The answer is because, especially with Medicare and Medicaid, these two govermenmt programs pay SUBSTANTIALLY less than the full and real cost. And I trust you keep hearing on the news that the government is cutting health care, just like the state budget extender a few week ago.
Doesn't Mohawk have to deal with the same economic environment? I would have to assume they receive the same number of Medicare and Medicaid patients in proportion as REMS.
REMS has been having problems before government aid started getting cut.
Somethingt else to consider. With this ambulance issue, will REMS become a government ambulance service? I'm not positive, but I think many insurance plans exclude payment for services rendered by the government. Often a clause in insurance certificates.
Doesn't Mohawk have to deal with the same economic environment? I would have to assume they receive the same number of Medicare and Medicaid patients in proportion as REMS.
REMS has been having problems before government aid started getting cut.
See, that's something that I think we would need to know. It is indeed easier to say that we want to see their finances, their accounts receivable and payable. But do they have the same number of patients in proportion? That's a tough one. I would gather than Mohawk gets more medicaid (the city) than the RA might get. Medicare for older people, not sure what the make up is between where MA's patient base is (primarily city) vs RA. But then did someone say MA covers the other towns too? But then, if RA is considered government ambulance and insurance doesn't cover government entities' services, it would be necessary to now that too, which is something not easily obtainable. I'm not saying this would be the case, but just let me throw this question out there. If people with private insurance (from employers, direct pay plans, etc) excluded payment to a government entity - that's "IF" - and we'll say that some of the charges were very expensive and people didn't pay, it would be an account receivable, but hasn't been collected. Hey, but I'm not saying that the professional working people in town don't pay their bills either. But if the uncollected ones were the ones from RA if considered govt entity we wouldn't know if John and Mary's insurance plan was one that didn't cover it while Bob and Sue's plan did. If looking at their books, their books could not tell us what is uncolletected because that would probably be a violation of HIPPA, so we wouldn't even know that John and Mary are the uncollected/uncollectable acccounts.
See what I'm getting at? It's not easy to know. Does OSC have an audit on that see through ny website? And was it gadfly who wrote something about the IRS, are those papers available to view somewhere?
Optimists close their eyes and pretend problems are non existent. Better to have open eyes, see the truths, acknowledge the negatives, and speak up for the people rather than the politicos and their rich cronies.
If looking at their books, their books could not tell us what is uncolletected because that would probably be a violation of HIPPA, so we wouldn't even know that John and Mary are the uncollected/uncollectable acccounts.
No names or medical conditions need to be attached. The question is - How many calls? How many billed out? How many paid? Simple. I don't need to know the nature of the calls, or the medical records.
This can be simplified down to the widget concept.
- Business (A) determines it cost X amount of dollars to produce the widget. - Business (A) sell the widget for X amount of dollars to cover the expense to produce the widget.(Since it is not for profit, no need to mark up for profit.) - The consumer purchases the widget from business (A) on credit.(Since a paramedic isn't going to ask a patient in the middle of cardiac arrest for a down payment.) - Business (A) bills the costumer for the widget(Ambulance ride). - Business (A) gets in return: 1. partial payment 2. full payment 3 no payment
It would be interesting to see how they are billing out for their service.
Then I would suggest surrounding yourself with materials that do not conduct electricity.
We would not lose 2 paramedics...Rotterdam paramedics would still be the first responders when available. Mohawk has all of the backup necessary in the event of simultaneous emergencies. Regardless of where they are dispatched from, they maintain response times well within accepted national standards. It should also be noted that a significant number of residents already call Mohawk directly...and they are responding in a timely manner.
Glenville is not staffed because there is no substation there to staff.
So wait, your ok with PUBLIC Paramedics ( paid for with your taxes, employeed by the Rotterdam Police )
But you want Mohawk to take over Ambulance services?
Dont get me wrong, I think REMS should work on whatever options they can to be finanically viable.
However I do think people are delusional to think that Mohawk is going to replace 2 full time REMS ambulances with 2 full time Mohawk ones.
They will put 1 ambulance in Rotterdam ( MAYBE, thats a huge MAYBE ) and I can also bet that they would pull that ambulance into Schenectady if they needed to, fully stripping Rotterdam when they want to.
Money is the OVERALL bottom line for Mohawk. This is the same reason why you dont want for profit Fire or Police departments. You want them to make decisions based on the good of the public, not on the bank accounts.
Money is the OVERALL bottom line for Mohawk. This is the same reason why you dont want for profit Fire or Police departments. You want them to make decisions based on the good of the public, not on the bank accounts.
Ambulance service is not a necessary function of town government, it is an optional service. It is not even close to a fair comparison with police and fire. I don't believe "for the good of the public" is a reason for mismanaging and wasting taxpayer money.
You make the assumption that just because REMS isn't for profit their motives are somehow more pure, and with the authority of a taxing district would not become self serving by lining their pockets in salary and benefits. People need to understand that non profit doesn't mean FREE, it just means they don't make money above their expenses to reinvest into their business.
If the REMS truly were making decision for the good of the public, they would try a little harder to manage their business better. After all, the town residents ALLOW the REMS to do business in our town. Now they expect the residents to allowed them to operate in our town AND bailout them out financially.
Ambulance service is not a necessary function of town government, it is an optional service. It is not even close to a fair comparison with police and fire. I don't believe "for the good of the public" is a reason for mismanaging and wasting taxpayer money.
You make the assumption that just because REMS isn't for profit their motives are somehow more pure, and with the authority of a taxing district would not become self serving by lining their pockets in salary and benefits. People need to understand that non profit doesn't mean FREE, it just means they don't make money above their expenses to reinvest into their business.
If the REMS truly were making decision for the good of the public, they would try a little harder to manage their business better. After all, the town residents ALLOW the REMS to do business in our town. Now they expect the residents to allowed them to operate in our town AND bailout them out financially.
- I dont believe EMS is an optional service anymore. I'd actually love to know of places in the USA that their is no EMS service available. Ive heard of places in TX that are so remote Paramedics have to be flown in by helicopter because there isnt any service within a hundred miles.
- If your argument is that public service employees can be overcompensated for under performance i could not argue. It happens all the time and sadly some unions harbor individuals who do not work up to the level expected. However thats not to say that companies working for pure profit when it comes to some of these services ( Fire / Police / EMS ) are looking out for the public interest either. A balance needs to be found.
- Im not sure i agree that REMS is wasting Taxpayer money. REMS feels that it needs 2 ambulances to cover the town of Rotterdam. If REMS was under the Town Board, then they could step in and decide what capabilities REMS needs and decide how much money should be spent on it ( vs how much is collected from billing )
If REMS was under the Town Board, then they could step in and decide what capabilities REMS needs and decide how much money should be spent on it ( vs how much is collected from billing )
It is not the roll of government to be in the business of health care. We don't need the government to 'step in' and make an assumption on what only 'consumer need' should demand.
And I think that everyone in rotterdam can all agree that decisions are not always made with the best interest of the taxpayers in mind. Decisions, in most cases, are made by 'who you know'. PRIVATIZE! It is time for rotterdam to break the 'circle of community incest'! IMHO
When the INSANE are running the ASYLUM In individuals, insanity is rare; but in groups, parties, nations and epochs, it is the rule. -- Friedrich Nietzsche
“How fortunate for those in power that people never think.” Adolph Hitler
Ambulance service is not a necessary function of town government, it is an optional service. It is not even close to a fair comparison with police and fire. I don't believe "for the good of the public" is a reason for mismanaging and wasting taxpayer money.
You make the assumption that just because REMS isn't for profit their motives are somehow more pure, and with the authority of a taxing district would not become self serving by lining their pockets in salary and benefits. People need to understand that non profit doesn't mean FREE, it just means they don't make money above their expenses to reinvest into their business.
If the REMS truly were making decision for the good of the public, they would try a little harder to manage their business better. After all, the town residents ALLOW the REMS to do business in our town. Now they expect the residents to allowed them to operate in our town AND bailout them out financially.
- I dont believe EMS is an optional service anymore. I'd actually love to know of places in the USA that their is no EMS service available. Ive heard of places in TX that are so remote Paramedics have to be flown in by helicopter because there isnt any service within a hundred miles.
- If your argument is that public service employees can be overcompensated for under performance i could not argue. It happens all the time and sadly some unions harbor individuals who do not work up to the level expected. However thats not to say that companies working for pure profit when it comes to some of these services ( Fire / Police / EMS ) are looking out for the public interest either. A balance needs to be found.
- Im not sure i agree that REMS is wasting Taxpayer money. REMS feels that it needs 2 ambulances to cover the town of Rotterdam. If REMS was under the Town Board, then they could step in and decide what capabilities REMS needs and decide how much money should be spent on it ( vs how much is collected from billing )
REMS has to be run like a business if there's a demand for 2 ambulances due to the high number of calls then Mohawk would staff as many as needed as long as they were making enough money to make it profitable. It makes no sense to pay for 2 ambulances if one of them remains parked in the garage all day. As far as the police paramedics go they can do the function of a police officer or a paramedic depending on what the demand is. Non profit organizations just break even with their payroll but never make enough to pay for new equipment or unforeseen expenses. How much has proctors lowered with all the money that they bring in?
- Im not sure i agree that REMS is wasting Taxpayer money. REMS feels that it needs 2 ambulances to cover the town of Rotterdam. If REMS was under the Town Board, then they could step in and decide what capabilities REMS needs and decide how much money should be spent on it ( vs how much is collected from billing )
If REMS feel they need two Ambulances, then they need to charge what it cost to operate and staff two Ambulances. There has to be a break even point, the point where a certain number of service calls will pay for the cost of those ambulances. If 2 ambulances are not receiving enough calls to where they break even, then either; 1. They are not charging enough for the service to maintain 2 ambulances or 2. There is not enough demand to justify a second ambulance.
The pro tax posse associated with the Town Board (B. Godlewski...attorneys Doogie Howser and Joe Laccardi) tried to sneak in this unnecessary vote again at the last agenda meeting.
Only this time language made it clear in advance on one of the THREE related resolutions that there will be no absentee ballots. Fortunately this latest attempt was foiled right then and there, and never made it to the official agenda. The three steadfast Board Members who get it refused to allow it to go through in the absence of information they insist should be shared with the public...including the Mohawk option.
DiLeva continued to insist that the vote should not even occur...as a vote does not guarantee that REMS will be the designated EMS provider. If anything, it is all but guaranteed they won't be the provider, since they could not possibly compete in the bidding process...for which, again, a vote is unnecessary.
Just put it out to bid and get the beast off of our backs! If this present administration allows rems to continue, without going through the biding process, than it will just be more proof that both parties, locally, are the same!
And I did not send in a donation. Why? Because they already get my money through my taxes!!!
When the INSANE are running the ASYLUM In individuals, insanity is rare; but in groups, parties, nations and epochs, it is the rule. -- Friedrich Nietzsche
“How fortunate for those in power that people never think.” Adolph Hitler
Logged
