day, his bill ran somewhere around $1000. for a glamorous taxi. now the $600 doesn't cover anything else. for each patient, we use four pairs of gloves (one loading and one unloading x 2 people) and something the billing department calls an "infection pack," which is two sheets that go over the stretcher to make sure none of the patient's poo and/or filth gets transferred into another patient's poo and/or filth. then there's oxygen. i believe there is just one flat fee for oxygen use, which means that if you are on 2L by nasal cannula (the little nose things they wrap around your ears in the hospital), you get charged the same as someone whom required 12L. now that's about the end of it on a BLS truck. unless you get suctioned, which is another charge (charge for the verb: suction, plus the canister, suction tip and tubing).

now most of the time, insurance will pay for ambulance rides... as long as they are necessary. however, i have had countless patients need an ambulance because, and i quote, "could not sit for an extended period of time," so they needed to lay down. i believe that if you cannot sit for an extended period of time, and that you MUST lie down, you shouldn't be going anywhere. truth is, when we put someone on a stretcher, we lift their heads up (also called semi-fowlers position) so the center of gravity is basically the same as if they were sitting. with an angled head rest, you've got the straight downward force of gravity plus the half of your body at the 45 degree angle sliding down the headrest. if you don't understand, i'll draw it for you.

i don't buy it for a minute that someone absolutely cannot sit for an extended period of time. i don't buy it, and neither will the insurance company, which brings me back to my blog that i wrote some time ago; people think they're entitled. maybe it's not that serious. perhaps some people just really want an ambulance. but don't think for one minute that medicare will front the bill because you would rather lie down on a stretcher than sit on a bus.