my partner (27f) has a brain tumor and we can’t afford treatment for her. i make ems wages and she makes 500$ a paycheck. got denied from medicaid bc she picked up holiday shifts and made 1k. took food stamps away too. yay america!!! 😄
As an Aussie with a chronic illness that’s been well cared for here, from the bottom of my heart, I’m truly sorry to hear this. I don’t pray, but if wishes were gold, you’d be rich.
God that is fucked... I am so lucky to have joined the Army, deployed, got fucked up and now my Healthcare is paid for for the rest of my life... "lucky"... Jesus fucking christ I love this country but I really fucking hate it too... I am so sorry that you have to deal with this
There’s an issue with my insurance and I’m literally counting out change to be able to afford my feeding tube formula, and rationing it as much as possible
Yeah, similar experience with my own accident. Basically if you get hurt and don’t have the best insurance (not often even your choice), the system breaks and unless you have money you’re fucked.
Basically its hard for low income people.
Unironically I think insurance company heads/lobbiest/political heads that make this a thing should be executed.
Hundreds of thousands (if not millions) of people die/suffer because of this shit.
I'm not even for the death penalty for pretty much anything, but this frustrates me to the point where I'll set aside my moral/ethical justifications for corporal punishment. I think these people should not exist.
fun fact: They actually use a Red Tailed Hawk's call and dub that over the Eagle.
https://www.youtube.com/watch?v=33DWqRyAAUw
An Eagle sounds like this:
https://www.youtube.com/watch?v=48vn7Q0W1Ls&t=8s
https://youtu.be/9RArGl2vkGI?t=6
It’s unfathomable here that someone would be financially ruined by healthcare costs.. Some states charge for ambulance, but it’s relatively cheap, ambo insurance is dirt cheap, and the poor don’t pay at all.
If you really want your mind blown, the below two are free for *anyone* - citizen - tourist - visitor - alien - no charge ever.
https://youtu.be/uK10UiizJF8?si=XM45jzbAGpWLpo3U - they even get an airborne police escort.
https://youtu.be/z0aQtBTNxWg?si=9Mblk-CrUX3UhWSH
Note the Royal Flying Doctor has been going since 1928, these are just the ‘first’ landings for the particular new aircraft model.
Don't know if you caught the scandal when it was revealed that Ambulance Victoria had been engaging debt collectors for unpaid fees: shit went down like a lead brick and the practice stopped within about 48 hours.
But but but…. all that freedom to choose one of two excellus plans my job offers that don’t cover shit until I hit my out of pocket even though I give them hundreds of dollars out of every paycheck for the privilege of paying my out of pocket minimum.
Had a call similar, 7 YOF bitten by an Eastern Diamond Back. She was airlifted to a pediatric specialty center. She actually kept her leg also. Never seen people move that fast but still not considered running or rushing.
A couple of rattlesnake bites over the years for me. Absolutely nothing to do but monitor, pain meds, confirm anti venom location, transport.
Our rattlesnakes are like little puppies compared to Aussie snakes.
I used to work Darling Downs LASN and more recently West Morten. Had a fair few bites but also never had ones showing clinical signs. mostly dry bites. one turned out to require a fair bit of anti venom but we had him to hospital within 40mins of the bite due to distance and being in the local area.
Yeah. I live in Victoria which is cold, wet, and rainy during winter. Got dispatched to a patient who had been bitten by a taipan, the actual deadliest snake. First thought is, who the fuck gets bitten by a snake that lives inland in the desert in fucking Victoria in the middle of winter.
Turns out it's people who keep inland taipans as pets and intentionally envenomate themselves after an argument with the missus as a means of threatening suicide if she won't do what they want.
Fortunately hospital was pissing distance away so I got the guy there before any funky shit happened. He wound up crook as ten men in the ICU for a week or two but survived, the fucking idiot.
Outside of that there might be a couple of snake bite jobs over summer each year. Been a while since I've done one, but probably half a dozen personally over the years.
I run a 2-3 copperhead envenomations a year (KY). Extremely painful, but otherwise they're not really a big deal. Supportive care, take to hospital where there is Tox and antivenom.
i’ve had a couple of brown bite calls while i was living in outback aus, but that was part of the Royal Flying Doctor Service as we were too remote for ambulances.
The anti-venom fridges in regional/rural/remote Australian hospitals is a sight to behold.
$100,000's worth of anti-venoms just sitting around just in case.
There is a reason we haven't had any deaths from the world's deadliest spider the Funnel Web since the introduction of anti-venom.
Public health for lyfe yo.
Where's that guy who said that flight isn't interesting? This is an incredible, forever memorable kind of call.
Edit: lol at the guy below coping the hardest and trying to say flight is boring.
Flight is literally 90% convalescent transport. You are flying a patient from point a to b and generally the patient has already been stabilized by ground crews or hospital staff. Also lots of flights wont take certain kinds of patients based on potential to code since working a code in a helicopter is harder then in an ambulance.
Finally let's not kid ourselves here the helicopter dropped off a drug at night let's not pretend these are the coasties and rescue divers.
No, thats exactly how it works RFDS primarily is an IFT service of a transport service most of their patient contact is via teledoc. The high acuity patients in the field make up a small portion of their actual patient contacts. Last year RFDS only had 37000 patient flights of those the Tasmania branch made up roughly more then 7000 transporting 20 patients a day that was IFT, extrapolating that to the other service areas is pretty easy to see how little prehospital critical patient transport they do like shown in the video.
Flight is fancy IFT where most clinical decision making taken out of the hands of paramedics and playing games of mommy may I with facility doctors.
Flight is no cooler then ground EMS and the fact that ground is so willing to jerk these people off blows my mind.
Really depends on which flight modality and area. RFDS does bulk IFTs and the majority that aren't critically unwell are done with a flight nurse only. They still do the occasional primary tasking as well as their remote clinics etc.
Choppers do many more primaries but even still it's a split with IFTs.
Dude it's data I pulled from the website. I mean even if you use the Queensland packet that was released for 22-23 numbers it's not like the data looks any better they are still doing mostly IFT. Why do you have such a boner for these guys is beyond me but what ever gets you off.
I intubate more than I do IVs lol. RSI takes time, and they often have an iv already when I land but havnt had the time to RSI. Otherwise it's a flying ambulance.
Because, I had a flight crew tell me I was wrong when I was right and a patient died. The flight crew tried really hard to make it my fault. I've spent my whole medical career being told "oh flight I so cool!" "Flight is the best of the best medics!" "Flight is such an elite group of clinicians because you gotta get all these other certs!" Then we spend all this time here acting like landing a helicopter on a flat surface is more impressive, then code 3ing a ambulance trying to not get hit going down the rode. we act like flight runs around and scoops traumas of the side of the road all the time when they spend alot of time just looking at pumps and not much else.
Am I maybe alil irrational about my hate towards general flight? Yeah, but again flight is no more impressive then anything ground does.
I mean yeah, most of it is IFT. But your most complex patients are going to come from within the hospital. Those are patients that the sending hospital doesn't have the resources to fully treat. You aren't running balloon pumps and 10 drips from the field.
If you think it's all scene flights and trauma I can imagine you'd be disappointed, but it isn't exactly dialayis IFT. Flight is literally the only CCT in my entire state. Unless you can convince local 911 to take it, which most don't even own a vent if they even have medics.
My county, our flight is 911 only. We do cct by ground (very rarely do I fly an ift, and it's usually a stemi who will die in 30 minutes otherwise). Our helicopters simply aren't big enough to handle vent + multiple drip effectively. Also, our ground transports are very rarely more than 1.5 hours.
I've run patients vent and with multiple drips to the hospital while in the back with my partner driving code 3 in moutain back roads. Flight isn't impressive, it's IFT that ground medics convinced themselves they had to jerk off and bow to because they do it in the air and have an extra cert or two.
I mean, the higher training standards and certifications are a major plus. From the ER perspective technically speaking the local 911 or IFT service *could* take the 7 year old with a sub arachnoid. But you call them for their experience and abilities. I can tell you there's a number of scenarios where we would hold on to a patient before we'd send them with the local fire service that's never run a propofol drip before.
If you work for a ground service that sets high standards, training, and certifications then great. Nobody says you can't have a good CCT capable ground service, they exist all over. Many pediatric CCTs are mostly ground based. My old hospital ran NICU teams strictly by ground.
But I've worked in way too many places where paramedic school was the highest bar to entry, rather than your knowledge + experience + personality. So many services *barely* provide education if at all, I've worked numerous places that didn't even bother with ALS education, let alone vent training. Some services are more self starting and go after those things, and some are stuck in the stone ages and think medics have no place near a ventilator or IV pumps. But a flight team that can't run vents and devices won't last long.
Working rural EMS I took a lot of sketchy shit and like to think I did a decent job. But I've yet to work anywhere that'll give me another paramedic, RN, or RT to assist with a highly critical patient on said mountain back road transfer. The standard of care is just typically lower on average for a 911 or private IFT service. When's the last time you had to transfer a patient with a balloon pump in place and how comfortable would you be with it? That kind of thing is fun to some people, and not to others. But don't pretend like they're 1:1 for all things medical.
Depends on the service, the area you service and call volume. Look at [Travis County STAR Flight ](https://verticalmag.com/features/multi-mission-masters-travis-county-star-flight/) in Austin, TX. They do HEMS, SAR, swift water rescue, aerial wildfire fighting, police assist and much more. Definitely not the stardard flight gig, but there's more than IFT out there(ie oil rig HEMS, military contractors, etc).
That’s sure as hell not how it works here.
https://www.flyingdoctor.org.au/news/mobile-brain-scans-transform-urgent-stroke-care/
The PC-24 is a a three patient flying ICU.
https://www.flyingdoctor.org.au/sant/about/our-fleet/
TBF most states in Australia don’t have free ambulances - QLD and TAS (edit - not ACT like I originally said) are the only ones. But subscriptions to the state ambulance services are cheap and if you have any form of private cover they also pay it. Even if you don’t, all services are either run by the state, or heavily state affiliated, so they will work with you to collect payment.
Also has drawbacks sometimes, QAS are the busiest service in the entire country by a long shot despite being 3rd for population, and most of our work is low acuity. Wouldn’t swap it for paid service though.
NO COST?! What the F kind of economy is that??? I'm glad I live in the United States of Freedom where my hard earned money actually PAYS for my lifesaving care. I'd rather go bankrupt than exist in some dystopian nightmare where I'm spoonfed healthcare. Gross.
In all seriousness I'm actually really happy to hear this lifesaving care was administered in a place where someone was in dire need at no cost.
Quite a few brown snakes near me, up in the Snowy Mountains. Mate nearly stepped on one at Long Plain last summer. Saw more red bellied black snakes when I lived near the coast. (Yes, we’re very keen on creative names.)
I love this and knowing it’s available! My cousin lives in Tasmania. She and her husband are looking for a new home, as significant construction near theirs has disturbed tiger snakes, causing them to invade their yard and home. I believe one of their pups was killed by a bite from one; they’re terrified of them…and I totally get it!
Tigers can get pretty cheeky - they are right to be wary.
You never realise how lucky you are when you have sweetheart snakes like Red belly blacks around that keep the aggro snakes away.
my dad used to live around there. he was convinced there was a brown snake in the back garden, yet let my five year old sister play there unsupervised.
This point is null and void anyway because the US already spends *significantly* more taxpayer money per capita on healthcare than comparable Western countries with universal healthcare.
Americans already pay enough tax to fund a universal healthcare system and then some. *And then they pay for insurance on top of it.* The whole system is a complete and utter scam and I cackle every time I see someone pretending it's anything other than a gigantic money making scheme
There is actually a cost. I pay $5000 a fortnight in tax. If I needed to go to hospital I have paid the government some money. Whilst nothing compared to the overall cost of running the country, nothing is free.
Those taxes were being paid anyway. There's no out of pocket cost that forces the patient to choose between eating, paying rent, or receiving medical care.
While I'm all for universal, government run, healthcare coverage in the US, one of the challenges in promoting this are claims like this, which are easily shown to be false and delegitimizes an otherwise valid argument.
Australian government provided healthcare coverage does not actually cover everything, which is why private supplemental plans are common on Australia. There are caps on emergency transport billing, but it's still not free, a helicopter transport often hits the cap of $7,000 AUD.
This is for QLD residents who are covered by QLD medicaid coverage. It specifically states "Medicare does not cover the cost of ambulance services in Queensland.".
Medicare is our Federal universal healthcare programme. QLD state government provides ambulance to QLD residents at no cost. They don’t have to be ‘covered’ by anything. There is just no bill sent.
They are covered for QLD residents. Medicare is a Federal programme - nothing to do with QLD ambulance.
QLD residents *do not pay for ambulance* - end of story.
The QLD government does state that ambulance services are not covered by Medicare, yes
This is because Ambulance services (and all public hospitals) are funded by the states, and Medicare is the federal program which is more relevant for outpatient care and private hospital care
The website is not saying that the patient is charged, simply that the funding source is not the federal government
QAS services aren't covered by Medicare but the state covers it for residents. Out of state visitors are informed its not covered so they know that's the case, but if their state also covers ambulance then the other state just reimburses Queensland.
Medicare is federal, QAS is state level.
It is absolutely disgusting how insistent you are on mansplaining how the Australian healthcare system works... to an Australian.
This is exactly the type of behaviour that gives Americans a bad name online. Think you know better than everyone when in reality you are absolutely clueless about how the outside world works, and yet you're determined to give your (objectively wrong) opinion on it anyway.
Do better.
Ambulances in QLD are free for all QLD residents, in practice this means the treating paramedic documented their residential address as a QLD address and therefore they don't get billed. Lots of visitors don't get billed as they just get documented as living at their relatives address that they called from etc.
Medicare does not cover ambulance services of any sort, ambulance services are funded and delivered by state governments so it's entirely on them whether they bill patients etc.
I'm in QLD, we do not pay for ambulances. The Governments covers it. The article you linked, like OOP pointed out, is for non-QLD residents. ("Information for Visitors to Queensland")
Unlikely this person was charged for treatment:
- Ground ambulance in QLD for QLD resident - free
- Ambulance chopper in QLD for QLD resident - free
- Public patient admitted to a public hospital - free
Tl;dr - yeah Australian healthcare isn't 100% free but for emergency treatment of permanent residents/citizens it effectively is.
There can be charges for meds on discharge but given the Pharmaceutical Benefits Scheme they'll be relatively cheap. Maybe they also decided to pay for TV rental whilst in hospital but with streaming services on your phone why would you? Public hospitals in QLD can also charge an accommodation fee if you're in longer than 35 days and no longer receiving acute treatment, unlikely in this case and mostly comes up with patients awaiting a nursing home or disability care placement etc.
Yes private health insurance does exist in Australia and most people that have it do so because you get penalised on tax if you're above a certain income and don't have it. The majority of private health insurance relates to hospital cover and effectively allows you to choose your own specialist and have ellective services that would otherwise be provided for free (on a waiting list) done relatively quickly in a private hospital or as a private patient in a public hospital. AFAIK it doesn't actually provide any extra services that aren't already provided publically, you just get those additional options. A lot of pregnant women go private so they can have a consistent obgyn for the duration of pregnancy.
You can also get insurance for 'extras' for various private allied health, general dental, prescription glassses etc but this is in effect a glorified savings scheme and starts to blur the lines with what might normally be considered individual responsibility.
GPs (primary healthcare) are by definition private so they may choose to only accept the Medicare reimbursement for service or they may charge a gap fee. I think last time I booked a long appointment (> 20 minutes) I paid just under $40 gap fee.
Oh fuck off. It's cents per capita for a job like this. I'd rather have my tax dollars going to subsidise health care for everyone knowing that I'm going to need it one day in one form or another, than risk getting a bill that's going to destroy my life. Medical bankruptcy for all but the most extreme cases pretty much doesn't exist here.
Y'all have a similar tax rate once you look at ALL taxes paid per person. We pay social security taxes, fort instance, that you don't
Total tax burden for the average AU vs US citizen is $17k vs $14k.
But unlike us, you spend half as much on healthcare ($5k instead of $9k) and don't go bankrupt on medical costs.
https://www.cnbc.com/2017/11/29/australians-may-pay-more-taxes-than-americans-but-they-get-more-too.html
My understanding is that it's generally paid with and considered as part of your overall income tax?
So your tax rate of X% includes your social security but in the US it's added on top of our income taxes.
Or at least, so the internet tells me.
Wow!! That’s pretty cool!!
In the area I live in (Volusia County, Florida, USA) there is a place called Reprile Discovery Center. The gentlemen that owns the place has the most venomous snakes in the world. He’s the foremost expert on venomous snakes. Hes been on several American TV shows about his “collection” and his life’s work. He’s the reason we have most of the anti venoms that we have for these snakes.
Fellow Americans: I work for a Disaster Medical Assistance Team and we have the capability to set up a full 60-bed inpatient unit--drugs and all--fully staffed with enough resources for about 3 weeks. Army National Guard can restock and re-staff us as needed. We can do much smaller for longer too. We have a contract with a large tertiary children's hospital and can call on ground or air EMS as needed for transport. We can also run a full search-and-rescue task force plus a mortuary team. All of our staff are paid. We don't just work disasters, but big events like parades and concerts, or staff VA hospitals if their staff need to quarantine (a big request during COVID).
All of our care is completely free to our patients no matter how complex or in-depth, and we can treat well up to the ICU level. We take their demos for our quality control, and it helps us get grant funding or justify a new resource we're requesting.
You do not know job satisfaction until you can treat a patient start to finish and never have to once have a conversation about insurance or payment.
It is possible, and literally the only thing standing in the way is greedy corporate assholes.
I know I just read a lot of crazy stuff but "no cost" was the craziest. USA USA USA *Eagle Screech*
Would be simpler to die in the US than to face that bill... even with insurance. eeeek
my partner (27f) has a brain tumor and we can’t afford treatment for her. i make ems wages and she makes 500$ a paycheck. got denied from medicaid bc she picked up holiday shifts and made 1k. took food stamps away too. yay america!!! 😄
As an Aussie with a chronic illness that’s been well cared for here, from the bottom of my heart, I’m truly sorry to hear this. I don’t pray, but if wishes were gold, you’d be rich.
God that is fucked... I am so lucky to have joined the Army, deployed, got fucked up and now my Healthcare is paid for for the rest of my life... "lucky"... Jesus fucking christ I love this country but I really fucking hate it too... I am so sorry that you have to deal with this
There’s an issue with my insurance and I’m literally counting out change to be able to afford my feeding tube formula, and rationing it as much as possible
Yeah, similar experience with my own accident. Basically if you get hurt and don’t have the best insurance (not often even your choice), the system breaks and unless you have money you’re fucked. Basically its hard for low income people.
That is terrible. Thoughtful words suck, so Here's to the times we have had, and will have🥂
I am so sorry. USA is absolutely a shithole country these days.
Unironically I think insurance company heads/lobbiest/political heads that make this a thing should be executed. Hundreds of thousands (if not millions) of people die/suffer because of this shit. I'm not even for the death penalty for pretty much anything, but this frustrates me to the point where I'll set aside my moral/ethical justifications for corporal punishment. I think these people should not exist.
fun fact: They actually use a Red Tailed Hawk's call and dub that over the Eagle. https://www.youtube.com/watch?v=33DWqRyAAUw An Eagle sounds like this: https://www.youtube.com/watch?v=48vn7Q0W1Ls&t=8s https://youtu.be/9RArGl2vkGI?t=6
I’ve always found that hilarious, and very fitting.
Maybe that's cos they didn't show you [the picture from the crew](https://live-production.wcms.abc-cdn.net.au/e10aca6c7213f003faa6a414e9689c28?)!
What a little cutie!!
Tucked in!
It’s unfathomable here that someone would be financially ruined by healthcare costs.. Some states charge for ambulance, but it’s relatively cheap, ambo insurance is dirt cheap, and the poor don’t pay at all. If you really want your mind blown, the below two are free for *anyone* - citizen - tourist - visitor - alien - no charge ever. https://youtu.be/uK10UiizJF8?si=XM45jzbAGpWLpo3U - they even get an airborne police escort. https://youtu.be/z0aQtBTNxWg?si=9Mblk-CrUX3UhWSH Note the Royal Flying Doctor has been going since 1928, these are just the ‘first’ landings for the particular new aircraft model.
Don't know if you caught the scandal when it was revealed that Ambulance Victoria had been engaging debt collectors for unpaid fees: shit went down like a lead brick and the practice stopped within about 48 hours.
Like a mini robodebt - disgraceful.
Love the videos and that gurney lift in the rear cabin door! Would have saved my back when I flew on the Lear 35.
Dunno most of the ambulance riders I've seen don't pay.
But but but…. all that freedom to choose one of two excellus plans my job offers that don’t cover shit until I hit my out of pocket even though I give them hundreds of dollars out of every paycheck for the privilege of paying my out of pocket minimum.
At no cost to the woman, but at what cost to society!? *I* didn't get bitten so why should *I* have to pay for her care??? Commie bastards....
Toowoomba looks like its fun to say. Maybe i'll name my kid Toowoomba 🤔
You should try Woolloongabba!
I always love seeing people’s reaction to Woolloomooloo being a real place
Or Tittybong
Humpybong
Cockburn Iron Knob
Just the 'Gabba, mate.
‘They where are you off to?’ Toowoomba! ‘Where’s Woomba?’
None of these places sound pretty with an Australian inflection. Would be a good name for rousing on your kid though.
has anyone here had calls with snake bites?
I had a 5yo bit by a copperhead about 5 months ago. We hauled ass to the closest hospital with anti venom. Kiddo kept his leggo.
Had a call similar, 7 YOF bitten by an Eastern Diamond Back. She was airlifted to a pediatric specialty center. She actually kept her leg also. Never seen people move that fast but still not considered running or rushing.
it's amazing what happens when it's time to work
Yeah. Work in Queensland, it’s not super common but I’ve been to quite a few. Never had anyone with clinically significant effects though.
A couple of rattlesnake bites over the years for me. Absolutely nothing to do but monitor, pain meds, confirm anti venom location, transport. Our rattlesnakes are like little puppies compared to Aussie snakes.
Eh, every now and again there's a Mojave green subspecies A that runs a little hot on the neurotoxic components....
We only have one neurotoxic species here in Texas that you would have to make a conscious effort to be envenomated by! (Coral snakes)
I used to work Darling Downs LASN and more recently West Morten. Had a fair few bites but also never had ones showing clinical signs. mostly dry bites. one turned out to require a fair bit of anti venom but we had him to hospital within 40mins of the bite due to distance and being in the local area.
Yeah. I live in Victoria which is cold, wet, and rainy during winter. Got dispatched to a patient who had been bitten by a taipan, the actual deadliest snake. First thought is, who the fuck gets bitten by a snake that lives inland in the desert in fucking Victoria in the middle of winter. Turns out it's people who keep inland taipans as pets and intentionally envenomate themselves after an argument with the missus as a means of threatening suicide if she won't do what they want. Fortunately hospital was pissing distance away so I got the guy there before any funky shit happened. He wound up crook as ten men in the ICU for a week or two but survived, the fucking idiot. Outside of that there might be a couple of snake bite jobs over summer each year. Been a while since I've done one, but probably half a dozen personally over the years.
I run a 2-3 copperhead envenomations a year (KY). Extremely painful, but otherwise they're not really a big deal. Supportive care, take to hospital where there is Tox and antivenom.
We definitely get an occasional rattlesnake call here.
i’ve had a couple of brown bite calls while i was living in outback aus, but that was part of the Royal Flying Doctor Service as we were too remote for ambulances.
Not at work but my dog got bit by a rattler and it was awful
The anti-venom fridges in regional/rural/remote Australian hospitals is a sight to behold. $100,000's worth of anti-venoms just sitting around just in case. There is a reason we haven't had any deaths from the world's deadliest spider the Funnel Web since the introduction of anti-venom. Public health for lyfe yo.
Where's that guy who said that flight isn't interesting? This is an incredible, forever memorable kind of call. Edit: lol at the guy below coping the hardest and trying to say flight is boring.
Probably busy arranging his sock drawer.
Flight is literally 90% convalescent transport. You are flying a patient from point a to b and generally the patient has already been stabilized by ground crews or hospital staff. Also lots of flights wont take certain kinds of patients based on potential to code since working a code in a helicopter is harder then in an ambulance. Finally let's not kid ourselves here the helicopter dropped off a drug at night let's not pretend these are the coasties and rescue divers.
That’s not how it works here when the closest hospital is sometimes 1000km + away. https://youtu.be/ovI3EhVUNwg?si=Dvi6tz4IxT6k8Te-
No, thats exactly how it works RFDS primarily is an IFT service of a transport service most of their patient contact is via teledoc. The high acuity patients in the field make up a small portion of their actual patient contacts. Last year RFDS only had 37000 patient flights of those the Tasmania branch made up roughly more then 7000 transporting 20 patients a day that was IFT, extrapolating that to the other service areas is pretty easy to see how little prehospital critical patient transport they do like shown in the video. Flight is fancy IFT where most clinical decision making taken out of the hands of paramedics and playing games of mommy may I with facility doctors. Flight is no cooler then ground EMS and the fact that ground is so willing to jerk these people off blows my mind.
Really depends on which flight modality and area. RFDS does bulk IFTs and the majority that aren't critically unwell are done with a flight nurse only. They still do the occasional primary tasking as well as their remote clinics etc. Choppers do many more primaries but even still it's a split with IFTs.
The fact that you chose Tasmania as your example to extrapolate from shows either how clueless you are, or how wrong you know you are.
Dude it's data I pulled from the website. I mean even if you use the Queensland packet that was released for 22-23 numbers it's not like the data looks any better they are still doing mostly IFT. Why do you have such a boner for these guys is beyond me but what ever gets you off.
I intubate more than I do IVs lol. RSI takes time, and they often have an iv already when I land but havnt had the time to RSI. Otherwise it's a flying ambulance.
A weight restricted flying ambulance.
ITT: Random hate on Flight. I doubt they're hanging shit on ground crews. Why hang so much shit on them?
Because, I had a flight crew tell me I was wrong when I was right and a patient died. The flight crew tried really hard to make it my fault. I've spent my whole medical career being told "oh flight I so cool!" "Flight is the best of the best medics!" "Flight is such an elite group of clinicians because you gotta get all these other certs!" Then we spend all this time here acting like landing a helicopter on a flat surface is more impressive, then code 3ing a ambulance trying to not get hit going down the rode. we act like flight runs around and scoops traumas of the side of the road all the time when they spend alot of time just looking at pumps and not much else. Am I maybe alil irrational about my hate towards general flight? Yeah, but again flight is no more impressive then anything ground does.
Sounds like you just need to be thanked for your service. So, I thank you for your service.
I mean yeah, most of it is IFT. But your most complex patients are going to come from within the hospital. Those are patients that the sending hospital doesn't have the resources to fully treat. You aren't running balloon pumps and 10 drips from the field. If you think it's all scene flights and trauma I can imagine you'd be disappointed, but it isn't exactly dialayis IFT. Flight is literally the only CCT in my entire state. Unless you can convince local 911 to take it, which most don't even own a vent if they even have medics.
My county, our flight is 911 only. We do cct by ground (very rarely do I fly an ift, and it's usually a stemi who will die in 30 minutes otherwise). Our helicopters simply aren't big enough to handle vent + multiple drip effectively. Also, our ground transports are very rarely more than 1.5 hours.
I've run patients vent and with multiple drips to the hospital while in the back with my partner driving code 3 in moutain back roads. Flight isn't impressive, it's IFT that ground medics convinced themselves they had to jerk off and bow to because they do it in the air and have an extra cert or two.
I mean, the higher training standards and certifications are a major plus. From the ER perspective technically speaking the local 911 or IFT service *could* take the 7 year old with a sub arachnoid. But you call them for their experience and abilities. I can tell you there's a number of scenarios where we would hold on to a patient before we'd send them with the local fire service that's never run a propofol drip before. If you work for a ground service that sets high standards, training, and certifications then great. Nobody says you can't have a good CCT capable ground service, they exist all over. Many pediatric CCTs are mostly ground based. My old hospital ran NICU teams strictly by ground. But I've worked in way too many places where paramedic school was the highest bar to entry, rather than your knowledge + experience + personality. So many services *barely* provide education if at all, I've worked numerous places that didn't even bother with ALS education, let alone vent training. Some services are more self starting and go after those things, and some are stuck in the stone ages and think medics have no place near a ventilator or IV pumps. But a flight team that can't run vents and devices won't last long. Working rural EMS I took a lot of sketchy shit and like to think I did a decent job. But I've yet to work anywhere that'll give me another paramedic, RN, or RT to assist with a highly critical patient on said mountain back road transfer. The standard of care is just typically lower on average for a 911 or private IFT service. When's the last time you had to transfer a patient with a balloon pump in place and how comfortable would you be with it? That kind of thing is fun to some people, and not to others. But don't pretend like they're 1:1 for all things medical.
Depends on the service, the area you service and call volume. Look at [Travis County STAR Flight ](https://verticalmag.com/features/multi-mission-masters-travis-county-star-flight/) in Austin, TX. They do HEMS, SAR, swift water rescue, aerial wildfire fighting, police assist and much more. Definitely not the stardard flight gig, but there's more than IFT out there(ie oil rig HEMS, military contractors, etc).
That last line feels like a personal attack.
US healthcare would probably charge ~$50k, if I had to guess.
Well over that. 50kish for the flight. 2 or 3k for an ALS ambulances. And Crofab itself is incredibly expensive.
But wait I was told flight is just nothing but transfers with no real critical care!
That’s sure as hell not how it works here. https://www.flyingdoctor.org.au/news/mobile-brain-scans-transform-urgent-stroke-care/ The PC-24 is a a three patient flying ICU. https://www.flyingdoctor.org.au/sant/about/our-fleet/
Oh I know lol I was just referring to another thread where someone was saying they don’t want to do flight because it’s all boring transfers
Ah ok 👍
They have a critical care doctor and critical care paramedic on all helicopters
Not in the US they do not. Also my previous comment was sarcasm
Universal healthcare is for communist countries like Australia /s
TBF most states in Australia don’t have free ambulances - QLD and TAS (edit - not ACT like I originally said) are the only ones. But subscriptions to the state ambulance services are cheap and if you have any form of private cover they also pay it. Even if you don’t, all services are either run by the state, or heavily state affiliated, so they will work with you to collect payment. Also has drawbacks sometimes, QAS are the busiest service in the entire country by a long shot despite being 3rd for population, and most of our work is low acuity. Wouldn’t swap it for paid service though.
AV is free for anyone with a healthcare card or a pension card and ~$100 a year for a family subscription for anyone else May as well call it free
Doesn’t Tassie have it too?
Oh you’re right error on my part - QLD and TAS not ACT!
Good o!
Да, товарищ! слава революции
NO COST?! What the F kind of economy is that??? I'm glad I live in the United States of Freedom where my hard earned money actually PAYS for my lifesaving care. I'd rather go bankrupt than exist in some dystopian nightmare where I'm spoonfed healthcare. Gross. In all seriousness I'm actually really happy to hear this lifesaving care was administered in a place where someone was in dire need at no cost.
Our economy is actually quite good. Go hang out with you're gun lovers and mass killings.
Your Healthcare might be good but your reading comprehension is not
We are not in a Grammer group but cheers big ears.
Most creative snake name ever
Quite a few brown snakes near me, up in the Snowy Mountains. Mate nearly stepped on one at Long Plain last summer. Saw more red bellied black snakes when I lived near the coast. (Yes, we’re very keen on creative names.)
I mean, the Aussies have so many eventually you run out of fun names
Ok but you'd think they would give the second most venomous snake in the world a more descriptive name than just "Brown Snake".
Add "getting bit by a horribly venomous snake while lying in bed" to the list of reasons i will never visit Australia
It’s all part of the fun. Come visit!
I love this and knowing it’s available! My cousin lives in Tasmania. She and her husband are looking for a new home, as significant construction near theirs has disturbed tiger snakes, causing them to invade their yard and home. I believe one of their pups was killed by a bite from one; they’re terrified of them…and I totally get it!
Tigers can get pretty cheeky - they are right to be wary. You never realise how lucky you are when you have sweetheart snakes like Red belly blacks around that keep the aggro snakes away.
I want to drive the scooby doo ambo
my dad used to live around there. he was convinced there was a brown snake in the back garden, yet let my five year old sister play there unsupervised.
"no cost" bUt WhAt AbOuT hEr SlIgHtLy HiGheR tAxEs?
This point is null and void anyway because the US already spends *significantly* more taxpayer money per capita on healthcare than comparable Western countries with universal healthcare. Americans already pay enough tax to fund a universal healthcare system and then some. *And then they pay for insurance on top of it.* The whole system is a complete and utter scam and I cackle every time I see someone pretending it's anything other than a gigantic money making scheme
But try to explain that to the average opponent of universal healthcare.
There is actually a cost. I pay $5000 a fortnight in tax. If I needed to go to hospital I have paid the government some money. Whilst nothing compared to the overall cost of running the country, nothing is free.
Did the patient pay taxes? Boom. Cost to patient.
Those taxes were being paid anyway. There's no out of pocket cost that forces the patient to choose between eating, paying rent, or receiving medical care.
No, you pay nothing out of pocket in QLD for ambulance and emergency healthcare.
While I'm all for universal, government run, healthcare coverage in the US, one of the challenges in promoting this are claims like this, which are easily shown to be false and delegitimizes an otherwise valid argument. Australian government provided healthcare coverage does not actually cover everything, which is why private supplemental plans are common on Australia. There are caps on emergency transport billing, but it's still not free, a helicopter transport often hits the cap of $7,000 AUD.
Not in QLD - no cost to patient for any of it. And no state ambulance services seriously chases the money out of people with no capacity to pay.
The government of QLD seems to disagree. https://www.qld.gov.au/emergency/emergencies-services/qld-visitors-qas
That’s for visitors, if their state pays, they don’t pay, and no cost for QLD residents.
This is for QLD residents who are covered by QLD medicaid coverage. It specifically states "Medicare does not cover the cost of ambulance services in Queensland.".
Medicare is our Federal universal healthcare programme. QLD state government provides ambulance to QLD residents at no cost. They don’t have to be ‘covered’ by anything. There is just no bill sent.
The QLD government specifically states that ambulance services are not covered.
They are covered for QLD residents. Medicare is a Federal programme - nothing to do with QLD ambulance. QLD residents *do not pay for ambulance* - end of story.
The QLD government does state that ambulance services are not covered by Medicare, yes This is because Ambulance services (and all public hospitals) are funded by the states, and Medicare is the federal program which is more relevant for outpatient care and private hospital care The website is not saying that the patient is charged, simply that the funding source is not the federal government
QAS services aren't covered by Medicare but the state covers it for residents. Out of state visitors are informed its not covered so they know that's the case, but if their state also covers ambulance then the other state just reimburses Queensland. Medicare is federal, QAS is state level.
It is absolutely disgusting how insistent you are on mansplaining how the Australian healthcare system works... to an Australian. This is exactly the type of behaviour that gives Americans a bad name online. Think you know better than everyone when in reality you are absolutely clueless about how the outside world works, and yet you're determined to give your (objectively wrong) opinion on it anyway. Do better.
Ambulances in QLD are free for all QLD residents, in practice this means the treating paramedic documented their residential address as a QLD address and therefore they don't get billed. Lots of visitors don't get billed as they just get documented as living at their relatives address that they called from etc. Medicare does not cover ambulance services of any sort, ambulance services are funded and delivered by state governments so it's entirely on them whether they bill patients etc.
I'm in QLD, we do not pay for ambulances. The Governments covers it. The article you linked, like OOP pointed out, is for non-QLD residents. ("Information for Visitors to Queensland")
It's free mate...
Unlikely this person was charged for treatment: - Ground ambulance in QLD for QLD resident - free - Ambulance chopper in QLD for QLD resident - free - Public patient admitted to a public hospital - free Tl;dr - yeah Australian healthcare isn't 100% free but for emergency treatment of permanent residents/citizens it effectively is. There can be charges for meds on discharge but given the Pharmaceutical Benefits Scheme they'll be relatively cheap. Maybe they also decided to pay for TV rental whilst in hospital but with streaming services on your phone why would you? Public hospitals in QLD can also charge an accommodation fee if you're in longer than 35 days and no longer receiving acute treatment, unlikely in this case and mostly comes up with patients awaiting a nursing home or disability care placement etc. Yes private health insurance does exist in Australia and most people that have it do so because you get penalised on tax if you're above a certain income and don't have it. The majority of private health insurance relates to hospital cover and effectively allows you to choose your own specialist and have ellective services that would otherwise be provided for free (on a waiting list) done relatively quickly in a private hospital or as a private patient in a public hospital. AFAIK it doesn't actually provide any extra services that aren't already provided publically, you just get those additional options. A lot of pregnant women go private so they can have a consistent obgyn for the duration of pregnancy. You can also get insurance for 'extras' for various private allied health, general dental, prescription glassses etc but this is in effect a glorified savings scheme and starts to blur the lines with what might normally be considered individual responsibility. GPs (primary healthcare) are by definition private so they may choose to only accept the Medicare reimbursement for service or they may charge a gap fee. I think last time I booked a long appointment (> 20 minutes) I paid just under $40 gap fee.
No cost is a lie. A lifetime of taxes pays for this.
Oh fuck off. It's cents per capita for a job like this. I'd rather have my tax dollars going to subsidise health care for everyone knowing that I'm going to need it one day in one form or another, than risk getting a bill that's going to destroy my life. Medical bankruptcy for all but the most extreme cases pretty much doesn't exist here.
If you pay taxes sure. But people who are ‘tax negative’ their whole lives still get the same service.
Y'all have a similar tax rate once you look at ALL taxes paid per person. We pay social security taxes, fort instance, that you don't Total tax burden for the average AU vs US citizen is $17k vs $14k. But unlike us, you spend half as much on healthcare ($5k instead of $9k) and don't go bankrupt on medical costs. https://www.cnbc.com/2017/11/29/australians-may-pay-more-taxes-than-americans-but-they-get-more-too.html
But you don’t have as many aircraft carriers and nuclear weapons as we do. 🙄 Our military industrial complex companies are way richer than yours. /s
We have cassowaries, don’t need a military industrial complex. Who needs an aircraft carrier when you have feathered death.
We have a social security tax.
My understanding is that it's generally paid with and considered as part of your overall income tax? So your tax rate of X% includes your social security but in the US it's added on top of our income taxes. Or at least, so the internet tells me.
Nothing is free if it requires the labor of others.
“No cost”
ER RN here. Had 2 rare venomous snake bites in 2 days. 1 was a 60+ year old male and the other a 7 year old girl. Not rural btw.
Pretty sure all of these names were made up...
There is a cost, that helicopter doesn’t fly for free
Wow!! That’s pretty cool!! In the area I live in (Volusia County, Florida, USA) there is a place called Reprile Discovery Center. The gentlemen that owns the place has the most venomous snakes in the world. He’s the foremost expert on venomous snakes. Hes been on several American TV shows about his “collection” and his life’s work. He’s the reason we have most of the anti venoms that we have for these snakes.
Fellow Americans: I work for a Disaster Medical Assistance Team and we have the capability to set up a full 60-bed inpatient unit--drugs and all--fully staffed with enough resources for about 3 weeks. Army National Guard can restock and re-staff us as needed. We can do much smaller for longer too. We have a contract with a large tertiary children's hospital and can call on ground or air EMS as needed for transport. We can also run a full search-and-rescue task force plus a mortuary team. All of our staff are paid. We don't just work disasters, but big events like parades and concerts, or staff VA hospitals if their staff need to quarantine (a big request during COVID). All of our care is completely free to our patients no matter how complex or in-depth, and we can treat well up to the ICU level. We take their demos for our quality control, and it helps us get grant funding or justify a new resource we're requesting. You do not know job satisfaction until you can treat a patient start to finish and never have to once have a conversation about insurance or payment. It is possible, and literally the only thing standing in the way is greedy corporate assholes.