
                         Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: TUESDAY, June 13, 1995                   TAG: 9506130046
SECTION: VIRGINIA                    PAGE: C-1   EDITION: METRO 
SOURCE: RAY REED
DATELINE:                                 LENGTH: Medium

EMERGENCY RESPONSES CAN'T BE SLIM

Q: A couple of weeks ago, I was in Tanglewood Mall and saw a man getting sick. Someone called 911 and asked if they could take him to the emergency room. They sent a fire truck and an ambulance, and eight men came down the store aisle to take one man to the emergency room. It just seems like a waste of money. Why did they have to do it that way?

B.M., Roanoke County

A: The response may have looked like overkill; but if the victim had been near death, a crew that size wouldn't be too large, said Tommy Fuqua, Roanoke County fire and rescue chief.

Most likely the call to 911 indicated the victim had an unknown illness that could have required advanced life support, Fuqua said.

The standard daytime response to such a call requires both an ambulance and a fire truck. The ambulance has a minimum crew of two people; the fire truck has three. All five are trained as paramedics or emergency medical technicians, and at least three are cross-trained as firefighters.

Ambulances with two-person crews can handle routine injuries, but more hands are needed for advanced life support.

If it turns out the extra help isn't needed, the fire crew returns quickly.

You saw eight people in the response team. Most likely the other three were volunteer crew members who just happened to be available that day, Fuqua said. There's also a chance an employee of the store or mall may have been among the extra three.

Nighttime responses to a call like this one may not include the fire truck. With volunteers normally available at night, ambulance crews can have three or four people - enough to provide advanced life support if it's needed.|

Insurance lobbying

Q: Last year, insurance companies used hundreds of thousands of dollars to fight medical insurance reform. Has that cost been passed on to the consumer in higher premiums?

T.B., Troutville

A: It's hard to give an unqualified ``yes'' to this question. Insurance companies, though, treat lobbying as one of their normal business expenses.

Most companies are members of insurance lobbying groups and pay a fee based on the premiums they collect. Some companies have their own lobbyists, too.

Your question was relayed to the Health Insurance Association for America, perhaps the leading insurance lobbyist in the reform fight. Its spokesman responded with an explanation that health insurance yields only a 2 percent profit for the companies, much less than the profit for other parts of the health care industry, such as doctors and hospitals.

It was less than a direct answer.

There is no clear money trail in company budgets that allows someone to say, ``Yes, those print ads and TV commercials on health care reform cost $1 million, and they increased premiums to cover it.''

Instead, all costs - from claims to office expenses - are totaled. Premiums are adjusted to cover the bottom line.

Got a question about something that might affect other people, too? Something you've come across and wondered about? Give us a call at 981-3118. Maybe we can find the answer.

by CNB