The debate on whether or not EMS personnel should be allowed to carry firearms is once again making it’s rounds. I posted an article “Should EMS be Allowed to Carry Weapons?” back in 2010 and to this day, it still receives more visits and comments than any other article on my entire blog. It’s a heated issue and there are valid points to both sides of the argument.

Several EMS bloggers have weighed in on the subject recently and their opinions vary from strong support to opposition. Kelly Grayson made reference to recent activity in Virginia where legislators are considering removing a long-standing ban on EMS personnel carrying firearms:

Allow me to make a prediction on what will happen if Virginia ambulance crews start to carry weapons…….

……No blood in the streets, no Wild West-style shootouts (largely a Hollywood fiction in which most anti-gun types fervently believe), no EMT’s bustin’ caps in unruly patients, no unruly patients disarming those ignorant, untrained EMT’s and shooting them with their own weapons, no EMT’s barging into unsafe scenes  bolstered with a misplaced sense of invulnerability because they’re packing heat.
-Kelly Grayson

 Greg Friese from “Everyday EMS Tips” put his personal opinion aside and asked 2 very valid questions:

Why is concealed carry preferable to open carry?

Intuitively I think a visible firearm is a better deterrent, easier to access, and quicker to access than a concealed weapon. What am I missing? Why aren’t we arguing and advocating for open carry in the EMS workplace?

Which patient would you have shot?

Many apparatus bay and training room conversations start with “If only I would have had … I could have … ”
-Greg Friese

The majority of reader comments advocated for concealed as opposed to open carry. In the EMS setting, I have to agree. Open carry adds another safety element as weapon retention becomes a high priority. I’m a big advocate of the element of surprise. I don’t want to be viewed as an enforcement figure, and I’m not trying to scare anyone off. I just want to be able to defend myself, should that need ever arise. Chances are, I’ll never need it, but I would rather have it and never use it than need it and not have it.

My biggest issue with the whole thing is the fact that I’m expected to check my god-given rights at the time clock. Any time I can legally carry, I do. Like I said before, I’ll probably never need it, but like car and health insurance, it’s certainly nice to have when I do. I’m not looking to enter dangerous scenes, engage in physical confrontations or take on any other additional risks. I just want to be able to carry a means to defend myself just like I do when I’m off duty.

Before writing this article, I asked my friends on Twitter and Facebook for their opinions and I was very surprised at the response I got. Many of my EMS friends – most of which are 2nd Amendment supporters – actually voiced extreme opposition to the idea of EMS personnel carrying firearms. I was completely taken by surprise to say the least. The common theme was that most of our coworkers can’t or shouldn’t be trusted with the responsibility of concealed carry. To be honest, I was shocked to see how little confidence most of us have in our peers. This of course led me to ask if guns were really the issue, or is it the people that we are employing? I could write an entire article on that subject, so I’ll leave that question alone and let the readers duke it out.

My view on the matter is simple. I believe that if you are legally able to own a firearm, you should be allowed to carry it whenever you feel necessary. Crossing a state line, entering a doorway or punching a time clock shouldn’t stop law-abiding citizens from exercising their god-given rights to self-defense. I’m not asking agencies to issue firearms or take on any additional risks. I’m just as much of an advocate for one’s right to choose not to carry. All I’m asking is that I be given the option to exercise my rights, should I so choose.

I’m constantly finding myself in debates over which healthcare delivery model is “the best”. Many people argue in favor of government-based healthcare, while many others stand by private / for-profit delivery models. The truth is, they all suck. Money controls the care. Bottom line, no arguing, it’s just the hard truth. You can’t sustain any form of practice without a source of income, there’s just no way around that. So where the real argument lies, is where the money comes from.

Everybody has a budget and has to live within that budget to stay in business. This is no different between any of the delivery models. When the money runs low in a socialized system, income is increased by raising taxes while the private sector raises prices. Either way, the poor bastard working paycheck to paycheck winds up being the only one really affected.

So which one is better?

It’s no secret that I’m not a huge fan of government-ran healthcare, but that doesn’t mean I think the private-sector is without fault. My issue with government being in control of healthcare is their lack of ability to balance a budget. It just seems like healthcare would be yet another thing on the chopping block when it comes time to reduce the deficit. Instead of the sob stories telling us that “we will have to lay off police officers, firefighters and teachers if we don’t raise these taxes”, we will have the pleasure of having nurses and doctors added to that list. Plus, there is just too much red-tape and BS that goes into getting anything done.

Now I meant it when I said the private-sector isn’t perfect. As a matter of fact, they are far from it. Profit margins and favors to share-holders certainly do their share to affect patient care. Now let me set the record straight. I’m OK with someone making a profit off healthcare. That’s what drives growth and creates jobs. What’s troubling is some of the measures that are often taken to increase those profits.

Throughout my experience in healthcare, I would have to say that non-profit is my favorite delivery model. Like I said, there is still a budget but not so much of a profit margin to compete with. You tend to see things actually being done to benefit the patients that we serve. It’s just a different mentality. I currently work for 2 non-profit entities and I can say that we do a lot of things to benefit our patients that aren’t covered by medicare or probably any insurance agency. It’s just done because it’s the right thing to do.

Of course, there are always exceptions. For example, my last employer was a for-profit ambulance service. While we were in business to turn a profit, we did a ton of things to improve patient comfort, safety, crew comfort, etc. None of which was required. I know that there are a lot of government-based services that do the same as well, it’s just not the norm.

That’s just my opinion, ableit a biased one.

The real problems

The issues around our healthcare problems in the U.S. aren’t a matter of delivery methods. It’s a matter of reimbursement, abuse and lawsuits and all 3 are directly related to each other. It’s like that movie “Human Centipede” with lawsuits being on the front of the of the chain, abuse right behind and reimbursement on the tail end.

Side note – If you haven’t seen Human Centipede, consider yourself lucky. Whatever you do, DON’T watch that movie, it will scar you for life. If you have seen it – god forbid – then you should get the humor in the reference. 

Lawsuits by themselves aren’t necessarily raising the cost of healthcare, but what they do is encourage defensive medicine. Doctors start ordering tests that they know aren’t necessary only to be “safe” just in case it’s actually something serious. So the 19-year-old with a headache and no other symptoms gets a CT scan and the frequent flyer who comes with the same complaint of chest pain every week gets a full cardiac workup. Those are just a couple examples of what the ER’s see on a regular basis.

A system that encourages defensive medicine also encourages abuse. The frequent-flyer previously mentioned will continue to come in on a regular basis, because he knows that nobody is going to just do a medical screening exam and send him away. Whether it’s food or attention he’s after, he knows he’s going to get it and so he continues to come back. Once again, that’s just one example.

So now comes the problem of reimbursement. Every time our frequent-flyer uses emergency services generates a bill. A bill that’s not going to get paid. Even if he is covered by Medicaid / Medicare, they are only going to cover a fraction of the cost. So what happens to the uncovered portion of the bill? Well, prices for these services just continue to increase in order to make up for the lost revenue. See: COST SHIFTING

Solutions, anyone?

Throwing money at the problem or changing our delivery model does nothing without addressing the core issues that got us here in the first place. As it currently stands, the people who pay for their insurance are essentially paying for those that don’t. Switching to a single-payer system or socialized system doesn’t change that. That problem with never go away.

What we need is better access to primary care providers and incentives for seeking appropriate levels of care. There isn’t much incentive for a primary-care physician to see Medicaid or Medicare patients because the reimbursement is terrible. Something has to be done about that. But not in the way that you might think. A trip to the family doctor or urgent care is going to be far less than a full-blown work-up at the ER. If more people were seeing their doctors instead of using emergency services to address their problems, then our insurance providers – both private and public – would have more money to spend on things like reimbursement.

Now this sounds fine and dandy, but getting people to seek appropriate levels of care isn’t going to happen by asking them nicely. There has to be serious incentives. For me, such incentives already exist. For me or my family to visit the ER, we pay a $100 co-pay unless we are admitted. In that case, the co-pay is waived. So every time me or a member of my family gets sick, we have to decide what will be the best way to seek medical attention. Obviously I’m not going to pay $100 for a sore throat, I’m going to pay $25 to see a PCP. Why can’t we use a similar system for Medicaid?

Like I said, asking nicely isn’t going to do the trick and neither will sending a bill. I think most would agree that people that habitually abuse emergency services aren’t going to willingly fork over the cash for a co-pay. And nobody is going to turn them away for lack of ability to pay, and that’s perfectly OK. But what we can do is deduct that co-pay from other benefits, like welfare. I would even go as far as saying that a $30 ER co-pay would substantially reduce the abuse.

If you set out a box of free donuts, people will naturally over-consume. If you charge even 50 cents people will most likely only take one, if even any. When people are visiting ER’s because they don’t have enough money for Tylenol, then we know we have a huge problem. Nobody is held accountable, so why would they act any different?

People abuse the system because it’s not only allowed, it’s encouraged. Until we actually get serious about addressing the high cost of healthcare, nothing is going to change. It doesn’t matter how much money we throw at it or who’s running the show.

I have somewhat refrained from posting political rants on this blog for a little while now, but there has been a lot going on in the political world and I gotta get some stuff off my chest.

Most of you know where I stand with my beliefs. I tend to be very conservative on most things, sometimes moderate with others. I respect other people’s opinions and beliefs and I can only wish for the same in return. Obviously we don’t always get what we wish for.

Unfortunately I’m going to have to go “Hannibal” on some of my fellow conservatives and “eat my own” for a post. I’m sure as a result, the hate-mail folder will probably get a few extra hits this time around.

I have come to a crossroads with my beliefs and I find myself having to choose between values that I stand for. I have realized that many of my beliefs contradict each other, and I feel that it is a direct result from the problems that the 2-party system has created. I hate having to choose sides because frankly, I don’t believe in everything either party stands for. Yes, I consider my beliefs to be conservative, but that doesn’t mean I think the Republicans are always right.

A wise man once told me that the constitution protects not only the rights that I like, but it also protects your rights that I don’t. For the most part, I have accepted that. I may firmly believe in my right to keep and bear arms, but I would never support forcing people to own and carry firearms. I certainly disagree with just about everything that comes out of Michael Moore’s mouth, but I would stand side-by-side with him to defend his right to free speech.

So why haven’t I done the same with things like gay marriage and abortion?

I asked myself this recently and I had a really hard time answering it. The truth is, neither issue really affects me. I’m not homosexual and I wouldn’t consider having an abortion (not that it’s physically possible, but you get the point). If the federal government decided to allow gay marriage nation-wide, it really wouldn’t affect me. Nobody is forcing me to marry another man and nobody is demanding that my wife and I have an abortion next time she gets pregnant.

So I guess where I am going with this, is that I have had to figure out what’s important to me. We can’t sit here and say that we don’t want our rights taken away, but then turn around and hack away at the rights of the people we don’t agree with. Yes, I still believe that abortion is wrong, but I still have the choice not to get one. The same goes for drinking and driving. I think it’s wrong to get plowed and then get behind the wheel of a car, but I’m not about to rally to outlaw bars or alcohol.

My political beliefs are actually quite simple. I don’t want government telling me that I have to or can’t do anything. As long as it doesn’t affect anyone else, let me make the decision on what’s right or wrong.

Where the Republican Party has gone wrong is they seem to spend all their time addressing the issues that don’t really affect anyone. What DOES matter are things like the economy, taxes, war, and defending our god-given rights…..all of them. The beauty of this country is that we don’t have to follow a single belief system. We are still free to practice the religion of our choice. We can work any job we want, live anywhere we want, talk anyway we want, and most importantly, we still have the right and the means to protect it all.

What we need to do, is worry about the issues that really matter right now so that we still have the ability to debate over the little things that we don’t agree with.

The great state of California trusts me to carry and administer narcotics, drive commercial vehicles, raise children, and CARRY A CONCEALED FIREARM. But yet, when I buy a new pistol from the local gun shop, I STILL have to wait 10 days to pick it up. Why? Because I need a “cool down” period just in case I’m purchasing this firearm to intentionally harm someone with. Never mind the arsenal of weapons I already own – all of which the state knows about – and the fact that I entered and left the store with a loaded pistol under my waistband.

I can say that I feel Homer’s pain on this one:

Now on to the good news! In just 4 short days, I’ll be picking up this bad boy

I have always wanted a .22 pistol and I just never brought myself to get one. This Walther P22 looks promising. It’s comfortable, has a good reputation and has tons of accessories available. A range report will be available once I pick it up.

For once, the newspaper finally did our “boys in blue” a service:

http://www.bakersfield.com/news/local/x529881103/Officers-rescue-teen-girl-from-Kern-River

It was very refreshing to finally see a positive article in regards to local law enforcement in my area. Of course this was long overdue. Unfortunately the local paper has been too busy criticizing the police for shootings, excessive traffic tickets and various other forms of doing their job. What they don’t seem to report on is all of the officers that are involved in DARE programs, and activity leagues. No news there. They also don’t seem to pay attention to the officer that offered his large sandwich that he just purchased to a homeless woman that was denied entry at the over-crowded homeless shelter. Nope, nothing to report.

The Police Department in my town has taken quite the beating from the local rag and the general public for some time now. Granted, there have been a few bad apples from within the department. But as quickly as they discover wrong-doing on the part of an officer, they are just as quick to make things right. The departments around here will stand up to the screaming liberal, local media who choses to side with the mom of the 18 year old gang-banger who thought that pointing a gun at the cops was a good idea. But at the same time, they will eat their own when an officer abuses the badge.

Unfortunately, cops help out the public by “being the bad guys”. What I mean by that, is they are the ones who pull you over for speeding, arrest you for a DUI, or shoot you when you try to rob a bank. An unfortunate side-effect from this is a negative public perception.

What people don’t see is the positive effects that their work has on society. They don’t realize that traffic officers are the reason people pay attention to speed-limit signs and think twice before driving like an asshole through your child’s school zone. Most people that “tie one on” at the local bar aren’t worried that they might kill someone by driving home. They are worried about getting pulled over and losing their license. What’s the first thing a bank robber does before he enters the building? Check for cops.

When things are good and crime is low, nobody thinks to appreciate the hard work that law enforcement does. But they damn sure notice when things are bad. What’s the first thing someone says when a spree of car jackings or robbers happens?

Where are the cops?

http://www.latimes.com/news/local/la-me-guns-20110314,0,4773477.story

As most of you know, I am a huge proponent of allowing law abiding citizens to carry concealed weapons. For the most part, I support any bill that allows more of the good guys to carry…..except this one. This is just another example of politicians not wanting to live by the rules that they made. The double standard here in California is ridiculous.

What really pisses me off, is the fact that the writers and supporters of this bill have done everything they can to block any attempt that we have made to allow concealed carry in this state. They have blocked all of our efforts and voted against anything expands concealed carry rights. But now the rules they made aren’t good enough to protect them, so they want a new set of rules that applies ONLY TO THEM.

In California a citizen has to show “good cause” in order to obtain a CCW. It is then up to the local Sheriff or Police Chief to decide whether or not you are worthy of one. I am fortunate enough to live in a county where our local sheriff is very conservative and has made it easy for law abiding citizens to carry weapons. Despite what the media and anti-gunners will have you believe, there isn’t a wave of violence or blood and guts in the streets around here. As a matter of fact, in the 30-or-so years that we have been issuing the licences, not one person has ever committed a crime with a legally carried gun. It’s almost as if only the criminals do that…interesting.

Anyway, back to my point. The legislators here in the golden state have for a long time supported stricter gun laws and have opposed carrying weapons. But now that they feel that their job is dangerous, they want to be able to protect themselves. Yet they still don’t understand why the public wants the same protection. Well, they probably understand, they just don’t care.

I thought this was supposed to be a government of the people. But what do I know, I’m just a dumb-ass paramedic.