Health Care Reform and EMS: at odds or at peace?


CarolinaFireJournal - Amar Patel
Amar Patel MS, NREMT-P, CFC
08/01/2012 -

There’s a saying that the only thing you can count on is change, and that’s especially true when it comes to providing emergency services. Whether you’ve recently begun using an electronic medical record (EMR) to chart your patient’s vital signs (rather than writing them on paper), or you’re participating in a new, interactive fire and rescue training activity with high-tech simulation mannequins, you know change is inevitable. The key to dealing with change in a positive way is to embrace it.

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One of the ways EMS professionals are working directly with legislators and making sure their voices are heard is by participating in EMS on the Hill Day in Washington, D.C. Now in its third year and hosted by NAEMT, EMS on the Hill Day is the only national EMS advocacy event open to all EMS professionals.

However, one of the most controversial changes we’ve seen in health care recently — and one which has not been embraced by everyone — is President Obama’s health care reform bill, which passed into law in March 2010. The bill, which packs more than a 2,000 page punch, has brought about fierce debates between conservatives and their liberal counterparts.

One thing most people can agree on is the need for health care reform, but the best way to get there is up for discussion. Over the years, U.S. citizens have come to expect a great deal from their health care. But due to a number of factors – including a growing population and longer life expectancy – it’s unlikely Americans can continue to have their cake and eat it, too. But ask most people, and they’ll say they still want:

Access to the highest quality medical care. After all, the United States has always been a leader in expanding medical research and “blazing new trails” when it comes to diagnosis and treatment options.

Freedom of choice. We want to retain control over our health care choices, including who provides the care, where and when to receive the care, and what kind of care we get.

Affordability. We want to be able to pay for our health care and still have resources to live a comfortable lifestyle.

Equal opportunity to receive good health care. We want everyone to share in the benefits of good health care. No one should be denied access due to their inability to pay.

While these four general health system goals are all attractive and are widely endorsed in United States, the question remains: can all of them be achieved at once?

EMS Legislation: Making Our Voices Heard

Interestingly enough, EMS-related components were mentioned only four times in President Obama’s final health care bill, and those references were vague at best. It’s obvious that health care planners weren’t thinking about EMS and related services when they crafted the legislation. But as caregivers, you and I know that any major changes to the U.S. health care system will definitely impact us because of our daily interactions with hospitals and other organizations that are directly affected. We should look at this lack of detail about EMS services as an opportunity to write our own future. The challenge will be to help legislators and decision-makers understand that we have a unique perspective, and we have much to contribute.

One of the ways EMS professionals are working directly with legislators and making sure their voices are heard is by participating in EMS on the Hill Day in Washington, D.C. Now in its third year and hosted by NAEMT, EMS on the Hill Day is the only national EMS advocacy event open to all EMS professionals. At the event, nearly 200 EMS practitioners from 42 states and the District of Columbia attended meetings with their U.S. Senators, House Representatives, and their congressional staff to inform them about and lobby for key EMS issues and legislation. The March 2012 event included representation from all sectors of the EMS community, and those representatives sent a consistent message on the important issues facing EMS in our country.

But one thing we do know: health-care reform is unique for EMS
professionals because it affects us as individuals, our families,
our careers and the organizations for which we work. That makes
it critical that we help government get it right.

EMS on the Hill Day included an informative pre-Hill visit briefing to prepare participants for their congressional visits, as well as valuable networking opportunities to share EMS experiences and knowledge. As a bonus event for 2012, attendees were invited to participate in the Reimbursement Task Force meeting of the American Ambulance Association. The meeting addressed reimbursement issues affecting EMS and discussed health care reform, Medicare ambulance relief and other hot topics. This year’s legislative priorities included the Medicare Ambulance Access Preservation Act, Public Safety Officers’ Benefits Improvements Act, and Field EMS Quality, Innovation, and Cost Effectiveness Improvements Act.

According to Jim Judge, Director, Region II, and NAEMT Advocacy Committee Chair, the participation of so many EMS professionals in EMS on the Hill Day helped ensure that EMS has a strong voice in government decisions that directly affect them and their ability to provide quality patient care. “We look forward to continuing to work with our congressional representatives throughout the year to ensure they hear and understand our issues and concerns.”

How Health Care Reform Will Affect First Responders

When asked if health care reform has directly affected EMS professionals with regards to their education and training, EMS leaders say no – at least, not yet.

“I’m not aware of any changes in first responder procedures or protocols as a result of President Obama’s health care law,” says Chris Hendges, a shift supervisor with the Harnett County EMS Administrative Staff. “EMS professionals are taught to thoroughly evaluate the patient(s) after arriving at the scene of an emergency. Then, based on standing orders provided by the medical director who oversees that particular EMS organization, the first responders treat the patient(s) accordingly and provide transport to the appropriate health care facility.”

But one thing we do know: health-care reform is unique for EMS professionals because it affects us as individuals, our families, our careers and the organizations for which we work. That makes it critical that we help government get it right.

The bottom line is that health-care reform has to be about common sense. Just like those who attended EMS on the Hill Day, we must encourage our legislators to work together for the good of the American people – to give them access to the quality health care they deserve at a price they can afford.

Amar Patel is the Director of the Center for Innovative Learning at WakeMed Health and Hospitals. Mr. Patel is responsible for integrating technology based educational programs to include human patient simulation, healthcare gaming, and hybrid education into regional educational programs. As a member of the Center for Patient Safety, Mr. Patel strives daily to make changes to processes in healthcare that will directly improve patient and provider safety.
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