Florida Governor Charlie Crist

It appears that despite the huge Haitian relief effort so far, the question of costs has stopped the transportation of critically ill, or injured Haitian patients to Florida hospitals.

Republican Florida Governor Charlie Crist (don’t for a moment confuse him with Christ) has asked the federal government to help pay for care. A reasonable request on the surface, but cannot the money issue get taken care of afterward? In the meantime, people are dying for Crist’s sakes!

Just to think that this “compassionate conservative” is running for the U.S. Senate this year. To quote from Crist’s campaign website: ” Charlie Crist strongly opposes the health care legislation being debated in Congress. A government run health care system is not the answer to our nation’s health care needs but instead it is the typical answer of liberals and Democrats in Congress. The American people need a health care system that provides choice and access to quality health care at affordable costs. These health care opportunities are not found in the legislation championed by President Obama, Nancy Pelosi and Harry Reid.”

Another great champion of health care for everybody and of human rights in general. Phooey!!!

Our friends at BadGalsRadio have another take on this. Take a look.

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Update, January 31, 2010: “Late Sunday, White House spokesman Tommy Vietor said the medical airlift was on track to resume by early Monday. The White House received assurances that additional medical capacity exists in the U.S. and among its international partners for the patients.”

So, we didn’t have “additional medical capacity”? Is that a joke? A few hundred patients would have strained our “medical capacity”? Don’t give us that. It was an issue of money, all along. Another argument for reforming our health care industry – the most expensive anywhere.

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Here is an Associated Press story on the original subject:
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By JENNIFER KAY, Associated Press Writer

MIAMI – The U.S. military has halted flights carrying Haitian earthquake victims to the United States because of an apparent cost dispute, though a doctor warned that some injured patients faced imminent death if the flights don’t resume.

The evacuations were temporarily suspended Wednesday, said Capt. Kevin Aandahl, spokesman for U.S. Transportation Command. The flights were halted a day after Florida Gov. Charlie Crist asked the federal government to help pay for care.

However, Dr. Barth Green, a doctor involved in the relief effort in Port-au-Prince, warned that his patients needed to get to better hospitals.

“We have 100 critically ill patients who will die in the next day or two if we don’t Medevac them,” said Green, chairman of the University of Miami’s Global Institute for Community Health and Development.

At a temporary field hospital at Haiti’s international airport, set up with donations to Green’s institute, two men had already died of tetanus. Doctors said 5-year-old Betina Joseph faced a similar fate within 24 hours unless evacuated to a U.S. hospital where she can be put on a respirator.

The girl – infected with tetanus through a two-inch cut on her thigh – weakly shooed a fly buzzing around her face as her mother caressed her corn rows, apparently unaware that getting the girl out could mean life or death.

“If we can’t save her by getting her out right away, we won’t save her,” said Dr. David Pitcher, one of 34 surgeons staffing the field hospital.

“If we can’t save her by getting her out right away, we won’t save her,” said Dr. David Pitcher, one of 34 surgeons staffing the field hospital.

There were some states that would not accept patients who needed care in the U.S., and they could not be transported without a hospital to accept them, Aandahl said.

Aandahl declined to specify which states declined to accept patients, and he referred further questions to a Pentagon press office, where an after-hours answering service could not accept incoming messages Saturday.

Florida officials said Saturday that they were not aware of any hospital in the state refusing to take in the patients. However, in a letter Tuesday to Health and Human Services Secretary Kathleen Sebelius, the governor said “Florida’s health care system is quickly reaching saturation, especially in the area of high level trauma care.”

Crist asked Sebelius to activate the National Disaster Medical System, which is typically used in domestic disasters and pays for victims’ care. His letter noted the state’s health care system was already stretched by the winter tourism season and annual “snowbird” migration. South Florida hospitals also were preparing for a surge in visitors for the NFL Pro Bowl on Sunday and the Super Bowl next weekend.

While in Tampa on Saturday, Crist said Florida’s Department of Children and Families Secretary George Sheldon estimated the state’s costs had reached about $7 million.

Poor coordination and limited resources, not medical care costs, drove the governor’s request, said John Cherry, spokesman for the state Division of Emergency Management.

“We’ve made it clear that (the cost) is an issue we’ll deal with down the road,” he said.

Health officials say the medical flights landed without any advance notice, and the poor coordination may be keeping some survivors from getting the help they need, Cherry said. He cited the case of a burn victim flown earlier this week into Tampa, which is not equipped to treat those injuries.

Crist said his state remains committed to caring for injured earthquake victims and reuniting families, though he was reaching out to other states to help care for them as well.

As of Friday, the Florida Department of Health reported that 526 patients had been received at hospitals in the state: more than 400 in South Florida, 76 in the Orlando area and 37 in the Tampa area. Four burn victims were transported to North Carolina, Crist spokesman Sterling Ivey said.

“Recently we learned that federal planning is underway to move between 30-50 critically ill patients per day for an indefinite period of time,” Crist told Sebelius, saying Florida could not handle so many patients.

More than 135 patients remain hospitalized in South Florida, said Jeanne Eckes-Roper, the health and medical chairwoman of a state domestic security task force for the South Florida region.

She requested on Monday that new patients be taken elsewhere in Florida.

“We had to make sure we did not overwhelm our capacity,” she said. “We stand ready to take whatever the government wants to give us.”

Aandahl said no evacuation requests have been made by U.S. military medical facilities in Haiti, including the hospital ship the USNS Comfort, since the flights were suspended Wednesday.

There were only about a dozen medical evacuations by the U.S. military after the Jan. 12 earthquake, he said.

Associated Press writer Frank Bajak contributed to this report from Port-au-Prince, Haiti.

Technorati Tags: Crist, Dollar, evacuation, Florida, Haiti, Haitian, hospitals, medical, patients

This is partly based on a recent AP story

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While we discuss health-care reform, healthy food and environmental conditions, as it turns out, there’s still another issue to be addressed – extremely heavy patients. Although morbidly obese people can probably be found in almost every country and on almost every continent, this could most likely be filed under the ‘Only in America” category.

A panicked Kansas ambulance crew had a critically ill patient, but the man weighed more than 1,000 pounds and could not fit inside the vehicle. And the stretcher wasn’t sturdy enough to hold him.

Finally somebody had an idea. They could use a forklift to load the man – bed and all – onto a flatbed truck. There was no other choice.

As the nation battles the obesity crisis, ambulance crews are trying to improve how they transport extremely heavy patients, who become significantly more difficult to move as they surpass 350 pounds. And caring for such patients is expensive, requiring costly equipment and extra workers, so some ambulance companies have started charging higher fees for especially overweight people.

The move to modify ambulances is just the latest effort to accommodate plus-sized patients. Some hospitals already offer specially designed beds, wheelchairs, walkers and even commodes.

Ambulance companies say it’s time for insurance providers, Medicaid and Medicare, or patients themselves to begin paying the added costs, which are cutting into their razor-thin profit margins.

In the past, ambulance companies often absorbed the extra expense of serving the obese. Now they are adding charges similar to those already imposed on intensive-care patients, people requiring multiple medications and patients on ventilators.

Transporting extremely heavy people costs about 2.5 times as much as normal-weight patients. It takes more time to move them and requires three to four times more crewmembers, who often must use expensive specialty equipment.

Shawnee County Commission last summer raised ambulance fees from $629 to $1,172 for critical-care patients and people who are 500 pounds or heavier.

In Colorado Springs, Colo., and the Nebraska cities of Omaha and Lincoln, the fees are $1,421 for an extremely obese patient, compared with $758 for a typical patient.

Before those ambulances had heavy-duty equipment, crews just had to make do, often calling in burly firefighters to help lift patients.

The Centers for Disease Control and Prevention has long said that nearly a third of Americans are obese. About 5 percent of the population is morbidly obese, meaning they are more than 100 pounds heavier than their ideal weight.

Some critics say the higher fees are a form of discrimination.

Higher payments for heavy patients are commonplace in Oregon and Washington because the insurance industry there acknowledges the additional costs.

Ambulance companies say the insurance industry is their best hope for closing the financial gap.

As with any medical service, ambulance companies bill private insurers or government health care programs. Medicare and Medicaid do not pay extra for transporting the extremely obese, although that’s something the ambulance industry wants to change. The uninsured are charged directly, but many of them cannot pay.

Proponents of the extra fees say obese patients are grateful for equipment that eliminates the need for flatbed trucks and forklifts.

Like many ambulance companies, a unit in Topeka recently spent about $10,000 to retrofit an ambulance with equipment that accommodates patients weighing up to 1,600 pounds. Ambulance services with helicopters also are creating larger patient compartments and adding stronger gurneys.

Sales of specialized lift systems nationwide are expected to reach $193 million by 2012, up from $75 million in 2004, according to EMS Insider, an industry newsletter. The sale of specialized stretchers is expected to nearly double to $50 million in 2012.

Technorati Tags: ambulances, forklifts, heavy, obesity, patients