Y'all thought shit was bad?
My wife just came into our home office and checked her email, at which point she was alarmed that her lab visit from the NIH to review a project was cancelled. Evidently, the Trump/Musk administration has frozen meetings, travel, and communications for HHS in addition to the typical government hiring freeze when administrations change. Since the proposed cuts to research could be detrimental to her career prospects and render her PhD in immunology useless, I couldn't help but to start investigating how fucked up healthcare is about to get....
- 40% of EMS transports are for patients covered by Medicare. Currently it is unclear exactly what kinds of changes will be made to Medicare that directly impact reimbursement for EMS. However, physicians are receiving a 3% cut and Trump has revoked executive order 14087, which was designed to identify a list of prescription drugs that would, under the plan, require only a $2 copay a month for anyone on Medicare.
- About 16% of EMS transports are patients covered by Medicaid. (Honestly, I think that number sounds low..) Eligibility is based on percentage of federal poverty level income and household size. States can choose to expand coverage to adults at up to 133% of FPL ($15,060/year for an individual) and all 50 states currently cover children at up to 133% of FPL. Currently the Feds match the state's contribution at no less than 50% for these programs (less wealthy states are higher), but some GOP members are calling for a match rate as low as 40%.
- Not a fucking thing on your rig is made in America. If your rig happens to be a Ford, it was likely assembled in Mexico. Add whatever ridiculous tariff to that already insane expense.
I'm sure someone will want to nickel and dime me on math here, but that's beside the point. EMS is already an afterthought and I have yet to run across an agency that is flush with cash, pays well, has nice shit, and provides a decent working environment. Any gains on reimbursement, grants to better the service, or anything else positive is about to go out the fucking window. Local governments may step up and implement new taxes that can help, but I don't see how any low-income and/or rural area is going to make a big enough dent in the cost to cover it. Large metropolitan departments that provide fire/EMS can probably weather the storm with some penny pinching, but the vast majority of private and rural services are going to find themselves in FUCKED UP situations.
Safe to say that EMS wages aren't going to improve any time soon... but, we're all used to having 2 or 3 jobs!
Sarcasm aside, this REALLY isn't about politics. These are human beings that aren't going to get the preventative care that they need and in turn are going to further rely on emergency services. Then, with a higher workload and less recuperation of costs, EMS providers are going to keep getting the same shit-end of the stick, and will eventually go do something else.
There are really only two possible outcomes:
More people relying on services, less funds to operate with, services can not afford to keep the doors open.
A hysterical mother meets you at the front door holding a small child that's pulseless and apneic and you are required to obtain proof of insurance or a deposit payable by credit or debit to begin administering care.
And if you have no problem with outlook #2, what in the actual fuck are you doing here?