September 8, 2008

Editorial: Medevac Service Due for Cutbacks, Legislative Scrutiny

After years of stubborn refusal to do so, the state police medevac unit has cut back on the use of its helicopters, which suggests that they were being overused in flying accident victims to the University of Maryland Shock Trauma Center.

Officials announced last week that the service will be transporting fewer patients. Unless there are extenuating circumstances, patients will be taken by ambulance to the nearest trauma center if that will take no more than 30 minutes. In addition, paramedics will not be automatically flying patients who have been involved in roll-over accidents, high-speed chases and other situations that don't always result in serious injury.

The unit's director avoids admitting that the expensive, tax- paid program has been abused, but has instead launched a pre- emptive strike to offset legislative scrutiny. The legislature needs to approve a request for more than $130 million to replace the program's aging fleet of 12 helicopters.

The legislative examination follows a Capital story (March 30) revealing that almost half of the patients transported to the shock trauma center - at a cost of $6,000 each - were not seriously injured. These patients had non-life-threatening injuries and were released within 24 hours, raising the question of why less- expensive ambulances weren't used to transport them instead.

The helicopter unit, operated by the Maryland State Police, is the only one in the country supported by taxes.

Emotional stories generated by the program's undeniable successes, and the anxieties of Marylanders who like such a service available, have allowed the police to deflect any serious questions about operations. Until now the rhetoric has justified a $20 million annual budget, and helped the state's vaunted shock trauma center keep busy.

We don't dispute the need for a helicopter medevac unit or the stellar reputation of this country's first shock trauma center - Marylanders are lucky to have such services. But patient transportation fees can be paid by insurers, as they are elsewhere, and this service has been overused at great cost to taxpayers. We're happy that medevac administrators are finally cutting back.

Dr. Robert Bass, director of the Maryland Institute for Emergency Medical Services Systems, was called before the Joint Committee on Health Care Delivery and Financing last week. Next he'll face the legislature's Joint Audit Committee, where state Sen. John Astle of Annapolis, a former medevac helicopter pilot, is expected to grill Dr. Bass on maintenance issues.

The committee's job will be to determine if all 12 helicopters recommended by Gov. Martin O'Malley are really necessary. If ambulances could offer essentially the same services in nearly half of the 5,000 or so cases each year, we suspect they aren't. And it appears that helicopter maintenance logs are incomplete or nonexistent, putting a further obstacle in the path of legislators who want to understand how wisely the $20 million annual allocation is spent.

Until now the medevac unit has escaped serious scrutiny because no one wants to publicly challenge a popular service that saves lives. But given that, half the time, the lives of those using the service are not in any danger, the scrutiny is reasonable. {Corrections:} {Status:}

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