Montana Public Radio recently aired a story and web article that highlighted the plight of a Butte, MT family who was shocked to receive a $56,000 bill for a medical flight from Butte to Seattle. The family was fully insured but their daughter's life saving flight was unfortunately provided by an out of network MEDEVAC service. NPR took this opportunity to draw up a long standing debate about aviation based emergency medical companies engaging in what seems to the general public like price gouging of the middle class by the wealthy and well connected.
No doubt, $56,000 is a lot of money, so let's break some of that cost down so that we can better understand the bill. While NPR did qualify that aircraft and specialized aircrews are expensive they refrained to say just how expensive. They didn't mention for instance that every single time you start certain jet engines it must be recorded in a logbook; that engine may have a limit on those 'cycles' and once the limit is met the aircraft must be taken offline, and the engine must be disassebled, inspected, and have certain compenents replaced - that makes false alarms are very costly. It's these many small but extremely necessary literal and figurative moving parts that makes flying in the United States infinitely safer than driving, riding a train, or taking a shower. While the mere act of moving an aircraft around at 550 miles per hour through any weather is expensive enough I think it's much more expensive to do so with two highly trained and equipped medical professionals on board. Keep in mind this is not always the same equipment found in every hospital nationwide; much of this gear is specifically designed to handle fluctuating atmospheric pressures found in the aircraft cabin.
Some will note that the list I have compiled is by no means complete, nevertheless it should serve the reader a clear idea of some of the fixed and revolving costs relative to running a small operation. Scale that up and the costs of being ready to go 24/7/365 become much greater. Fly an airplane empty (ferry flight) while heading to pickup a passenger/patient and now you're just burning money - that money has to be recouped somewhere.
I have true empathy for the plight of the Thompson family but I don't think their target should be the very providers who managed to offer a lifesaving albeit expensive service on short notice. If they do continue fighting these lifesaving organizations, certain government agencies will likely suceed in upping their involvement. That inevitably results in increased costs through direct oversight or lack of supply as providers unable to cope with more paperwork (in an already paperwork rich environment) begin to drop out of the industry. For those that remain in the field, the quality of care provided will almost certainly diminish due to greater workloads.
Conversely, I would gladly support a movement led by the Thompson's and their allies to target any insurance company whose modus operandi is to disguise what 'coverage' really means. That doesn't mean we have to put anyone out of business, it just means that insurance companies should act responsibly and educate the public if such an anticipated component of modern medicine is not covered under a policy. By highlighting the limitations of medical insurance we can help ensure that more surprises don't befall more decent Americans.