Reducing the Cost of Health Insurance (-pat on my own back)
I helped save over $1,200 of tax payer money last night!
One of my part time jobs is with a private ambulance service in a major city. Most of our work is moving people from one medical center to another. (from an Emergency Department to a nursing home or from a community Emergency Department to one that has the specialist or rooms for the patient.)
As a result most of the people using this service are on Medicare or Medicaid (50% or so) or uninsured (10% or so). Ambulances are not cheep. If you have ever used one you have seen that.
There are three levels of care in the area I’m in, and in the four different states i’ve done private ambulance work in. (the army moves you about a lot so you get a look at how different states do things)
The first level is ‘ATS’: Alternative Transport Service or “Wheelchair Van”. This is mostly people who can’t walk far or at all who need to go home from the hospital or to a nursing home after a surgery. They don’t need much help medically and most drivers are not Paramedics or EMT’s, they just get CPR trained and how to work the lift. Not a lot of training to get, and often they are paid a bit less than an EMT. (Here they start at $9.50 per hour) The cost for this service is ruffly $50 plus a $3.75 per mile charge from where you start to where you end.
The second level is “Basic Life Support” Ambulance. Here is a real ambulance, but just a basic level of medical care. Oxygen, splinting, monitoring of vitals, and other basic care as allowed by the state you are in. One driver and one person in the back with the patient. These two are trained at least to the EMT Basic level of Emergency Care. Requires a State certification and continuing education to maintain it. The cost for this service starts at about $350, more if Oxygen is used, or other equipment, as well as the per mile charge which here runs $6.25. (Here we see EMT-Basic’s start around $10 to $10.50 an hour)
The third level is “Advanced Life Support” Ambulance. Here the patient is getting a Paramedic providing care/support. They may be receiving medication in transport, IV, Cardiac Monitor, ventilation, etc. All the “cool” stuff you see on TV, but more likely what the person had in their hospital room going with them. (even the machine that goes “BING”). Again you will have two people in the ambulance, one at minimum is a Paramedic, the other often is an EMT-Basic. This service starts at $950, more if equipment and medication is used on top of the per mile charge. (Here a Paramedic will start at $14 per hour).
Now, how did I “save” tax payers money? Two calls last night came in as “ALS” because the patient was receiving fluids through an IV. Which meets the requirement for ALS. On arrival the fluid was about done and the Nurse was going to change out a new bag. I asked if the fluid was needed for the 20 minute trip and he said no the receiving hospital could hang it there. Since there was now no fluid hanging, it no longer meet the standard for ALS, but rather BLS. I let the nurse know this and he was not aware that there was a price difference.
When we came back for the second trip, same set up but this time the nurse planned ahead and ended the IV fluid. Making the trip BLS. Both patients were on Medicaid.
I hope this will develop a longer term savings because I explained to the nurse team and doctor at this standalone Emergency Department the rules for pricing and care. The nurse I dealt with said he would be more aware of transport decisions for level of care. You can send a person with an IV Lock (an IV without fluids running) for short transports as a basic run and $600 less. If you are just sending the patient with fluids running for the only reason of keeping the IV open – preventing clotting of the catheter- it becomes ALS. Short trips don’t need the IV bag flowing, so why not keep costs low?
If we could get more Health Care providers to consider the cost before ordering something, we could see lower costs.
New York’s Oppressive Gun Laws will cost the State.
I’ve sent the following letter to several papers and the cc at the end:
An Open letter to the Citizens of New York and its government;
I am William V Kone, the seventh generation to be born in Tompkins County New York. Because of Military Service, I have not lived in New York for over half my life. In that time I kept my residency in New York because I always planed on returning when I retired. I have now given up that hope and my residency.
It only seems fair to give the reason for this decision to sever ties with a State that my family has been an active part of since 1794. The final act by the government of New York that has caused this is the recent passing of yet another anti-firearm law. That is the last straw.
For years I let NYS tax my income even while stationed in other states, paid the high fees to register and inspect my cars, paid high property taxes, struggled though excessive regulations, and begged for permission to own a firearm even though it is a right listed in the Constitution I have sworn to protect and defend.
But no more. The recent oppressive law will not allow me to bring home my firearms, will make me a felon for a “violent” crime of having empty magazines (a “crime” that only exists in 5 other states), prohibit me from ever giving my firearms to my daughters, restrict my ability to protect my family, and make it a crime to have more than 7 bullets for my daughters to protect themselves with.
That was too much. On top of all the other issues, the high taxes on income, the high sales taxes, high property taxes, excessive rules on land use, restrictions on building homes, large number of fees and fines, high crime rates, the high cost of living, and low quality of roads and services this law and the new ones being proposed to take away all semi-auto rifles is too much.
Some of you are saying “good riddance, we don’t need your type here anyways”. I’m sorry you feel that way, New York is losing a stable family that is highly educated, hard working, has a history of public service. No more will I pay taxes to NYS, sales, income or any fees. I won’t be setting up a business after I retire in New York. My kids are not likely to go to college in NYS or get jobs here.
New York is losing a firefighter/Paramedic, Emergency Manager, and military vet in me, and an Industrial Engineer and Minister in my spouse. We won’t be building our dream home that generates property tax, we wont be earning income in New York to be taxed on, we won’t be paying the high cost of living that generates sales taxes.
We will be retiring to some place that respects our Constitutional listed rights, that does not treat us as sources of funding for others, that provides good service for the taxes they do collect, and is more responsive to the voters. (and able to budget with out massive debt servicing). We are looking at Ohio, Kentucky, Indiana and New Hampshire.
We will still visit, just not as often, or need to as more of the family moves out of state. I would urge others to look at how the state treats you, and consider moving. If you do, write the Governor and state officials, let them know why and what the state is losing when you do.
To the Citizens of New York, We live in a Republic, we don’t have to stay where we are not wanted or are treated badly. Other states are excited to have firearm owners who will work hard and are good neighbors.
To the government of New York, repealing this recent bad law won’t get me to return. The state needs to make fundamental changes. It can’t keep treating working citizens as piggy banks to be taxed, fee’ed and fined at will to fund inefficient unneeded programs. It shouldn’t and can’t keep restricting the basic rights of the Citizens of New York. You don’t own us, we will leave.
William V Kone, BSc, NREMT-P
currently serving in US Military in a unit in Wheeling WV.
Former tax payer and resident of the Town of Caroline, Tompkins county.
cc: Governor Cuomo; LT Gov. Duffy; Comptroller DiNapoli; AG Schneiderman; Sectary Perales; Sen. Seward; Assembly Woman Lifton; Mayor Myrick; Supervisor Barber
Mayor Myrick and Supervisor Barber are outspoke gun haters. Barber is well known for calling all semi-automatic rifles “automatic machine-guns” or “rapid fire automatic guns”. I doubt it will do much, this letter, but i’m hoping others will see this and give thought to leaving. I don’t think NY will change. The system is to stacked to keep the existing power mad representatives in power.
Gun Control, yeah I know.
People say you should not post about hot topics or such. But I feel the need to put public a conversation I’ve had with a pro-gun-control advocate. To be fair, it was the most rational conversation i’ve had in the last few days.
My argument was that most of the gun control ideas being pushed would result in a defacto gun ban. No they would not ban all guns, but the ideas if enacted would result in fewer people being able to own guns, and that this was the short term goal. The long term goal is total ban. The writer said he had ideas that did not do this, but were rational and would have prevented the murders in Connecticut. (his comments are in italics, my answers in normal. His posts were in two grouping’s, i’ve put my answers in between as if it was a conversation.)
1. All Firearms sold, resold, or gifted here on must be Registered.
1) you want to create a national registry of every weapon a citizen owns and track that ownership as a way to prevent crimes? In other nations the national registry was used to confiscate weapons (Australia, New Zealand, France, etc) or to target minority citizens (Rwanda, Turkey, Kosovo – by the Serbs). New Jersey used its registry to go after “assault” weapons which it made illegal with out a grandfather clause till the courts ruled otherwise. I don’t see how this will prevent what happened here, as the weapons were all registered with the state.
2. All people Purchasing Firearms Must have a License.
2) License requirements are specifically designed to restrict ownership. They ad additional costs to the ownership of what ever is licensed, allow additional restrictions on the use of the items licensed, and turn a right into a privilege granted by the government. This makes it much harder to afford to buy, driving low income people out of the market, it also adds an expense in time to jump through hoops to get, costing more money in lost wages. Further depriving low income people of the right to buy. In addition, Conn required all owners to hold a license, which the owner did hold.
3. To get a license one needs to complete a NRA level qualification course.
3) Would this be for each weapon? Or just one? Even then, all this does is raise the cost to own a weapon, depriving low income families of the ability to have effective means to defend themselves. It also makes it hard for average people to meet this requirement which would restrict access even more. All this serves is to increase the cost of ownership to a point that prohibits all but the wealthy access. It is not cheep to give up two days for a 16 hour basic course, in my case that would mean $240 less in earnings on top of the cost of the course which is not cheep. Oh, and in Conn, the owner had taken several gun safety courses along with her sons.
4. To get a concealed permit, or license to distribute firearms, you need liability insurance.
4) Insurance for liability is also another way to raise the cost of ownership. What would be insured against? That you as a owner misbehaved with the weapon? (you are liable under crimal law and civil law now.) Or that it is to cover the cost of defending yourself/family in court when you do use the weapon to save your loved one’s lives? (being sued by the attacker is not uncommon, how much more common if they know you have access to money?) The wealthy won’t have a problem coming up with the $200 a year but many gun owners will.
5. All states must coordinate and share databases on Firearms registration and gun crime.
5) Having the Federal Government take over what the States currently do is an interesting argument, it would force the four states that don’t require State registration to start, and would allow the Fed Gov to have a complete idea of who owns what. (at least those who follow the law.) Which I point back to #1. Currently the FBI tracks gun crimes, granted there is no requirement that all police departments submit crime reports to the FBI but it is around 95% now. Still not seeing how that would prevent this other than we could be sure that the FBI is informed of the crime.
6. Converting a weapon to fully automatic requires a special license.
6) That is already the law. In fact, merely owning the parts to make such a conversion is illegal with out special permission.
7. Adequete incentives need to be provided to bring in and register existing firearms not already in the system.
7) Well if you’re going to do #1, this would be a good idea. But I like to point out that “incentives” when used by the government seldom are friendly and often are expensive.
8. “Assualt” style weapons will be deleted as a category of weaponry. Automatic, Not Automatic, Shot Gun, and barrel length are the only Categorizations necessary for detailing levels of Licenses available.
8) I could go with this one. Automatic, Non-Automatic, Shot Gun. I like that. Right now we only have Automatic, Rifle, Pistol, Shotgun. It would end the non-sense that Ms. Feinstein is pushing with her AWB law (that uses type of stock, color, and cosmetic features for her ban). However you slip in another thing here: “the only categorizations necessary for detailing levels of Licenses” your licensing plan would have levels. Each one would result in more cost, more training, more fees and less access for the non wealthy.
Four of the eight ideas you would like to see, would reduce the ability of average people to own weapons. Not directly by law, but by cost. This is what I mean by a defacto gun ban. Each would increase the amount of time and money to be able to buy a weapon that could be used effectively to protect your family. Sort of like saying “you can use all the pot you want, just pay the tax. Except the tax is $200,000 an ounce.” See no ban here.
Three of the eight really just enforce the first four. (and adding a cost borne by the tax payers or will require fees in addition to cover the cost)
It could be argued that five of these ideas are currently law in Conn, and did nothing to stop the crime. In the last several shootings these laws were already on the books. Even still, 6 is the law.
These are slightly different from what I have seen as “reasonable” but they still result in making it harder and more expensive to own firearms, driving current gun owners to give them up due to the cost and preventing new gun owners from coming in. This is what I oppose. I am for lowering the cost of entry, making it easier to have new people join in. (though lately at the range it has been very crowded, and at times I miss the old days when hardly anyone came.)
Raising the cost is a defacto ban. It just hurts the low income hardest.
His response to my answers was:
My Driver’s License cost $34, my car cost $20,000. Trust me, the license didn’t prevent me from buying a car.
Driver Licenses cost less vs the value of the car. In NYS,[where the writer is from] to get a permit it cost around $95, plus $5 each time you want to make a change to your permit, plus the processing fee which varies by county. You spend close to $200 for the first gun just to get the permit. (you have to cover the cost of the Fingerprint check, back ground check, taxes, etc)
When you look at the cost of a gun, say $250, spending $200 to get a permit to buy the $250 gun becomes more of a concern. (add in the time needed to complete the process means loss of work time. I had to take two half day’s off each time I wanted to buy a firearm to get the coupon and permit amended.) Now if the permit was $34 every two years that would be different. But that is the problem. Pro-gun control advocates want to make it harder for people to get guns. They can’t pass laws to ban them outright, but can make it so people are less likely to make the effort because it cost so much in time and money.
This is why NY has such low rates of gun ownership, the cost is to high to get in and with the additional requirements (where you can carry, what you can shoot at, where you can shoot, what ammo you can own, etc) The result is even if you own a weapon, you can’t do much with it so why bother with the cost.
Yes, it is a restriction on my right to own, which is the goal. I don’t like that this is the case and is why I fight against it. I work three part time jobs to make ends meet, and $200+ a year to be allowed to own what I own, in addition to some of the other ideas you said you would like, could turn this into $800 a year or more. (Training, insurance, taxes, transfer fees, etc)
What happens when I end up with the choice of paying the fees/taxes/license or paying rent? I have to give up my firearms. We have to eat, I might not need to defend my family again. Because of money I play the odds and hope that no one will try to attack me and mine. In the mean time I’ve had to give up family history.
*******
I’m not sure this is a good reply to a pro-gun control advocate, but I think it makes clearer what these “reasonable” ideas are aimed at. Reducing the number of people who have access to guns.
Seceding from the United States
I have been asked about these “secede” from the US petitions on the white house web page.
All these petitions do is get a response from the White House. That will go something like this: “Thank you for your interest in the workings of the government. We take pride in responding to the questions and requests from the general public. But after careful consideration we will be unable to comply with your request.”
I would answer these petitions like this:
“You anti-American scum who hate the Constitution and this Nation so much that you would destroy this Nation that I and millions others have fought to defend. Get Bent. You are less than 1% of the Nation’s population, have expressed your opinion, and you are wrong. You would destroy this Nation because you are not getting your way rather than working to fix things. My two year old is better behaved than you. You may hate this Nation, hate the Constitution, but fortunately 99.8% of America does not.”
See, what these people want is to rip apart these United States because they do not like the result of an election. One election did not go the way they wanted so now they want to tear apart this Nation. The same people who will be the first to say they love America, are the people demanding to take their state and leave. These are people who hate the US and the idea that anyone other than them should have a say in how this Nation is run. When they don’t get their way or don’t like the rules everyone has to live under they demand special treatment at the same time complaining that others are getting special treatment. These are the people who will complain about everything and are never happy unless they are the one in charge and no one else has any say.
They are not part of America that loves this Nation and upholds and defends the Constitution.
Veterans day, why i’m not excited.
It is veterans day. I always feel weird when someone thanks me for having had the privilege of serving the nation. Some of this is from the fact that I have served, but I have been paid for that service. I was/am just doing the job I volunteered to do and have been paid for.
After all, do you thank the dustman for picking up your trash? Do you thank the casher at the store for ringing you up? Or the highway worker for filling in pot holes? Not normally because you say “they were paid for their work and they chose to take that job.”
I know, I know, military service is different to some extent. It is more along the lines of Police and Fire/EMS service. Maybe the thanks is some understanding that this voluntary service has some higher risk than other employment.
Lastly, I feel weird when I get thanked because serving is a privilege. Not everyone is allowed to serve. In fact I would not be allowed to join the military today because of something that happened to me when I was 8 years old. Only a select number of people get to serve. And it saddens me that so few over all even try to see if they can serve. Being thanked for being allowed to serve feels weird also.
I appreciate that I will be thanked. It has been a privilege to serve. But if I don’t seem thrilled to be thanked, this is why.
We were thrown out of our house!
Yesterday we got “thrown out of our home” by the North Olmsted Fire Department. Our neighbors, a garden supply store, had a propane tank spring a leak (or a leek as it was only a week after St. Crispin’s day, ah those funny Welsh)
At 0555 we woke up to someone pounding on our door. Turned out to be a Fireman who greeted us with “Not the news you want to hear first thing in the morning but we are evacuating the area”. This was only a short time, about five hours. But it could have been longer, up to three days.
I know most of you think i’m all squared away, high speed, low drag, really cool Emergency Management Grad with tons of great ideas? I’m not. We did not have our BOB (bug out bag) ready. What was on the list to put in the BOB was lacking also. Had they wanted us to shelter in place, we would have been in even more confused state.
So, I would ask each of you to do something: get a pad of paper, pen or other writing tool, and sit down. Write down everything you think you would need to go away for three days – cloths, food, toys for the kids, family entertainment, chargers for electronics, maps, etc. Then go get it all and put it in a pile neatly. Then get a bag or tub that will hold it all. There, your BOB is now done and you are better off than we were.
The “Most important election of our Life Time! (Again)
Freedom is not free. Freemen are not equal. Equal men are not free.
Last night at the ICU i had a small conversation with the Charge Nurse. She was urging everyone to register to vote. She explained that “this is the most important election of our life time” (something i’ve heard every four years since 1984) and “you realize that if just 2,000 more people had voted in 2000 we would not have gone to war”.
I normally don’t get involved in these kinds of talks when I’m doing the student thing as part of my Paramedic training. I’m there to learn not talk politics. But this time she asked me directly “are you registered to vote?” and I said “I don’t like to encourage politicians, voting just makes them want to do more.”. Normally this gets most people to drop the subject and we can go on with life. But then she told me those two statements. I felt that I was allowed to give my view.
I started with a response to the “Just 2,000 more votes statement”. ”You mean had just 2,000 more people voted for Gore, not just 2,000 more people voted. Because 2,000 more votes divided up would not change anything.” This got a statement of agreement and a restatement of if Gore had won in 2000, we would not have gone to war, “see all those lives lost or gone into debt”.
“No, we would have gone to war, likely lots more wars.” was my response. The Charge Nurse said no because it was all Bush’s fault for the nation going to war. Because Bush was President, she said, the US got attacked on 9/11 and it was just an excuse for Bush to invade Iraq.
I then explained: No, you have to keep in mind that Bin Ladin started planning the WTC attacks in 1999, under Clinton/Gore. This was in retaliation for the Clinton/Gore policies of embargo of Iraq, deployment of US troops in Saudi Arabia, bombing of Afghanistan, Yemen, Kenya, Nairobi, Iraq, and support of Israel. Keep in mind that Gore, in the debates with Bush, restated his support of all that and a call for further “nation building” that worked so well in Serbia, Kosovo, Macedonia, and Somalia. Gore had repeatedly stated support for sending troops to Sudan, Somalia, and other “failed states” to include Afghanistan and Iraq. Gore also supported the embargo of Iraq, regular bombing of Iraq and expanding the number of troops in Saudi Arabia. While Bush campaigned under the idea that the US should not be sending troops to invade other nations that are not a threat to the US.
The only rational belief we can have is that, as Bush stated, the that the attack on 9/11 changed his view. Gore, on the other hand, was willing and eager to attack Iraq, Afghanistan, Somalia, Sudan and other nations with out 9/11. 9/11 was going to happen either way. Gore was on record as being in favor of war with out provocation, and he would have been chomping at the bit with it.
The Charge Nurse gave some weak response that Gore would have made Afghanistan a priority and would have used peaceful means to change Iraq and would not have cause the US to become so debt ridden. She touted out the lame “Clinton left the budget with $5 trillion is surplus” To which I said “that is not true, Clinton took office with $4.3 trillion in debt, he left office with $5.6 trillion in debt. The ‘surplus’ was projected for 10 years into the future with the idea that the budget would only grow at 2% a year, for ten years and the tax revenue would grow at 5% a year in that same time.” Now Bush did not help thing with his tax cuts AND doubling of government spending growth on top of the war spending.
Over all, she did not change her mind. Gore would not have invaded Iraq or Afghanistan, he would have kept a balanced budget for 8 years and paid off the national debt, and 9/11 would not have happened. And if I had any understanding of what that would have meant to the Soldiers I would not be so non-political. That is the thing about politics, you don’t change politically active people’s minds with facts. Only emotions over minor issues by making them either or issues. After the Charge Nurse left, one of the other nurses who had been tuning into the conversation asked me how I knew so much. I explained that I was in the Army Reserves, was on Active Duty in 2003, so I knew what it meant to the Soldiers. So I pay attention and remember. This may be the most important election in our life time…again. But i’m not going to vote for evil, even if it is the lesser of them, it is still evil.
Freedom is not free. Freemen are not equal. Equal men are not free.
