There was another Task Force meeting in mid July that I could not attend.  I’ve heard that Jackie Wright was there and took minutes and sent them to Trustee Chris Thomas.  I’d like to see them!  So I asked the Village Clerk.  She hasn’t seen them.  I asked Jackie Wright.  She said that she had sent them to Chris Thomas, and didn’t feel comfortable releasing them directly to me.  So I wrote to Chris Thomas and every member of the Village Board and the Ulysses Town Board, requesting the minutes, on July 17th.  I haven’t heard a word from any of them. So on Monday I filed a Freedom of Information Act request for them at Village Hall.

Here’s a number from Amy’s Senior Recital.

This is a growth industry.  We should be asking ourselves if we want to help it grow.

There was an article in the New England Journal of Medicine in 2003 titled “Costs of Health Care Administration in the United States and Canada.”  http://www.pnhp.org/publications/nejmadmin.pdf

results
In 1999, health administration costs totaled at least $294.3 billion in the United States,
or $1,059 per capita, as compared with $307 per capita in Canada. After exclusions, administration
accounted for 31.0 percent of health care expenditures in the United States
and 16.7 percent of health care expenditures in Canada.

conclusions
The gap between U.S. and Canadian spending on health care administration has grown
to $752 per capita. A large sum might be saved in the United States if administrative costs
could be trimmed by implementing a Canadian-style health care system.

But our Village Board wants to move in the opposite direction from that advocated by the authors.  We have a Canadian-style EMS. But our Village Board wants to add to the $752 per capita difference, by inviting the third party billing company, and the private insurance companies, to profit off of our EMS

Our EMS has almost no administrative costs now, but the Village Board wants to hire a “third party billing company”  to handle the complicated billing and coding, and then send bills to the insurance companies who want that bill, so that they can be part of the game and profit off of it.

And if that’s not bad enough, it will decrease volunteerism, and people will be less apt to call 911 in an emergency for fear of the cost, which will increase the mortality rate.

Pathetic.

audio clip

Now that the Town Board has withdrawn that support (see post below) he not only is continuing to push forward, but he is ridiculing the Town Board for their position.  “Disingenuous” is a good word to describe this, but Chris called the Town Board members “disingenuous” at the last EMS task force meeting!

audio from June 24th Task Force Meeting

Mayor Petrovic should ask for Chris Thomas’s resignation.  He has announced that he intends to sell his house and leave the area. The only reason that I can imagine that he continues to push for ambulance privatization, is to pad his CV.

Trumansburg artist Dan Burgevin and his friend Alan Vogel have purchased a 14-1/2-ton diesel school bus which Dan will drive on the 21st Pastors for Peace US-Cuba Friendship Caravan.

The bus, whose purchase was made possible by a matching contribution from the  Fingerlakes Grassroots Festival of Music and Dance,  is in the process of being readied for its thousands mile journey on one of fourteen routes into Canada and through the U.S., picking up aid and volunteers, then across the border through Mexico where the bus will be loaded along with the rest of the Caravan aid onto a Cuban ship in Tampico, destination Havana.

The video is mostly time-lapse photography over a two-day period when the bus was being inspected, lubricated, having the oil and antifreeze changed, washed and coated with white with “gripper” paint –a fresh canvas for a muralist Dan Burgevin to do his magic with the help of volunteers along the route.

The Cuban fusion ensemble Mezcla (who performed at Castaways in Ithaca and at the Rochester International Jazz Festival as part of a recently completed US tour) provides the musical backdrop –appropriately an adaptation of Irving Berlins’s “I’ll See You in C.U.B.A.”

“There’s going to be thousands of miles, tons of aid for the Cuban people.”, Dan Burgevin says upon completion of the first coat of paint.  “I’ll just drive the thing, but the spirit of Trumansburg made this thing fly. ”

Next stop for Dan will be Ontario Canada to pick up humanitarian aid.  He then returns to Ithaca on Thursday, July 8, where locally collected aid –prioritizing construction tools, supplies, and hardware;  medicines and medical supplies; school supplies and sports and cultural materials– will be loaded on the bus.

A press conference is scheduled for 4 pm by the bus in Dewitt Park, with a potluck dinner at the Unitarian Church Parlor at 6 pm with caravan speakers (there will be three other caravanistas joining Dan in Ithaca), Mezcla music video, Cuban percussion and dance (all for a voluntary donation).

This will be Dan’s fourth trip to Cuba with Pastors for Peace.  He wants to remind everyone that there still is time to register to participate in this year’s caravan.  You coiuld literally get on the bus in Ithaca for Cubs.  For more information on the Caravan, go to pastorsforpeace.org.

While in Cuba, Dan will be engaged in a mural project in Havana, which he initiated on last years Caravan.  He will be working with Cuba artists under the auspices of I.C.A.P., the Cuban Institute of Friendship between the Peoples.

Please come to the event on Thursday, July 8.  If you have aid to contribute, or can help with the the Cuban night dinner, send an email to aid-at-ithacacuba.net.

Peace,
Ithaca Friends of Cuba

Ithaca Friends of Cuba website, currently at ithacacubafriendship.org will soon be migrated to a new domain, ithacacuba.net.

Town of Ulysses – Resolution

Whereas, the Ulysses Town Board is concerned that the proposed changes to the Village of Trumansburg’s EMS program are being implemented in a manner with little serious consideration of input from the Town of Ulysses or it’s residents, and

Whereas, the Ulysses Town Board believes that the proposed insurance – only billing plan has not been well enough considered in some aspects that can have serious consequences for equity and ensuring that no one in our community might refuse care or emergency services for fear of the costs, and

Whereas, the community has had little to no input on options to receive EMS that may be more economical or provided in a faster manner, and

Whereas, the Ulysses Town Board also believes that calling the current proposal “insurance only”  is deceptive, and the task force process is not open and transparent with minutes taken and made available to the public.

Therefore, be it resolved that the Ulysses Town Board is not in support of the proposed changes to the Trumansburg EMS under the current process.

6/23/2010

The next evening there was a meeting of the EMS Task Force which exists to implement the plan.  Kevin Romer and Liz Thomas represented the Town of Ulysses.  They passed out copies of the new resolution, and some heated discussion followed, but it seemed apparent that Trustee Chris Thomas (main proponent of the privatization plan) had no intention of dropping the plan.  This is very strange in light of his clear statement last year, that he would not move forward without the support of the Town.  Listen to him hear at a Town Board meeting last year.

link to audio

This same day, Roxanne Marino, Kevin Romer, and Liz Thomas, attended a Village Board meeting and further expressed their hesitations about the Village’s plan. Trustee Chris Thomas then brought forward a resolution including the following,

Therefore, be it resolved that the Village of Trumansburg shall move forward in good faith to establish any and all requirements, policies and procedures necessary to adopt a fee-for-service EMS ambulance service with a target inception date of June 1, 2010.

Thomas –Aye
Hart——–Aye
Hrubos—-Aye
Petrovic—Aye
Nottke—–Nay   (Debbie Nottke is the only member of the board with emergency medical experience)

The Village Board showed amazing contempt for the opinion of the Town Board, and the Town of Ulysses provides most of the funds for the Trumansburg EMS.

It is now six months later, and the Village has done nothing to address the concerns raised in Supervisor Marino’s letter, and they continue to work toward implementing their ill-conceived plan which will risk lives, decrease volunteerism, and raise insurance premiums.

I will post Supervisor Marino’s full letter, and the Chris Thomas’s resolution, in full at http://trumansburgambulance.blogspot.com/

NOW THEREFORE, it is recommended that the town boards of each of the towns which are presently part of the Trumansburg Fire Protection District adopt the following billing policy:

1.  Statement of Policy.
The Village of Trumansburg EMS Department is dedicated to providing quality EMS services, regardless of ability to pay. That is absolutely true regarding the current configuration, and blatantly false as regards the proposed changes.  Financial circumstances will not affect the care that any person receives. That’s ridiculous.  I have posted several epedimiological studies at http://trumansburgambulance.blogspot.com/ which indicate that people are less likely to call for help when there is a fee for service system. Financial circumstances will definately affect the care a person receives if they don’t make the call.  How  obvious is that? All patients will be treated with respect and fairness. Imagine a single mother with an asthmatic child.  She has a minimum wage job, and a health insurance policy with a $5000 deductilbe, because that’s all that she can afford.  Her child has an attack, she doesn’t call, drives the kid to the hospital herself, and the kid dies on the way.  Will the trustees have treated them with respect and fairness? Residents of the district (as defined below) will only receive balance bills for co-pays and deductibles. It sounds like whoever wrote this (Chris Thomas I assume) has decided that the underinsured will not be subsidized and has put it down in writing in this official looking document even though it hasn’t been voted on.  This document ought to say “Draft” at the top. Individuals from out of the district will be required to pay full charges for all services. The fellow from Professional Ambulance Billing said that in Orchard Park 39% of calls were for people out of the district. We are in a popular tourist area with the wineries and the State Park.  Suppose we too are 39%, from outside the district, plus perhaps 12% underinsured with large deductibles.  That would mean that more than half of patients might be billed in full – and more importantly, have a tendency not to call when they need help.  It is stupid to continue to call this “insurance only billing”

The Village Board had still not decided wether or not they will subsidize copays and deductibles and/or pick up the tab for nonresidents who have the misfortune of needing emergency medical assistance.

I was quiet as a mouse for this long meeting.  At the end I politely asked if I could ask a question.  Chris Thomas said I could.  I asked if the reason that they had decided to do this “insurance only billing” was that they were concerned that the uninsured might not call when they should call, for fear of a bill.  Steam started to come out of Chris’s ears, and he said that he would not answer leading questions like that. I don’t understand why this is a not a legitimate question.  I said that I would assume the answer was yes, and then asked why the underinsured, and the nonresidents deserved less of our concern than the uninsured.  Chris then said that I was not at a public meeting, and he refused to answer.  Odd.  The meeting was in the Village Hall which is a public building, that is maintained with my tax dollars, and in fact, my tax dollars support many of the public employees that were present.

The board hopes to begin billing by January 1st, in spite of a multitude of unanswered questions.

Private, for profit health insurance companies shouldn’t exist.  We should have a single payer system (like our current Trumansburg EMS) But, of course they do exist, and hence the sucker fish exist. Medical billing has been made very complicated.  Too complicated for the village clerk to handle.  An entire industry has grown up to deal with this paper work.  My spam filter is full of invitations to learn how to earn a good living in the medical billing industry. Who pays for all this paperwork?  We do.

We don’t need these third party billing companies.  We should leave our EMS structured just the way it is.

My sources tell me that the next meeting where the task force will interview http://www.medexbilling.com/ will be Thursday June 10th at 7:00 at the Village Hall.  (oddly it’s not on the calendar at the village website)

The Village Board has been investigating, for several years, how best to obtain a second source of water for Trumansburg.  No one argues that there is any imminent danger of our primary source failing.  We get our water from a well drilled on the shore of Cayuga Lake.  The water quality and quantity are excellent.  The well is capable of providing us with considerably more water than we are likely to need for the foreseeable future.  Why then does the Board intend to borrow hundreds of thousands of dollars to get a second source, and add this expense to our water bills?

The Tompkins County Health Department has told the Village that we cannot extend our water mains until we get the second source.  This annoys our libertarian Board, because they are suffering from a fundamentally flawed understanding of how our society needs to operate now and in the years ahead.  They are big fans of economic growth, and believe that growing our water infrastructure is part and parcel of this.  They would probably tell us that economic growth will expand the tax base, resulting in lower taxes and improve our standard of living.  Will it?

Our society has passed the point at which our growth and our consumption are sustainable.  We would need several planet earths to enable us to continue to consume at the rate we do now.  Every decision such as whether or not to drill a second well, or extend our water mains, or allow gas drilling corporations to drill in Ulysses, must be scrutinized and rejected if it represents unsustainable growth.  Redundant water systems don’t fit the bill.

The Health Department has actually done the Board a favor by placing a moratorium on extending our water mains.  The Board should deflect criticism from developers onto the Health Department, and state that we cannot afford to waste resources and burden their water customers with higher rates.

An example of sustainable development would be improvements to our water treatment plant.  Currently we exceed permissible limits of pathogens into Cayuga Lake every time we get heavy rain.  I would be happy to pay taxes to correct this, and we could be proud to be part of a community that protected it’s natural resources.

The BP disaster in the Gulf illustrates clearly, that the earth cannot tolerate further growth.

The intensity of feelings that the prospect of natural gas drilling has raised is illustrated by the formation of a new branch of Earth First in our area. “No drilling! No compromise!” is the motto of Finger Lakes Earth First, which refers to its activities as a kind of “defense” of our local ecosystems.

From the logo used by Finger Lakes Earth First, it seems pretty clear that at least some of the group’s “defense” could include monkeywrenching – protest through sabotage.

With something as literally explosive as natural gas, monkeywrenching against natural gas drilling could become dangerous. What are the ethical considerations Earth Firsters ought to take into account in their anti-drilling activities in our area?