AMU Emergency Management Opinion Public Safety

New Policies Needed for Civilian Medical Evacuations by Air

By Allison G.S. Knox
Contributor, EDM Digest

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 health care 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 health care 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.

Hard for Patients without Medical Training to 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 for a Workable Solution

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 health care policies.

Allison G.S. Knox

Allison G. S. Knox teaches in the fire science and emergency management departments at the University. Focusing on emergency management and emergency medical services policy, she often writes and advocates about these issues. Allison works as an Intermittent Emergency Management Specialist in the Administration for Strategic Preparedness and Response. She also serves as the At-Large Director of the National Association of Emergency Medical Technicians, Chancellor of the Southeast Region on the Board of Trustees with Pi Gamma Mu International Honor Society in Social Sciences, chair of Pi Gamma Mu’s Leadership Development Program and Assistant Editor for the International Journal of Paramedicine. Prior to teaching, Allison worked for a member of Congress in Washington, D.C. and in a Level One trauma center emergency department. She is an emergency medical technician and holds five master’s degrees.

Comments are closed.