Having been at my Lieutenant position for a while on the boo-boo-bus I can say that this is one of the most f#*ked up situations. The waste and abuse has gone on for years and must be corrected but this isn't the way to do it. People call 9-1-1 for the dumbest shit that isn't an emergency. When the local EMS provider downgrades the call or refuses to transport then the idiot patients call a private. We won't refuse them because we can bill the 12 digit Ohio dignitary card. That fabulous card that the tax paying people provide. One time a patient asked that I get his wallet from the table, I asked where his money came from and his reply was that it was his from his check. I politely reminded him that he was carrying my money,that I worked for,and was taken from me, and i have no say so in how he spends it. As he WALKED to our ambulance in the parking lot downstairs he thanked us because a taxi is too expensive! Hellloooo,,,,a cab is what, 20 or 25 thousand new? A basic ambulance is about 90 thousand! An ambulance trip starts at $350 and can go way up,quickly. But he isn't paying it, we are! Then the flippin political rapists find any and all reasons to decline the payout. They won't tell you all the reasons at once, but one at a time. Do the call in January,bill it in February,denied in March,correct and resubmit in April,new decline in May,correct and resubmit again,wash,rinse,repeat. You might get money 9 monthes later. Insurance companies are worse. They pay what they think it is worth. So to survive this we have to bill some things higher to get paid what it should be and make up for the rest. If everybody goes on Government money,then who will provide the tax base to fund this? I'm sorry for venting but I do have some insight on this. I have gotton my ass in trouble with employers for telling patients where their fuckin bread is buttered from!!!