Many may have read in the local news paper that the squabble of the Fire Department v EMSA that EMSA has come up with a new projection of cost to the taxpayer. Either way your figure it you come up with some real money. To continue operations by taxing your water bill again as instead a necessity of life it has become a vehicle to increase taxes again. The new proposal being kicked around on taxing the water you drink or taxing your home, which they have decided if it does not come up to the community standard for tax purposes it should be torn down.
Seems that we are talking about a subsidy of $4.5 to $5 million dollars plus med-care payments and other accessed costs placed in effect this year.
Am I living in the past too much when I think we are talking about a million here and a million there adds up to real money?
What are the other posters thoughts? Does this smell like our crown jewel river?
I think EMSA should start cutting the bloated executive compensation packages and golden parachutes of their top brass before they start asking for more tax dollars.
I needed EMSA about four months ago following a car wreck. My bill was just under $500.00 for a one mile ride. Was that trip subsidized?
quote:
Originally posted by guido911
I needed EMSA about four months ago following a car wreck. My bill was just under $500.00 for a one mile ride. Was that trip subsidized?
Yes (hint: you're paying for a tad more than the gas it takes to go one mile). But -- if you have insurance and/or actually paid your bill, take heart. You subsidized others as well.
"The circle of liiiiiife . . . ."
That $500 ride was cheap compared to OKC where it costs over $700 for a ride. Of course, not to be outdone by OKC, EMSA is raising the cost of ride to exactly what OKC charges.
I think that's the point is that EMSA has been charging $200 less than what they should be in Tulsa. COL isn't much different in OKC.
I do find it interesting though that after the contract bidding EMSA decides to spring it on us they want a new tax. From the photo in the paper, it's not only the salaries which are bloated. That Williams guy could stand to eat a little less.
Just how is the proposed new charge on City utility bills for EMSA supposed to work? I understand that if this is enacted, the current voluntary annual EMSA subscription service would be abolished.
For example sake, lets say the charge is inacted and is $3 per month for single-family residential service. Does this mean that unlimited EMSA service will be fully covered by the $3 monthly charge for all household residents? Does this render any ambulance benefit you have under personal health/accident insurance obsolete? For a person that has no insurance but pays the $3 monthly fee, are all ambulance fees covered with no out of pocket? Are renters that pay no water bill directly covered? Will non-residents that use EMSA service be billed directly and pay themselves, less any insurance benefit they may have?
I am really skeptical about this proposed utility bill charge. In my own opinion, I think it is best to leave well enough alone and the users of the service should pay the bulk of the cost. Why not take it a step further and have a surcharge to subsidize hospitals too, to reimburse them for uninsured emergency room patients? EMSA doesn't seem to be hurting these days judging from how employees are compensated. If rates have to rise in the future to cover charity or bad-debt writeoffs, then so be it, but EMSA should fully disclose and be able to defend how rates are determined. Just because OKC rates are higher is absolutely no justification to raise Tulsa rates. Rates should be determined locally, based on local costs and expense history.
I thought the whole changes was do to a loss in medicare subsidies. If they're on medicare, they're probably not paying an emsa bill, whether it be $500 or $1000.
quote:
Originally posted by sgrizzle
I thought the whole changes was do to a loss in medicare subsidies. If they're on medicare, they're probably not paying an emsa bill, whether it be $500 or $1000.
I see the service abused quite frequently. To wit: there is an elderly woman a few houses down who lives with her M.R. daughter. The husband passed away a few years back. They don't have a car because the mother never learned to drive and the state won't allow the daughter to. The elderly woman gets these nose bleeds every few weeks that won't stop. Instead of getting a neighbor or family member to take her to the hospital, they call 911, we get a visit from a fire truck and ambulance on our block. They go to St. Johns and are home in a few hours when they get the bleeding stopped.
My wife is a nurse and has offered several times to take her even if it's in the middle of the night and the invitation has been ignored. I think part of it is they are lonesome and they get attention.
Aliens also like to use ambulances for relatively small emergencies. The logic to them is that if they come to the hospital in an ambulance, they get to the front of the line instead of waiting three hours to see a doc. I bet EMSA gets shafted on better than half of those calls.
Just another example of how the rest of us pay for the ignorance or just plain disregard for personal responsibility of others.
quote:
Originally posted by Conan71
I see the service abused quite frequently. To wit: there is an elderly woman a few houses down who lives with her M.R. daughter. The husband passed away a few years back. They don't have a car because the mother never learned to drive and the state won't allow the daughter to. The elderly woman gets these nose bleeds every few weeks that won't stop. Instead of getting a neighbor or family member to take her to the hospital, they call 911, we get a visit from a fire truck and ambulance on our block. They go to St. Johns and are home in a few hours when they get the bleeding stopped.
Just another example of how the rest of us pay for the ignorance or just plain disregard for personal responsibility of others.
I have seen a very similar example, in the house 2 doors down from me. Within the past year, there have been at least 6 calls at this house with fire trucks and EMSA showing up. I have only seen EMSA actually transporting a person from this house 1 time. I don't know the circumstances for certain, but judging from the habits and behaviour of these people, I doubt that they are paying the cost of these calls. In any event, I don't think the proposed surcharge on City water bills is the answer to this. There are always going to be some deadbeats that take advantage, and I assume that EMSA factors this in when setting rates.
Doctors don't make housecalls any more, but EMSA does, eh Steve?
quote:
Originally posted by Conan71
Doctors don't make housecalls any more, but EMSA does, eh Steve?
Apparently so, and I assume that is why an ambulance run is so darn expensive. If I were stapped for funds with no insurance, I would probably do the same thing, if alternative transportation was not available, but I would not call EMSA for a nosebleed or some minor situation that I could learn to take care of myself.
This same house next to me has also had at least 6 police calls in the past year, presumably for domestic violence issues. I talked to the police during the last call about a month ago, and all they would tell me is that there are several "at risk" youth living in the house and "they hang with the same." To quote the policeman, "Make sure your house is well lit outside at night, keep your doors and windows locked, and don't leave anything sitting around outside that you don't want stolen." I guess the best I can hope for is these trashy people do something to land themselves in jail and out of my neighborhood.
Steve,
Quite ironic we were just talking about this. Fire truck and ambulance showed up about 10 pm last night. Truck was there with four or five firemen for about 15 minutes, ambulance got there a couple of minutes after the fire unit and stayed for about another 20 to 30 minutes after the firetruck left, did not transport.
Just another house-call.
quote:
Originally posted by Conan71
Steve,
Quite ironic we were just talking about this. Fire truck and ambulance showed up about 10 pm last night. Truck was there with four or five firemen for about 15 minutes, ambulance got there a couple of minutes after the fire unit and stayed for about another 20 to 30 minutes after the firetruck left, did not transport.
Just another house-call.
That's exactly the same thing that is happening at the house 2 doors east me, it has happened at least 6 times in the past year. That and at least 6 police calls. I hope it doesn't come to it, but I fully expect to hear gunshots ring out over there some day. There is really not much I can do but protect my own property, keep my eyes and ears open for trouble, and hope these people go away soon.
quote:
Originally posted by Steve
There is really not much I can do but protect my own property, keep my eyes and ears open for trouble, and hope these people go away soon.
I think there is a Wannemacher's gun show coming up...[;)]
Here's the deal: Mayor Kathy put together a bunch of brains last year to study if EMSA or the Fire Department should provide ambulance service in Tulsa. Main reason that happened at all is because EMSA needed money this year for the first time to offset Medicare cutbacks. The group figured out that even though EMSA needed some dough, they were much cheaper and a better choice than fire department. Fast-forward to today – mayor has picked EMSA, but mayor doesn't have money to fund the service. So mayor looks at what other cities are doing. Owasso, Jenks, Coweta and others pay for ambulance by a water bill, so how about us? What EMSA wants to do is charge people about three bucks a month and give them a membership in return. They'd charge apartment complexes too based on how many people live there. And people who don't pay a water bill (snobs who wreck their Mercedes on I-44 between St. Louis and the Dallas Galleria, illegals) don't get a membership – they pay the whole load when EMSA's paramedics save their lives. It'd be nice if they paid EMSA in the same way they paid police and fire, but if it's a choice between fixing potholes or paying three bucks a month, I'll pay. Damn potholes have already cost me $1200 this year.
How much they charge for non-single family customers will be the key. If a regular residence is charged three dollars, will a 300 unit apartment complex be charged 900 dollars a month?
How do you charge non-residential customers? Businesses also have reasons to call for an ambulance.
What is the charge for a retail store when the customer is from out of town?
Due the fact that EMSA is a third party provider which is a public service duplicated by the fire department, who has the same resources to hire paramedic to run the vehicles own by the taxpayers of the city, it would indicate someone is cutting a piece of the pie that should go hungry.
The three dollars each meter would come to $36 yearly which is another bait on a fishing pole dangling before the citizens, same as the presumed $1.75 SWM fee in the beginning. The fairytale mayor can and as time go on it will become more noticeable to the struggling public that they are being baited again. Look the bait over and smell it before you swallow it. The roller coaster we are riding on may have already been dismantled.
i just saw those *****es on TV saying it would only cost each (legal tax paying non welfare citizen) only 10 cents a day to keep people recieving medical care with getting stuck with a fat bill.
well if you are in an emergency, regardless of how you got there, paying the bill is your problem. if you decide to not call an ambulance because you cant afford it and die as a result..thats just Darwin economics for ya, may the fittest survive. I'm sure there are plenty of low lifes around I would rather not subsidize to get picked up and taken to the hospital. You can feel the same way about me and thats fine, because I dont expect -NOR WANT- someone to pay my bill.
Anyone else see the giant full-page EMSA ad on page A10 of today's Tulsa World? The back page of the front section?
The ad touts what a great public service EMSA has been and then says:
"Our city leaders are crafting a plan that will provide quality EMSA care to ALL TULSANS for about 10 cents a day! In return, residents will never pay a bill for emergency ambulance care."
Although they don't flat out say it, they are obviously advocating the proposed EMSA subsidy on city utility bills. Ads of this sort make me immediately suspicious, if I were not already. I don't know what full page Tulsa World ads go for these days, but if EMSA has money to waste on propaganda such as this, they must not be hurting too badly.
well, when you chase down everybody with a cut finger in town, you can afford those ads.
This was the exact schpiel those *****es said on TV, my bull**** alarms were going off before she said anything because EMSA has no need to advertise PERIOD. This is tax payer lobbying. It should be banned unless an opposition group is given equal time at no charge.
if this passes people will call the ambulance for the dumbest of things, stumped toe, call an ambulance.....head stuck up your arse, call an ambulance. It is a vicious cycle that will keep costing more than the taxes bring in. EMSA bought off the fire department so they wouldnt push to take over the service, now they are going to try and get a tenure. **** this.
quote:
Originally posted by Steve
Anyone else see the giant full-page EMSA ad on page A10 of today's Tulsa World? The back page of the front section?
The ad touts what a great public service EMSA has been and then says:
"Our city leaders are crafting a plan that will provide quality EMSA care to ALL TULSANS for about 10 cents a day! In return, residents will never pay a bill for emergency ambulance care."
Although they don't flat out say it, they are obviously advocating the proposed EMSA subsidy on city utility bills. Ads of this sort make me immediately suspicious, if I were not already. I don't know what full page Tulsa World ads go for these days, but if EMSA has money to waste on propaganda such as this, they must not be hurting too badly.
The same full page ad is in the World today for the second day in a row. (Tues. page A5) It will probably appear many more times before the issue is settled. Whatever EMSA's financial situation is, they seem to have a fully funded advertising budget.
If one has the only ambulance contract in town it kind 'a floors the average citizen to see the adds in the only news paper and on the TV telling us how great a job they are doing. Sixty percent of the runs are transfers. A large percent of those are paid by Medicare. The complaint is that Medicare reduced their payments on which all the conversations seem to be about.
Has anyone looked to see how the amount was supposedly reduced?
I found today's Tulsa World article and proposal a little disappointing: http://www.tulsaworld.com/news/article.aspx?articleID=070321_1_A1_ERWor57062
We already have a voluntary program that costs $50 per year. Now we are going to offer a voluntary program that costs $43 a year in hopes more people will sign up and make up $2.3M.
I also found this little item interesting: Those who decide not to participate would be required to sign a document... How on earth do you enforce that section? Turn off my water if I don't sign the document?
How many people actually need a total care program. Does not most health/automobile insurance cover the cost of an ambulance ride (I know mine does)?
quote:
Originally posted by Wilbur
I found today's Tulsa World article and proposal a little disappointing: http://www.tulsaworld.com/news/article.aspx?articleID=070321_1_A1_ERWor57062
We already have a voluntary program that costs $50 per year. Now we are going to offer a voluntary program that costs $43 a year in hopes more people will sign up and make up $2.3M.
I also found this little item interesting: Those who decide not to participate would be required to sign a document... How on earth do you enforce that section? Turn off my water if I don't sign the document?
How many people actually need a total care program. Does not most health/automobile insurance cover the cost of an ambulance ride (I know mine does)?
I suppose that if you don't sign the waiver, you will have the charge on your monthly bill. If you don't pay the ambulance charge on the bill, eventually unpaid charges will result in your water being shut off and trash pickup halted.
The World article makes no mention of people without insurance. I assume they are fully covered too if they pay the $3.64 monthly fee. Seems to me that this would be incentive for private insurers to drop ambulance coverage from individual and group policies for Tulsa-area residents, since Tulsa is basically deciding to self-insure for ambulance service. Then EMSA would have to up rates and that $3.64 soon becomes $5.64, $10.64, $25.64 ...
And once again, the single person gets the shaft. Why should a single-person household have to pay the same tax as a household of 2,3,4 or more? Completely unfair.
Is EMSA a public utility or a private corporation? Councilor Martinson says "It's not EMSA's responsibility to figure out how we pay the bill, it's ours." This sounds like EMSA is a public utility. In that case, I say any resident that has bad-debt ambulance fees outstanding should have ambulance service terminated for themselves and their dependents until fees are paid. Either that or face jail time or community service. Maybe then abuse and deadbeats would decline and this whole utility tax nonsense would be moot.
This deal stinks to high heaven.
If this doesn't get voted down by the Council, they will be permanently marked as useless.
It isn't the responsibility of EMSA to find a way to get this paid, but it is to show why it's needed. If they're just trying to make up revenue the Feds say isn't needed, then it is just revenue protection.
The ad hock method being presented is a tax, which requires a vote. "Optional" fees which impose penalties are not optional.
quote:
Originally posted by Wrinkle
This deal stinks to high heaven.
If this doesn't get voted down by the Council, they will be permanently marked as useless.
It isn't the responsibility of EMSA to find a way to get this paid, but it is to show why it's needed. If they're just trying to make up revenue the Feds say isn't needed, then it is just revenue protection.
The ad hock method being presented is a tax, which requires a vote. "Optional" fees which impose penalties are not optional.
Boy, you got that right. It double-stinks to high heaven. The tone of the World article and Martinson's comments smacked of "blackmail" to me.
If EMSA would do a better job of bad debt collection and cost containment, maybe there would be no need for this discussion. I think we need an ambulance abuse ordinance like the city has for false burglar alarms. Give abusers of EMSA services fines, jail time, or community service.
Uninsured people who pay the fee would be fully covered under the Tulsa plan, but you made a good point about insurance companies trying to drop their ambulance coverage as a result.
quote:
Originally posted by blindnil
Uninsured people who pay the fee would be fully covered under the Tulsa plan, but you made a good point about insurance companies trying to drop their ambulance coverage as a result.
Why wouldn't they? Medicare and Medicaid may be prevented from this by law, but common sense tells me private insurers would be foolish not to drop ambulance coverage if they can legally do so. And no private insurance reimbursements would just put more upward pressure on EMSA rates. That $3.64 rate they are touting is just the beginning of a steady, upward climb if this scheme goes into effect.
will I be able to comment on the subject at the city council meeting tomorrow if I don't fill out a form for public comment? It is kinda hard to get the comment form in by Monday if they dont release the agenda until Wed.
You know, in the telephone world if a service is added to your bill without your consent is is called "cramming" Is there no legal recourse for something like this? I'd like a lawyer to chime in on that. I'll even file the suit if there are grounds. I agreed to sewer and trash service, I did not agree to TotalCare. In fact, since the service has been around for a while, I have had the opportunity to do so.
They also state that people living in apartments wont be covered if the landlord doesnt take an assessment on each unit (yeah right like they are going to do that) so this fee in no way is being apportioned correctly.
I think you can speak on any item that's on the agenda for action, as long as you sign in at the meeting. But, I don't think EMSA's on the agenda (//%22http://www.tulsacouncil.org/pdfs/meetings/Regular/CC%2003-22-07-6.pdf%22) for action this week. It's only on as a first reading, which is just reading the item and referring it to committee. It'll be back on next week I guess for public comment and action.
quote:
Originally posted by Kiah
I think you can speak on any item that's on the agenda for action, as long as you sign in at the meeting. But, I don't think EMSA's on the agenda (//%22http://www.tulsacouncil.org/pdfs/meetings/Regular/CC%2003-22-07-6.pdf%22) for action this week. It's only on as a first reading, which is just reading the item and referring it to committee. It'll be back on next week I guess for public comment and action.
The Tulsa World article today says "Councilors are expected to vote on the plan at their 6 p.m. March 29 meeting."
quote:
Originally posted by Steve
quote:
Originally posted by Kiah
I think you can speak on any item that's on the agenda for action, as long as you sign in at the meeting. But, I don't think EMSA's on the agenda (//%22http://www.tulsacouncil.org/pdfs/meetings/Regular/CC%2003-22-07-6.pdf%22) for action this week. It's only on as a first reading, which is just reading the item and referring it to committee. It'll be back on next week I guess for public comment and action.
The Tulsa World article today says "Councilors are expected to vote on the plan at their 6 p.m. March 29 meeting."
couldnt they vote on it at any time though?
oh and one other thing, the girl on the EMSA propagandacommercial looks like a bad Hillary Swank impersonator.
Some food for though:
'07 Departmental Budget:
Tulsa Fire Department - $56 million
EMSA - $2.3 million
source (//%22http://www.cityoftulsa.org/OurCity/Budget/documents/Sec03a-DepartmentalBudgetHighlights-PublicSafetyAndProtection.pdf%22) EMSA pays for itself for the most part by billing the patient and/or insurance, and partly by the taxpayers who the service is offered. The fire department is payed in full by the tax payers. So think about this: You pay a few dollars a month to support a service that when you need it, it will be there for you, and in return you or your insurance will receive a bill (EMSA). For a lot more money, you pay taxes on a service that if you need it, it will be there, but you won't receive a bill (FD).
So now lets think about if the ambulance service is turned over to the fire department. Now you're paying taxes to support a service that will be there if you need it. If you use it, you or your insurance will also receive a bill in addition to the tax money you pay.
The general population isn't aware of EMSA's standings nationwide as far as an EMS system goes. They are led to believe that all EMS services are on the same level, which is very far from the truth. I've run calls where the patient had a family member or friend drive them from the next county over just so EMSA would respond on them and not the service that covers that area.
EMSA is one of the top five services in the nation for cardiac arrests saves, and is also one of the cheapest on the tax-payer. There are a handful of other cities (comparable in size to Tulsa) that have cloned EMSA's way of operating and then tweaked it to fit their city/operations. EMSA also has very tight quality improvement/quality assurance, which is generally not the case in a fire-based EMS system. EMSA is required to respond to all medical emergencies, or potential medical emergencies (i.e. man down calls), where as not all fire-based EMS services are. How would you feel if you were the man down and had to wait for PD to respond before anyone realized you needed medical help, and then had to start an ambulance?
quote:
Originally posted by shadows
If one has the only ambulance contract in town it kind 'a floors the average citizen to see the adds in the only news paper and on the TV telling us how great a job they are doing. Sixty percent of the runs are transfers.
I'm not sure how you're figuring that 60%, but I know that on an average shift, we run eight calls with no more than one transfer. So even if we had two (this is uncommon), that's still only 25%.
quote:
Originally posted by Wilbur
I also found this little item interesting: Those who decide not to participate would be required to sign a document... How on earth do you enforce that section? Turn off my water if I don't sign the document?
How many people actually need a total care program. Does not most health/automobile insurance cover the cost of an ambulance ride (I know mine does)?
Most insurance does cover
part of the bill. The TotalCare is designed so you don't have to pay any unpaid portion if that's the case. However, a large number of our patients are covered by Medicare/Medicaid, which is where the problem lies now that there's been cutbacks.
The part of the article I find interesting is:
Covering the subsidy from the city's operational budget would force cuts in nonessential services, city leaders have said.source (//%22http://www.tulsaworld.com/news/article.aspx?articleID=070321_1_A1_ERWor57062%22)Now replace EMSA with say the police or fire department. Now how many people would agree that it would be acceptable to cut
nonessential services? What are these services and how much are
they costing taxpayers?
quote:
Originally posted by Double A
I think EMSA should start cutting the bloated executive compensation packages and golden parachutes of their top brass before they start asking for more tax dollars.
quote:
Originally posted by Conan71
From the photo in the paper, it's not only the salaries which are bloated.
I'm curious as to why you think we have all of this "high-paid top brass." Compared (per the '07 departmental budget highlights) to the fire departments 20 district chiefs, 147 fire captains, and over 15 other high positions.
Source (//%22http://www.cityoftulsa.org/OurCity/Budget/documents/Sec03a-DepartmentalBudgetHighlights-PublicSafetyAndProtection.pdf%22)quote:
Originally posted by Steve
EMSA doesn't seem to be hurting these days judging from how employees are compensated.
I must be missing something or just getting the short end of the stick because I make an hourly wage (which is comparable to working at a call center) and currently can't even afford health insurance. My car has 200k miles on it and I live pay-check to pay-check. Where's the "employee compensation" I'm missing?
quote:
Originally posted by sgrizzle
I thought the whole changes was do to a loss in medicare subsidies. If they're on medicare, they're probably not paying an emsa bill, whether it be $500 or $1000.
That's correct.
quote:
Originally posted by Steve
I don't know what full page Tulsa World ads go for these days, but if EMSA has money to waste on propaganda such as this, they must not be hurting too badly.
-
Whatever EMSA's financial situation is, they seem to have a fully funded advertising budget.
Let's see... running a multi-million dollar EMS operation... a few hundred dollars for a page in the Tulsa World. Not sure how you are comparing needing millions of dollars due to Medicare cutbacks to a few hundred dollars to educate people in what we do and why we need money to do it.
quote:
Originally posted by inteller
if this passes people will call the ambulance for the dumbest of things, stumped toe, call an ambulance.....head stuck up your arse, call an ambulance. It is a vicious cycle that will keep costing more than the taxes bring in. EMSA bought off the fire department so they wouldnt push to take over the service...
People already do call for all of that. EMSA didn't "buy off" the fire department. The fire department's proposal was not accepted by the Mayor and City Council because it was lacking in detail and was proven the numbers were too low based on real-life expenditures, not to mention the fact that the fire department proposed 24-hour paramedic shifts. I don't know about you, but I don't want to be a patient on that medic's 22nd hour, especially if he/she's working a high-volume station.
Mike G. - I understand all of your arguments and pretty much agree. To be factual, however, you must look up the cost of newspaper advertising. A full page is 129 column inches in black and white. When I worked there 20 years ago the rate was nearly $50 per column inch or nearly $6450 NOT including the cost of production if done by an agency. Little or no discount for re-runs too.
I would guess the total cost of each ad today would be approaching $9000-10,000 for the space and $2000 for production. Not an insignificant cost. But apparently pretty effective reach.
quote:
Originally posted by waterboy
Mike G. - I understand all of your arguments and pretty much agree. To be factual, however, you must look up the cost of newspaper advertising. A full page is 129 column inches in black and white. When I worked there 20 years ago the rate was nearly $50 per column inch or nearly $6450 NOT including the cost of production if done by an agency. Little or no discount for re-runs too.
I would guess the total cost of each ad today would be approaching $9000-10,000 for the space and $2000 for production. Not an insignificant cost. But apparently pretty effective reach.
I do stand corrected on that, as you are correct. I still think it is an effort, however, to educate the public on exactly what is being done to make sure we can maintain our quality of service. Again, the general population doesn't even know what we really do unless they either know someone that works at EMSA or has been a patient or friend of a patient that has needed us.
On a side note, that's darned expensive to advertise in the paper! I didn't realize it was that high now days. Maybe I need to get into that business, heh.
I believe advertising is only expensive when it doesn't work. EMSA was very strategic with this campaign and it worked because I have heard lots of people talking about this issue and this thread is even more proof.
The best part of the conversations I hear is that EMSA is discussed on a elevated level of essential services and protection. We use to have a hierarchy of who is more important... police, fire or ambulance. Most people thought every city needed a paid policeman but could live with a volunteer fire department and most people felt that ambulance was something that hospitals did.
Now people treat all three as essential public safety components that our citizens demand.
quote:
Originally posted by recyclemichael
I believe advertising is only expensive when it doesn't work. EMSA was very strategic with this campaign and it worked because I have heard lots of people talking about this issue and this thread is even more proof.
The best part of the conversations I hear is that EMSA is discussed on a elevated level of essential services and protection. We use to have a hierarchy of who is more important... police, fire or ambulance. Most people thought every city needed a paid policeman but could live with a volunteer fire department and most people felt that ambulance was something that hospitals did.
Now people treat all three as essential public safety components that our citizens demand.
they demand it because of sprawl. I live on the edge of tulsa, so I live in sprawl. however, i dont expect ambulance service to be available at all times because I chose to live here. therefore I dont consider it to be a public utility and I sure as hell won't be paying for it as such.
EMSAs grand scheme is to get an ad valorem tax passed so that you won't have an "option" to not take TotalCare. It is a grand plan to get them tenure with the city after their scare of almost losing to the fire department.
EMSA wont be the cheapest after this passes, because they are raising the rate to 1100 dollars to foist more money out of insurance companies who pay on a percentage basis. I suspect insurance carriers will start dropping their ambulance coverages like a rock here in Tulsa. An enterprising individual should get a health ins quote now and after this thing passes because I guarantee ins companies will start raising their rates nd changing their coverage if you live in Tulsa city limits.
In reading these post one might have the impression that EMSA is a backup for the fire department as it seems to be the first responders.
Seems that there would be some way to audit EMSA operational expense and submit it to the general public, if it is on the borderline of being a TRUST before adding more burden on the aging retirees.
It seems that the rolling stock is paid for by the city?
Is the supplies paid for by the city?
EMSA also servers other local communities.
Do the other communities use Tulsa's rolling stock ?
How much do they contribute to maintenance?
Who and when was the $1,100 dollar per run authorized?
If 60% are transfers' what % are Medicare or Medicate paid?
Isn't water a necessity of life?
Are those who are struggling to live on $400 SS monthly able to find the money to increase their 'whipping boy" water bill?
There is the provision to op out. (In the sales tax rebate it was discontinued because only those on the south side ask for it.) Is there a simple way to op out?
Could we double the fee on all meters South of 21 street and leave them off the meters North ot 21.
This blind increase on the water bill or increase on property taxes are not the answer but one would find it if they had representatives in the governing functions of the city. There are so many that are more concerned about how they are underpaid for their ability to rule.
quote:
Originally posted by inteller
I live on the edge of tulsa...
however, i dont expect ambulance service to be available at all times because I chose to live here. therefore I dont consider it to be a public utility and I sure as hell won't be paying for it as such.
EMSAs grand scheme is to get an ad valorem tax passed so that you won't have an "option" to not take TotalCare. It is a grand plan to get them tenure with the city after their scare of almost losing to the fire department.
Curious, where exactly do you live? If it's in EMSA's coverage area, then you are guaranteed an ambulance if you call. If you aren't in EMSA's coverage area, then there's no issue. And I don't understand your logic of not expecting an ambulance all the time. All area's of Oklahoma are covered by some sort of ambulance. Does this mean if you or a loved one or friend has an emergency, you are going to take care of it yourself and take them to a hospital on your own? CPR is very difficult in the back of a car.
There will be an option to 'opt out' of the TotalCare, you simply have to sign a waiver. I pay $3/month on my water bill in Jenks to support EMSA and some city Storm deal (not 100% sure what it is). The city of Jenks is already doing what is proposed to the City of Tulsa on the water bill.
I don't know if you know how the renewal contract works with EMSA. Every five years, the city has the option to find another provider for ambulance. This was built in to the contract with the city around 30 years ago. In that 30 years, the city has always chosen EMSA. This past time, the only difference was that the city didn't auto-renew the contract as they had done the past two times (or ten years) to make sure there wasn't a better option. This is the same for Oklahoma City as well. Oklahoma City Fire Department has been trying for a long time now to take over ambulance service and has been making a strong push for it lately. They are easily five to ten years ahead of Tulsa Fire as of the last contract to try to take over ambulance services and so far Oklahoma City has chosen EMSA. What makes you think that EMSA almost lost to Tulsa Fire? TFD's proposal was full of loop-holes and non-realistic numbers. Not sure how that constitutes almost losing.
Originally posted by shadowsIn reading these post one might have the impression that EMSA is a backup for the fire department as it seems to be the first responders.I think a better picture is the fire department is a backup to EMSA since they don't run on all calls and usually are cleared before they arrive or within minutes of arriving.It seems that the rolling stock is paid for by the city?The city has paid for all non-disposable equipment, with the exception of a few ambulances and support vehicles and some equipment funded by other means.Is the supplies paid for by the city?All disposable equipment and personnel are paid for by Paramedics Plus.EMSA also servers other local communities.EMSA serves Tulsa, Jenks, Bixby, Sand Springs, Leonard, Turley, Oakhurst, Berryhill, and some other areas.Do the other communities use Tulsa's rolling stock ?Yes, but they pay in to the subsidy. Example: I pay a couple of dollars a month on my water bill here in Jenks to support EMSA.How much do they contribute to maintenance?Who? The other area's served? I believe it's an equal amount per person served.Who and when was the $1,100 dollar per run authorized?Not sure, I believe this is part of the TotalCare/water bill charge. If you opt out, you agree to pay that amount (probably set by EMSA) since you aren't paying in.If 60% are transfers' what % are Medicare or Medicate paid?60% of our calls aren't transfers. I would shoot more towards 30-40%. And a large amount are Medicare/Medicaid from what I've seen. But I'm not 100% sure how many have private insurance.Isn't water a necessity of life?Yes.Are those who are struggling to live on $400 SS monthly able to find the money to increase their 'whipping boy" water bill?Most of those people either have TotalCare now or can afford a few extra dollars. Now I can't speak for them since I don't live off of SSI, but I don't see how it's much different than rising gas/electric/natural gas prices. Plus they can always opt out.There is the provision to op out. (In the sales tax rebate it was discontinued because only those on the south side ask for it.) Is there a simple way to op out?Yes, you just have to sign a waiver saying you don't want to pay the extra money on the water bill and you will be billed if you call an ambulance.Could we double the fee on all meters South of 21 street and leave them off the meters North ot 21.I doubt that would fly.
um I didn't post that last stuff you respionded to. please get your posters straight.
you didn't even understand my post anyways. but bottom line is I dont consider it a necessity and I dont expect to pay for it as such.
quote:
Originally posted by inteller
um I didn't post that last stuff you respionded to. please get your posters straight.
you didn't even understand my post anyways. but bottom line is I dont consider it a necessity and I dont expect to pay for it as such.
Whoops, sorry about that. Made the needed correction.
Again, where do you live and is it covered by EMSA? If you don't expect to pay for it, then you can opt-out. But do you not consider police and/or fire dept. a necessity? What is the logic in not needing an EMS system? I'm not saying your thinking is wrong, just trying to understand why anyone would think that.
Here's some more food for thought:
(Disclaimer: Approximate numbers used. Numbers are assumed to rise respectively over time.)
Opt-out ambulance bill = $1,100
TotalCare on water bill = $3/month
$1,100 divided by $3/mo. = 366.6 months
This means you could pay the $3/month for over 30 years before it would equal one opt-out ambulance bill. I know I'm under 30 and I've already used an ambulance once.
The 60% transfers was the percentage that was published during the EMSA-Fire Department discussions.
According to your post EMSA has a hand in the pocket of all the Metro citizens and can raise the rates to any figure they choose. The threat of a $1,100 ambulance "if you op out" needs to be looked into by the city.
In your evasive answer to the use of Tulsa bought rolling stock in out of town areas along with who contributes to their purchase is unanswered.
The prorated share of cost in the surrounding communities by population, as explained by you, needs further data.
There is a need for the citizens to understand where and how the millions of dollars are spent.
If a fee is placed on the water billing that is no more that an open check to be fill out by EMSA as the amount can be increased at their desecration. There are many households in the city that do not have the extra dollars to squander on a uncontrollable service.
Citizens can reduce their gas and electric bill by setting in hot or cold houses, turning lights off but there is no way that they can reduce a fee on the water bill or property taxes that is placed on there with no accountability.
Will the op out petition be included in the citizen water bill so unlike the sales tax rebate that many could not have access to nor understood it?
Any situation as this one being forced down the throats of the citizens they should be able to see what they are having to swallow. They surely have an audit of all their transactions. Where can the citizens see a copy?
Or is this the preverbal "PIG IN THE POKE" we are buying?
quote:
Originally posted by Mike G
quote:
Originally posted by inteller
um I didn't post that last stuff you respionded to. please get your posters straight.
you didn't even understand my post anyways. but bottom line is I dont consider it a necessity and I dont expect to pay for it as such.
Whoops, sorry about that. Made the needed correction.
Again, where do you live and is it covered by EMSA? If you don't expect to pay for it, then you can opt-out. But do you not consider police and/or fire dept. a necessity? What is the logic in not needing an EMS system? I'm not saying your thinking is wrong, just trying to understand why anyone would think that.
Here's some more food for thought:
(Disclaimer: Approximate numbers used. Numbers are assumed to rise respectively over time.)
Opt-out ambulance bill = $1,100
TotalCare on water bill = $3/month
$1,100 divided by $3/mo. = 366.6 months
This means you could pay the $3/month for over 30 years before it would equal one opt-out ambulance bill. I know I'm under 30 and I've already used an ambulance once.
I grew up all my life in the country. phones water and electricity were necessities. Not having an ambulance within 30 minutes just makes you think before you do stupid **** and maintain a healthy lifestyle.
As it is now I live 3 high speed minutes from an emergency room. If we need medical assistance I'm not waiting for the ambulance to show up as I'll be at the hospital by the time it would have arrived.
In the Sunday paper is printed that a ambulance run is $550 while we are throwing around the threaten charge is $1,100.
Reguardless the people should be informed the total cost including the additions of what a bill for the use of transportation to the hospital will cost. EMSA is not a golden chariot nor a public utility, but an organization hanging on the skirt of the city. The failure of the public to use the ambulance, which they are not required to do, will cause more harm by waiting to know if the problem merit's the escalating cost, loosing time on medical attention needs. Those with available cars will want to be transported in cars.
I lived in the city and the surrounding areas long before the Dr, Wife started promoting the EMSA concept and at that time only those with sever trauma were transported by ambulance.
If we want to create the illusion that EMSA is a utility then lets us make it a full utility under the control of the city. Take the politics out of the system and like many cities establish a uniform pricing per run and addition cost so the public can transport by car in order to save the garnishment on their substandard wages if need be . To the millionaire a few thousand dollars in transportation cost means little but to the working poor making $10 or less an hour it means they would have to go without essential provisions.
It cost over $25. in fees each month if you have a water meter before you can have a glass of water to take your morning pills.
Such fee's is liken a strangle rope around ones neck. The greatest effort to increase them is changing the computer that prints the bill.
There are many residents in the twilight zone of their lives who worked for 30 cents an hour, now are confronted with fees that they have or had any way to pay. No city has ever been able to tax themselves into prosperity but stumble over the faults of bankruptcy in trying.
If EMSA cannot trim within their budget then let them turn it over to the fire department.
Originally posted by shadowsThe 60% transfers was the percentage that was published during the EMSA-Fire Department discussions.Was that transfers or transports of overall calls? I know at night we only do 10-20% transfers, but that's just nights.In your evasive answer to the use of Tulsa bought rolling stock in out of town areas along with who contributes to their purchase is unanswered.Sorry, didn't mean to sound evasive. What do I need to explain better? There is a need for the citizens to understand where and how the millions of dollars are spent.I agreeIf a fee is placed on the water billing that is no more that an open check to be fill out by EMSA as the amount can be increased at their desecration. There are many households in the city that do not have the extra dollars to squander on a uncontrollable service.I believe that any amount added/raised on the water bill has to be approved by city council. Any situation as this one being forced down the throats of the citizens they should be able to see what they are having to swallow. They surely have an audit of all their transactions. Where can the citizens see a copy?That I don't knowquote:
Originally posted by inteller
I live on the edge of tulsa...
--
As it is now I live 3 high speed minutes from an emergency room. If we need medical assistance I'm not waiting for the ambulance to show up as I'll be at the hospital by the time it would have arrived.
Curious where there's an emergency room, on the "edge of Tulsa", that's "three high speed minutes away." Plus you have to take into consideration how many people don't go to the closest hospital. I've transported numerous patients from 12th and Trenton/Quaker area that want to go to St. Francis even though Hillcrest is a few blocks away.
quote:
Originally posted by shadows
Those with available cars will want to be transported in cars.
...
If EMSA cannot trim within their budget then let them turn it over to the fire department.
Those who want to go by car already can.
EMSA is one of the cheapest EMS systems in the nation to operate for tax-payers with higher care standards than most. Plus where do you think the fire dept. will get the money for it? Through taxes. EMSA basically supports itself.
It is times like this I am happy to live in Broken Arrow.
Our ambulance service is run by the fire department. And they don't do transfers.
Quote
[EMSA is one of the cheapest EMS systems in the nation to operate for tax-payers with higher care standards than most. Plus where do you think the fire dept. will get the money for it? Through taxes. EMSA basically supports itself.]
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This is the statement that we are trying to decipher. EMSA is a private operation that wants to be treated as a city department without regulation. Their income and operational cost are hidden from the general public but they want to be recognized as segmented public utility to have a place on our tax rolls though they serve other communities also. It may be the cheapest system if we take their word for it. If the total cost to the citizen for trip was public along with the operating cost we are intelligent enough to decide. If it is a public utility then they should be regulated by the corporation commission on what the charges are. The general public should vote on a franchise if it is a public utility. If it is a department of the city then it should be operated under the supervision of the fire department.
I understand the council meeting today was clouded by the increased fee on the water bill. The deal has been cut and the obliging councilors were only costing the city for more electricity for lights and wearing out the furniture.
tonight is the night! get out and tell the council what you think!
Gotta love what news comes out after a proposal gets approved. Like EMSA's utility bill program, now approved by Tulsa's City Council:
$816,000 to rebuild EMSA's cash reserves. Do I understand correctly that is $816,000 every year? Or does that mean another $816,000 for the general fund after year one?
$500,000 to reimburse people who signed up for Total Care under the $50 program. Okay, what happens after year one when they are all paid off? Another $500,000 a year for the general fund?
$181,000 for the cost of the city's utility bill assessment. What ever that means!
Lets look further.
The program applies to single family residential customers. Those in apartments will be informed they can sign up for the Total Care program at the same rate of $43 a year. So, those people in single family homes, most of who already have insurance that will pay their EMSA bill, will be paying the $43, unless they specifically opt out, which you know darn well there will be a scare tactic to get everyone to not opt out. Those people who live in apartments, many of which don't have insurance that will pay for the EMSA bill, aren't all of a sudden going to start signing up for the Total Care package any more then they already do, which means they still won't be paying for their $1100 ambulance ride.
Tulsa, you just got duped! Tax increase #1. Stand by for more.
I hope Mayor Taylor enjoys her 1 term.
quote:
Originally posted by Wilbur
Gotta love what news comes out after a proposal gets approved. Like EMSA's utility bill program, now approved by Tulsa's City Council:
$816,000 to rebuild EMSA's cash reserves. Do I understand correctly that is $816,000 every year? Or does that mean another $816,000 for the general fund after year one?
$500,000 to reimburse people who signed up for Total Care under the $50 program. Okay, what happens after year one when they are all paid off? Another $500,000 a year for the general fund?
$181,000 for the cost of the city's utility bill assessment. What ever that means!
Lets look further.
The program applies to single family residential customers. Those in apartments will be informed they can sign up for the Total Care program at the same rate of $43 a year. So, those people in single family homes, most of who already have insurance that will pay their EMSA bill, will be paying the $43, unless they specifically opt out, which you know darn well there will be a scare tactic to get everyone to not opt out. Those people who live in apartments, many of which don't have insurance that will pay for the EMSA bill, aren't all of a sudden going to start signing up for the Total Care package any more then they already do, which means they still won't be paying for their $1100 ambulance ride.
Tulsa, you just got duped! Tax increase #1. Stand by for more.
I think it's ripe for abuse. People who otherwise would have opted to drive to the hospital will now take the ambulance for sprained ankles and broken wrists. I think this is going to open a huge financial drain on EMSA and you are right there will be more.
quote:
Originally posted by Conan71
quote:
Originally posted by Wilbur
Gotta love what news comes out after a proposal gets approved. Like EMSA's utility bill program, now approved by Tulsa's City Council:
$816,000 to rebuild EMSA's cash reserves. Do I understand correctly that is $816,000 every year? Or does that mean another $816,000 for the general fund after year one?
$500,000 to reimburse people who signed up for Total Care under the $50 program. Okay, what happens after year one when they are all paid off? Another $500,000 a year for the general fund?
$181,000 for the cost of the city's utility bill assessment. What ever that means!
Lets look further.
The program applies to single family residential customers. Those in apartments will be informed they can sign up for the Total Care program at the same rate of $43 a year. So, those people in single family homes, most of who already have insurance that will pay their EMSA bill, will be paying the $43, unless they specifically opt out, which you know darn well there will be a scare tactic to get everyone to not opt out. Those people who live in apartments, many of which don't have insurance that will pay for the EMSA bill, aren't all of a sudden going to start signing up for the Total Care package any more then they already do, which means they still won't be paying for their $1100 ambulance ride.
Tulsa, you just got duped! Tax increase #1. Stand by for more.
I think it's ripe for abuse. People who otherwise would have opted to drive to the hospital will now take the ambulance for sprained ankles and broken wrists. I think this is going to open a huge financial drain on EMSA and you are right there will be more.
The GAUL of those a**holes at the council last night. They REFUSED to provide numbers for an opt in plan......they just said it would be horrendously expensive. Well guess what, I'm fixing to make it horrendously expensive for the opt out option you greedy bastards!
Sounds like EMSA must have greased some palms to make that deal pass the council.
quote:
Originally posted by Conan71
I think it's ripe for abuse. People who otherwise would have opted to drive to the hospital will now take the ambulance for sprained ankles and broken wrists. I think this is going to open a huge financial drain on EMSA and you are right there will be more.
I agree. Does this "new program" have any caps on service calls, any way to weed out abusers?
My prediction is that the utility bill charge will only last for 1 year. We will have a vote soon on an advalorem millage to fund EMSA. That way, EMSA will get automatic annual funding increases due to property value increases. (and future millage increases are possible too.) Still smells to me; I still think the users of EMSA services, their insurance and their own pockets, should foot the bill. If they stiff EMSA, give them fines, jail time, or community service.
The item on putting the of EMSA for Tulsa and the surrounding Burb's on the those who could less afford it, was a cut and dried proposition to further tax the working poor, retirees and the very limited income citizens. The total disbursement of the tax money EMSA would receive was never made public until the meeting was held to approve it on the those who are so unfortunate as to depend on water. The final part was when they started talking about 2.3 million dollar shortage and in the end the council says give them some 3 Million more. [They will find a place to spend it.]
The water department should add a line on the water bill whereas those on Medicare or as most insurances cover emergencies, asking the user if they wanted to opt out of double paying on the EMSA tax. It could be a simple line on the billing advising: "Make a check mark in the box if you are already being cover for ambulance service by health insurance or Medicare." This would be used in lieu of getting a paper and sending it to the city water trust in asserting the person wants to opt out of double paying for the ambulance service.
The passing of the tax on the water is an illustration of a council that does not represent the total number of citizens nor recognize the struggle of an aging population of the city.
There would be an advantage to hiring full time councilors at $100,000 dollars a year where the salary would make it more attractive to the professional politicians to run for and stay in the office. Their duty would be to follow the trends of the citizens needs by getting out the vote. The concept of any government is that the majority of citizens be represented.
One must remember the fire department cannot contribute to the political campaigns but EMSA seems to have all kinds of money to advertise with.
The suburbs are collecting our sales taxes that we need. Now it seems we are going to furnish them ambulance service by further taxing our poor.
I still say the fire fighters would have been a better choice for EMS service. I think if EMSA is short on cash, that the fat f*#k running EMSA should take a pay cut.
quote:
Originally posted by wavoka
I hope Mayor Taylor enjoys her 1 term.
Me too. I supported Taylor's opponent in the primary, but I voted for Taylor in the general election, just because she was a Democrat. I guess we all are allowed some mistakes. Hopefully, she will be a "one hit wonder."
(http://img.photobucket.com/albums/v246/mistymountainhop/gif/VOTE4TAY.gif)
amazingly Christiansen put himself in my good graces (temporarily) for voting against this one..though his reasons were kinda lame.
quote:
Originally posted by Steve
quote:
Originally posted by wavoka
I hope Mayor Taylor enjoys her 1 term.
Me too. I supported Taylor's opponent in the primary, but I voted for Taylor in the general election, just because she was a Democrat. I guess we all are allowed some mistakes. Hopefully, she will be a "one hit wonder."
she wont give you the chance to vote her out. Krazy Kathy will make a run for a state seat.
I promised I wouldn't say: "I told you so" about Ms. Taylor. Whoops, I just did. I'm amazed out of all the people in Tulsa, we were only left with Doofus and Doofette as candidates for Mayor.
I think I'll install a cistern, start crapping in a coffee can, and haul my trash to work, and tell them to pull my water meter- account closed. [:(!]
I heard her butter is all churned because Lafortune is planning a run for a state seat in her district.
quote:
Originally posted by inteller
quote:
Originally posted by Steve
quote:
Originally posted by wavoka
I hope Mayor Taylor enjoys her 1 term.
Me too. I supported Taylor's opponent in the primary, but I voted for Taylor in the general election, just because she was a Democrat. I guess we all are allowed some mistakes. Hopefully, she will be a "one hit wonder."
she wont give you the chance to vote her out. Krazy Kathy will make a run for a state seat.
Naw. She'll just change, or should I say, ignore, the charter so no more votes for mayor take place.
According to this blog post
http://roemerman.blogspot.com/
the city will not automatically be sending 'opt out' forms to everyone with their water bills for the EMSA fee. You must take the time to specifically call the city and request a form be mailed to you. Another tactic to make as many people pay the fee.
quote:
Originally posted by Wilbur
According to this blog post
http://roemerman.blogspot.com/
the city will not automatically be sending 'opt out' forms to everyone with their water bills for the EMSA fee. You must take the time to specifically call the city and request a form be mailed to you. Another tactic to make as many people pay the fee.
found this on tulsaworld.com
http://www.optoutemsa.com
someone is going to fix that problem.
I contacted Martinson's office yesterday and expressed my complete disatisfaction with his vote. There is a Dist. 5 meeting Monday at Hale and I will do it again in person. I agree that this deal is a bad one. People will be abusing this a lot. It will become a wambulance service.
Maybe the head of EMSA should skip a couple of buffets to save money. What a fat cat he is, literally. And I would like to know how much money they spent on those Tulsa World ads.
Another unintended consequence that will result is the dropping of ambulance coverage on our insurance.
quote:
Originally posted by NellieBly
Maybe the head of EMSA should skip a couple of buffets to save money. What a fat cat he is, literally.
no kidding. i would say pig though.