#Assassination Generation

I have been reading an alarming book that definitely needs to be widely read:  Assassination Generation by Lt. Col. Dave Grossman.  This book is about how children are being essentially trained to be murders by indulging in violent video games.  As a clinical psychologist and a concerned citizen, I have spoken to parents about how learned behaviors in the young go into the subconscious mind and later manifest.  Assassination Generation is a well-researched book with a lot of examples of young people who have gone out and carried out mass killings across this nation.   Every day, we hear of a young person obsessed with killing manages to go out and in irrational ways claiming the lives of innocent people.  America needs to wake up!  The video industry is making massive amounts of money targeting our young in addictive destructive behavior.  Read this book and share it, talk about this problem and help save the children.

Tough decisions 2017

As 2017 begins,  civilian helicopter medevac seems to still be an industry with ongoing  accidents injuring or claiming lives  still on the radar.  At the same time, there’s news of a new helicopter service for children in Atlanta,  called an  “flying  ICU”  the first of its kind that can transport critically injured children and their parents.   So there’s the potential for good news or ongoing bad news.  This seems to be an industry that must inevitably have to make hard line decisions.  Given the cost of a helicopter and staff to provide critical care intervention, one must consider how effective helicopter medevac service really is.  There are perceptions that this is a glutted helicopter market serving few patients.  Health care costs have not stopped escalating.  There was a study in the Silicon Valley area of California that reviewed 947 trauma patients transported to their trauma center.  Their findings were:  only 22.8% of those patients possibly benefited from transport.  In addition, they found that 33.5% of those patients were discharged from the ER and not admitted to the hospital.  So what’s the problem?   Are field personnel in need of greater training to be able to make more effective assessments?  Another good question is:  Did those transported between facilities by air have better outcomes than those transported by ground?    Without a doubt,  more research is needed so that the industry can make sound decisions that will improve life for those injured, and avoid tragic accidents claiming lives.  Continued high cost transport certainly drives escalating health care costs.  What can/ should the helicopter industry do?  What might constitute best business practice?

 

Proposed changes to Level I trauma center designation

In 2013, Dr. Christopher Urbina, former executive director and chief medical officer of the   Colorado Department of Public Health and Environment announced that the criteria for Level I designation as a trauma center would be reduced to treating 320 critically injured patients per year.   Research has demonstrated that centers that treat 600 critically injured per year have the best outcomes because it keeps their skills sharp. As other hospitals gear up to be designated trauma centers, this may be another case of too much competition at great expense.   The over designation of trauma centers would require Level I and II service to have to pay to have surgeons and other healthcare providers on call to assure that each hospital is prepared to provide intervention for the seriously injured 24 hours a day/ 365 days a year.   In essence the proposed change would simply increase competition and result in a duplication of services that drive up costs and dilute the quality of trauma care for Coloradoans.   Most trauma experts believe a population of 2.5 million in the Denver metro area justifies just a single Level I Trauma Center, not the three that we presently have.

In 2009 the American College of Surgeons conducted a comprehensive review of the Colorado Trauma System and completed with the assessment that it “likely reflects an excess of trauma centers that are competing for patients, reducing the volume at each center, and duplicating expensive resources.”

 

 

Obesity and helicopter transport

The National Center for Health Statistics reports obesity in America has reached alarming rates. It is one of the biggest drivers of healthcare costs that are estimated to range from $147 billion to nearly $210 billion per year. 68.5% of adults are overweight and 34.9% are obese.  Obesity among children and adolescents has escalated.   31.8% are overweight and 16.9% are obese. This is alarming and preventable. Certainly obesity has a negative effect as it increases diabetes and other health conditions.

In a critical care situation where a helicopter is called for transport, it is estimated 5,000 US patients are denied helicopter transport each year because they are too heavy or large to fit in an aircraft. This has created a dilemma for air transport providers. In an NBC report, Craig Yale, vice president of corporate development for Air Methods said, “It’s an issue for sure. We can get to a scene and find the patient is too heavy to be able to go.”    If a patient is too large or heavy to fit in the helicopter, they may not be able to receive the urgent care they need in a fast enough manner. In some cases patients simply cannot fit through the doors. In some instances, an overweight person may be able to fit into the aircraft, but their weight can sometimes prevent a helicopter from lifting off the ground.  This can pose a dangerous risk to all on board. A helicopter crashed in New York’s East River in October 2011 because it was over capacity by 50 pounds.

Americans seem to be sleep walking as they go about getting larger and larger compromising their health and setting poor examples for their children.   Helicopter transport services face having to deny service or invest in larger helicopters.   Obesity is something we need to address in schools and various healthcare facilities by focusing on the problem and teaching sound nutrition.   It can be difficult because when you attempt to mention the problem, a person may feel insulted and defensive. Still, programs need to be set in place to prevent this condition. It’s in everyone’s best interest.

 

The National Center for Health Statistics reports obesity in America has reached alarming rates. It is one of the biggest drivers of healthcare costs that are estimated to range from $147 billion to nearly $210 billion per year. 68.5% of adults are overweight and 34.9% are obese.  Obesity among children and adolescents has escalated.   31.8% are overweight and 16.9% are obese. This is alarming and preventable. Certainly obesity has a negative effect as it increases diabetes and other health conditions.

In a critical care situation where a helicopter is called for transport, it is estimated 5,000 US patients are denied helicopter transport each year because they are too heavy or large to fit in an aircraft. This has created a dilemma for air transport providers. In an NBC report, Craig Yale, vice president of corporate development for Air Methods said, “It’s an issue for sure. We can get to a scene and find the patient is too heavy to be able to go.”    If a patient is too large or heavy to fit in the helicopter, they may not be able to receive the urgent care they need in a fast enough manner. In some cases patients simply cannot fit through the doors. In some instances, an overweight person may be able to fit into the aircraft, but their weight can sometimes prevent a helicopter from lifting off the ground.  This can pose a dangerous risk to all on board. A helicopter crashed in New York’s East River in October 2011 because it was over capacity by 50 pounds.

Americans seem to be sleep walking as they go about getting larger and larger compromising their health and setting poor examples for their children.   Helicopter transport services face having to deny service or invest in larger helicopters.   Obesity is something we need to address in schools and various healthcare facilities by focusing on the problem and teaching sound nutrition.   It can be difficult because when you attempt to mention the problem, a person may feel insulted and defensive. Still, programs need to be set in place to prevent this condition. It’s in everyone’s best interest.

 

The National Center for Health Statistics reports obesity in America has reached alarming rates. It is one of the biggest drivers of healthcare costs that are estimated to range from $147 billion to nearly $210 billion per year. 68.5% of adults are overweight and 34.9% are obese.  Obesity among children and adolescents has escalated.   31.8% are overweight and 16.9% are obese. This is alarming and preventable. Certainly obesity has a negative effect as it increases diabetes and other health conditions.

In a critical care situation where a helicopter is called for transport, it is estimated 5,000 US patients are denied helicopter transport each year because they are too heavy or large to fit in an aircraft. This has created a dilemma for air transport providers. In an NBC report, Craig Yale, vice president of corporate development for Air Methods said, “It’s an issue for sure. We can get to a scene and find the patient is too heavy to be able to go.”    If a patient is too large or heavy to fit in the helicopter, they may not be able to receive the urgent care they need in a fast enough manner. In some cases patients simply cannot fit through the doors. In some instances, an overweight person may be able to fit into the aircraft, but their weight can sometimes prevent a helicopter from lifting off the ground.  This can pose a dangerous risk to all on board. A helicopter crashed in New York’s East River in October 2011 because it was over capacity by 50 pounds.

Americans seem to be sleep walking as they go about getting larger and larger compromising their health and setting poor examples for their children.   Helicopter transport services face having to deny service or invest in larger helicopters.   Obesity is something we need to address in schools and various healthcare facilities by focusing on the problem and teaching sound nutrition.   It can be difficult because when you attempt to mention the problem, a person may feel insulted and defensive. Still, programs need to be set in place to prevent this condition. It’s in everyone’s best interest.

 

#Air ambulance questionable practices

Tragically, the helicopter medevac industry is rife with controversy from multiple accidents to questionable practices in billing for services. Across the country victims of accidents are being confronted with sky-high bills that are not paid by insurance companies. When people are at their most vulnerable fearing for their lives, a helicopter may be called for transport. Once it arrives and the person is on a gurney, there is a request to sign a consent document.   No where on the document is there any estimate of the costs that will be incurred.   Since Federal law deregulated fares for the airline industry, air ambulances can pretty much charge whatever they like.   States are essentially unable to regulate sky-high bills. Many insurance companies refuse to fully cover what they view as “excessive” billing; this leaves families faced with huge unpaid balances. ABC news is discovering high prices and aggressive collection practices as families struggle with the aftermath of a tragic event for a family member.

A family of Owensboro, Ky. confronted with $47,000 bill for a 30 minute flight for their daughter strives to fend off aggressive debt collectors.   The “golden hour” which in past times has been regarded as the critical time frame to save a life. In some instances, even after a patient arrives at a hospital they may have to a considerable time before treatment.   In some instances, the trip to the hospital could have been made in faster time in an ambulance.  Typically, a paramedic in the field will make the decision to call for a helicopter. In some instances, the victim may be discharged from the emergency room. All of this poses the question: was a helicopter the most appropriate provider.

Across the country there similar complaints. In one instance a transport for a nine mile ride cost $26,000. Insurance did not pay for the total expense and left a family faced with a $10,725 bill along with interest. Air Methods, one of the largest helicopter medevac services based out of Englewood, Colorado operates a for-profit company, transporting more than 100,000 patients annually, across 48 states.   Essentially, there is no oversite on what a helicopter provider bills. This service argues, their pricing is based on having to be available 24/7, 365 days a year and highly trained flight nurses on board.   Further, 70 percent of those provided for are covered by Medicaid, Medicare or are uninsured.   In essence, those with insurance or resources are charged for those who cannot pay.   Air ambulances have a legal responsibility to respond without any knowledge of the patient’s ability to pay. ABC news  “Nightline” has carried out investigations finding similar stories across the country.

Tragically, the helicopter medevac industry is rife with controversy from multiple accidents to questionable practices in billing for services. Across the country victims of accidents are being confronted with sky-high bills that are not paid by insurance companies. When people are at their most vulnerable fearing for their lives, a helicopter may be called for transport. Once it arrives and the person is on a gurney, there is a request to sign a consent document.   No where on the document is there any estimate of the costs that will be incurred.   Since Federal law deregulated fares for the airline industry, air ambulances can pretty much charge whatever they like.   States are essentially unable to regulate sky-high bills. Many insurance companies refuse to fully cover what they view as “excessive” billing; this leaves families faced with huge unpaid balances. ABC news is discovering high prices and aggressive collection practices as families struggle with the aftermath of a tragic event for a family member.

A family of Owensboro, Ky. confronted with $47,000 bill for a 30 minute flight for their daughter strives to fend off aggressive debt collectors.   The “golden hour” which in past times has been regarded as the critical time frame to save a life. In some instances, even after a patient arrives at a hospital they may have to a considerable time before treatment.   In some instances, the trip to the hospital could have been made in faster time in an ambulance.  Typically, a paramedic in the field will make the decision to call for a helicopter. In some instances, the victim may be discharged from the emergency room. All of this poses the question: was a helicopter the most appropriate provider.

Across the country there similar complaints. In one instance a transport for a nine mile ride cost $26,000. Insurance did not pay for the total expense and left a family faced with a $10,725 bill along with interest. Air Methods, one of the largest helicopter medevac services based out of Englewood, Colorado operates a for-profit company, transporting more than 100,000 patients annually, across 48 states.   Essentially, there is no oversite on what a helicopter provider bills. This service argues, their pricing is based on having to be available 24/7, 365 days a year and highly trained flight nurses on board.   Further, 70 percent of those provided for are covered by Medicaid, Medicare or are uninsured.   In essence, those with insurance or resources are charged for those who cannot pay.   Air ambulances have a legal responsibility to respond without any knowledge of the patient’s ability to pay. ABC news  “Nightline” has carried out investigations finding similar stories across the country.

A Higher Power

The screenplay:  A Higher Power is a finalist in the Moondance International Film Festival

Script Title: A Higher Power   Genre: Drama

Logline :   Rookie flight nurse obsessed with saving lives  risks everything to expose  corrupt doctors who cash  in on the critically injured.

A Higher Power is in the vein of Emergency, but is set in the highly competitive medical arena of civilian helicopter medevac.   Havana, a community hospital launches, The Odyssey to increase its sphere of influence and solve its financial woes.

Candice, a middle age married woman with a self-actualizing young daughter, changes career from Ph.D. Psychologist to flight nurse. A rookie, haunted by a flawed decision in her past, she becomes obsessed with saving lives.

Complications arise when she has difficulty fitting into what she sees as a flawed EMS system. In this life and death arena, she fights to make the public aware of the hospital’s inability  to serve  the critically injured.  The hospital administrator  declares, “We’re not doing anything illegal; we’re providing a community service.”

Behind the scenes the hospital administrator and comptroller are embezzling the hospital’s money.

When Candice’s daughter, Tammie and friends are driving in the mountains they have an accident and are picked up by The Odyssey and taken to Havana . . .

Registered with Writers Guild  All  rights reserved

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

#Helicopter mission

The mission of medical helicopters mission as stated is to save lives. Is this really happening? Controversy exists in civilian helicopter medevac.   Years ago it was estimated that 250 strategically placed helicopter services could serve the needs of the country. Today, there are about 850 now in existence.  When Medicare started to pay for helicopter transport, helicopter medevac exploded as hospitals got into the helicopter business.   Today we see escalating healthcare costs.  When one considers the actual number of victims who are appropriately served, one has to ask: Are there too many helicopters out there?   Certainly there are injuries that do not justify helicopter transport and could just as well be served by ambulance.   In an urban setting, ambulances can more than likely serve the needs of those injured quickly.   There are times when it is difficult for a helicopter to land safely in a timely manner because the risks involved.   Rural areas with lower population density and poor roads claim more lives.  Bryan Bledso, of the University of Nevada School of Medicine who has participated in an expert study of Trooper 2’s crash said, “Helicopters fly medically unnecessary flights every day.”

 

#air ambulance cost #Medicare Retweet

Over the past couple of decades we have all become aware of the escalating costs of healthcare.   One that has come to surprise those who live in a rural area who have suffered an unexpected injury and are far from definitive care.   As helicopter services have boomed to cash in on Medicare and insurance payment, an unsuspecting public has been caught unaware. While an insurance may pay for actual medical treatment delivered in a hospital, it more than likely will not pay for the actual transport of the injured. These costs can be exorbitant and leave a family financially devastated as companies attempt to collect for service. Shockingly, some have received bills for $50,000 or more.

Medical helicopter service has indisputably saved lives, and in some instances have been totally inappropriate when an ambulance could have served the needs of the injured. Some patients transferred by helicopter have been discharged from the ER.   When the life of a family member may be at risk, one does not think of the costs involved; they simply act then later learn their insurance will not pay.

Air Methods, the largest air ambulance operator, with over $1 billion in revenue is promoting legislation that was introduced in the House of Representative in February. This would increase Medicare payments to air ambulance companies. The assertion is that higher payouts are needed to keep up with costs and cause air ambulance services to have to abandon certain areas.   Chief executive of the association asserts, “The reason this bill needs to pass is that it’s about access to health care. A strategy for air ambulance companies is to expand their network and add expensive new helicopters.

One of the effects of proliferation of helicopters is that it has created cutthroat completion as helicopters are chasing too few patients. This country simply does not need 850 air ambulances in large metropolitan areas perched on roof tops where they are inappropriately placed.   Nonprofit air ambulance operator make up a large portion of the industry are finding it harder to survive as they charge less than their large commercial rivals..

Given the escalating number of helicopter crashes that have claimed the lives of both crew and patients, it doesn’t look like the economics in this industry are favorable.  Passing legislation to have Medicare foot the bill is definitely an area that must be considered very carefully if at all.   This is an industry that needs to look at how it functions and focus on safety. Lawsuits can become expensive as others become more aware of the dynamics of the industry and seek to challenge it.

 

#Japan earthquake #helicopter rescue

Today, we’ve all been alerted to the devastation in Japan as the result of a 7.3 earthquake. This is undoubtedly one of the biggest tests Japanese rescue workers and those involved in helicopter as 41 people have been killed by two earthquakes and many are missing or trapped in a mountainous area. U.S. forces are offering emergency assistance. Notably, the U.S. has major military bases in Japan that can help.  USA Today just hours ago posted images of the devastation. It is estimated some 1500 are injured and many are presumably trapped in collapsed homes and building. The national government is said to have dispatched 20,000 troops —- many who are especially trained for these kind of rescue efforts.

http://www.usatoday.com/story/news/world/2016/04/17/japan-earthquakes/831

#emergency medical system

 

Today, most people look up and see a helicopter in the sky, but have little or no understanding of all the components that make up the medical emergency system. In truth, the helicopter service is only as good as the support services that back it up; this is true in the community as well as in the hospital. There simply is not much point to having a flight program without developing expertise at all levels. Once a patient is brought back to the hospital, every service must work in concert all the way from supplies, housekeeping, dietary, dispatch, pilots, nurses, and medical specialists to meet all the needs of the patient. All services have to be provided 24 hours a day whether or not a medical emergency is in process. Maintaining these services is very costly simply because life threatening circumstances, by their very nature, are unpredictable. It simply costs more to intervene and save a life than it does to respond to routine matters of medical care.

The helicopter is only one aspect of the EMS system. No one must ever make little of the ground network of paramedics and emergency technicians, and firemen who are usually first on scene. It is their job to quickly assess the gravity of the situation, make critical decisions and do all that they can to preserve a viable patient. Ironically, the public’s first line of defense in a life threatening crisis is often a volunteer or a poorly paid ambulance employee. Fortunately, for those in need, these people are not in the business of saving lives for money. They are usually self-motivated, want to help others, or require a high degree of stimulation, and challenge to make them feel a vital part of being alive.