You will see a link to an mp3 file of the meeting below. If you click on the link, you can listen from within your browser, but there is usually a way to move this mp3 file to your desktop. In Firefox, you wait for the whole file to move to the browser, (a minute or two) then you go - File - Save Page As..... and you can put it anywhere you want. The advantage is that you can then listen with other programs (Real Player, Itunes etc.) which allow you to adjust equalizer settings and they give you a time counter. With the time counter and my notes below, you can jump to the part that interests you.
LINK
The National Bureau of Economic Research has concluded that the combined federal, state, and local government average marginal tax rate for most workers to be about 40% of income.
Estimated median household income in 2005: $51,900 in Ulysses
$51,900 x 40% = $20,760 median total taxes paid per household
by my math our ambulance costs us about $30/person or $78/household (2.6 people/household)
so $78 per household ambulance tax
out of
$20,760 total combined federal, state and local taxes
tells us that
the ambulance cost that the Village wants to shift onto our insurance premiums, or federal and state taxes (medicaid, medicare) thus risking the health and welfare of many, and discouraging volunteerism, and reducing donations, amounts to less than 1/2 of one percent of our total taxes.
Kind of puts it into perspective doesn't it? Let's put our energy into reducing some serious tax burdens.
0 hours 0 minutes 0 seconds - Marty does the introduction
0-04-16 - Trustee Chris Thomas's talk.
0-05-00 Chris says that the ambulance budget is currently $320,000 and that at the current growth rate, in 10 years it will be over $600,000. This would represent an inflation rate of 8% per year. If you believe the Bush administration when they tell you the current rate of inflation is 2% to 3% per year, then go ahead and panic about the rapid increase in the cost of our ambulance system. If, on the other hand, you prefer to read the work of economists who do not drink Greenspan Koolaid, then you will realize that our actual rate of inflation is even higher than 8%. If the value of our real estate keeps pace with inflation over the next 10 years, then the resultant increase in taxes should cover the ambulance at about the same percentage of the Village tax.
0-05-16 - "a move to direct billing would largely shift this tax burden to private insurance, Medicare, and Medicaid" Key word "shift". Yes, exactly. We can shift the burden, trouble is it doesn't stay shifted onto other entities. They will shift it right back onto us.
0-5-25 "there are two primary reasons the Village is now looking at billing. The first is to try to take control of the escalating cost associated with the EMS service. (with my inane cost shifting plan) The second is to ensure that EMS services and the associated standard of care remain at the highest possible level." - This is a straw man argument. No one has complained of a decrease in the standard of care. If we continue to fund, with increases in line with inflation, then we will continue to have the current high standard of care, without billing.
0-05-45 Chris says we might be able to cost shift $252,000. If we ignore the senseless, and unethical nature of cost shifting, we are then struck with how little Chris intends to save us at such a high price in lost lives and lost volunteers. $252,000 divided by the 10,000 residents of the Fire District, is $25 apiece.
0-06-26 "This (awesome $25 cost shifting) would only be possible, if we are able to maintain our night time coverage with volunteer personnel. If for any reason we are not able to maintain volunteer coverage at night, the money saved would go to adding additional paid staff....." After Chris Thomas's talk, many volunteers talked about what a lousy idea it was. Norm Hummel (paramedic) said he would quit. hmmm.... "If for any reason we are not able to maintain volunteer coverage at night......" Is anybody paying attention here?
0-06-45 '' It would be better, in my opinion, if we had universal health care." Here he insinuates that sense we are never going to get what we want, we might as well give up, see if we can do a little cost shifting, and hope that not too many people get hurt too badly. I'm not sure Chris is being entirely honest here. He doesn't seem to be a single payer, universal health care kind of guy. Remember, he was a registered Libertarian according to the Tompkins County Board of Elections. Ben Curtis was one of the few allies Chris had at the meeting. Mr. Curtis is registered with the Independence Party. This is from their platform " Privatization Plank: Support an aggressive program, of privatizing government functions wherever and whenever possible." This is from the Libertarian Party Platform "All efforts by government to redistribute wealth,.... are improper in a free society." In other words, we have no business taxing ourselves, to support the ambulance service, that might help our neighbors, that can't afford health insurance.
In any case, whether these billing proponents really believe in single payer, universal health care or not, we need to bear in mind, that all politics is local. If we believe in progressive democratic principles (promote the general welfare) we should fight for them at every level of government. Gains at the federal level in workers rights, and civil rights, and a social safety net, have never happened without a mass movement at the grassroots demanding it. If we give up on a local level, the enormous pressure from the lobbyists for the insurance industry at the federal level will win out.
0-07-16 Chris explains when bills would be sent, and reiterates that uninsured and under insured people would receive a bill "by law". Then he attempts to assuage our fears by advocating for "non-aggressive collection" but says that "This doesn't mean that the uninsured don't have to pay" The few people who spoke in favor of billing kept bringing this up. They have fallen for the trick. They are hearing what they want to hear. They are allowing themselves to be comforted by this deceitful "non aggressive collection" argument. They are missing a very important point. If someone refuses ambulatory care for fear of a bill, and dies, it is too late, at that point, to discuss how aggressively the Village would have pursued collection, if they had accepted the care, and lived. They're dead. It will do them no good, in their grave, to know how magnanimous the Village's collection policies are.
Tell me, what percentage of the uninsured are likely to be aware of the collection policies of the Village's third party billing company? Maybe if we had an aggressive public information campaign, we might be able to get the word out to some of them, but such a campaign would invite lawsuits from insurance companies who would claim discrimination against them and their clients. Ask Chris Thomas, and the attorneys for the Village and the Town, if they would be in favor of such a campaign. I have heard Chris speak against the idea at Village Board meetings.
0-08-50 Chris talks about a subscription program, whereby the uninsured could pay 50-75 dollars/year to belong to the club that doesn't have to fear death from lack of expensive care. Two problems with that. A) They are already paying taxes and surely wish you would stop messing with the system and, B) If you succeed with your evil plan, not all of them will join the club and keep their subscription current in perpetuity. This reminds me of a period in our history when we had subscription based, private for profit Fire Departments. If you didn't pay your dues, they would let your house burn down. Ask our volunteers how they like this idea.
0-09-25 "The bottom line is there is no perfect solution, but there are ways to address issues that arise from moving to a system of billing" I'll give you a perfect solution Chris - leave it alone.
0-09-34 Straw man argument again. Hey Chris, who's complaining about standard of care? Chris then claims that an unacceptable number of calls have been answered by Bangs. I'm not sure about his numbers here - Norm Hummel didn't seem convinced. If, however, the community feels that too many calls are not being answered by our volunteers, then we should try to increase their numbers and participation. Senator George Winner's newsletter has mentioned incentives for volunteers such as student loan forgiveness, and credits towards courses at SUNY schools. This makes more sense than Chris Thomas's LOSAP program (retirement fund) because it would attract younger volunteers. Perhaps the Village could incentivize volunteerism in other ways. Perhaps we should occasionally set up a table in the High School to encourage volunteers. Offer free EMT, and paramedic training in exchange for volunteer hours. Scholarships to TC3?
0-10-50 "At night you have an almost 50-50 chance of paying Bangs on top of paying local taxes , insurance premiums, and paying into Medicaid and Medicare" No, Chris. If you have private health insurance, Medicaid, or Medicare, one would hope that they would pay Bangs. We only would have to continue to pay our $30/year each to maintain the Trumansburg Ambulance. That's not really that much is it?
0-11-08 Chris praises the volunteers in the same breath as he promotes the billing system that they reject. (I think that every volunteer that spoke, was against it) He bemoans the decreasing number of volunteers in the same breath as he proposes to make it less attractive to volunteer.
0-12-10 "The vast majority of money collected will be from insurance companies, those who should be paying for this service" No, Chris. We should be and are paying for it. The majority of those who spoke said they wanted to continue to pay for it. "And the argument that the money collected from these insurance companies will immediately and entirely be billed back to our community in the form of premiums, is a red herring not backed up by the least bit of information or research, but instead by loosely connected circumstances."
Well, Chris, nobody said "immediately and entirely", but yes, they will largely, and eventually be billed back to us. Here's some research for you; William McGuire is the CEO of United Health, one of the largest HMO's in the country. He makes 8 million/year plus bonuses, and has amassed 1.6 billion in stock options, one of the largest stock option fortunes in history. Bill gets around in a private jet. Let's look at some business basics. Bill has to balance income, expenses, and profit. If expenses go up (more people billing him) he has a tough choice to make. He can either raise income (premiums), or cut profit. Based on a quick look at his net worth, I think I know which one he has been choosing. Chris can obfuscate with talk about this account and that account and actuarial tables, but I'm not buying it. If we start billing, premiums will go up. There is no free lunch.
0-13-05 Chris talks about who was on the task force that unanimously recommended a referendum on billing. He includes Norm Hummel and Jackie Wright. But they spoke against it! He talks about how great it's working in Alden NY. I don't know what's in the water in Alden, but here in Trumansburg we've got too many good community minded citizens to be bamboozled with this scheme. Maybe Alden is a hotbed of Libertarianism. Maybe you should run for a spot on the board!
I asked Chris for the text of his speech which would have saved me some typing. He said no. I would have posted the whole thing. Odd.
0-14-40 Norm Hummel begins his excellent talk. "Some volunteers, myself included, have a real problem with government receiving revenue from my charity" good point, I never thought about it that way.
0-22-30 Geri Stevenson? 5316 Pine Ridge Rd. 100% in favor of billing. "But I had no idea that the volunteers would feel that their charity was having a price tag put on it" but she wants to bill the insurance companies "as long as our residents who do not have insurance are not really going to be penalized is definitely the way to go"
See what I mean? She fell for the "non aggressive collection" trick. She doesn't sound like the type that would want her neighbor to refuse care for fear of a bill and suffer dire consequences, but she fell for the trick.
0-24-48 Rene Carver 12 Salo Dr. Says by not billing we are subsidizing the insurance companies who are anticipating that they will be billed. Why would they waste time anticipating if they might get billed. They've got mountains of real world data. They know how much they are being billed. All they have to do is add profit, and collect the premiums.
"If, in fact there is a way to ensure that it is very, very, clear to those people (uninsured) that there is a way to have that bill taken care of, short of them writing a check, that would make me feel so much more comfortable. The last thing in the world that I would want to see, is if anyone is in a situation, for whatever reason, that they feel like they can not place that call, I have to wait for it to get worse, before I place that call, that's an area, that I don't want somebody to risk injury or further damage to themselves, or their family"
See what I mean. Another good hearted sucker. Chris Thomas has no intention to make it "very, very clear" that they don't have to pay. In fact, he thinks they should pay. He just said so.
0-27-40 Allen Carstensen 23 Strowbridge St. (that's me!) hey, I've got that right here on my computer. I'll just paste it in,
Health care in the United States is a right not a privilege. Progressives ever since Harry Truman have been trying to pass legislation to build a universal health care system. We find inspiration for the struggle in the preamble to the Constitution.
We the people of the United States, in order to form a more perfect union, establish justice, insure domestic tranquility, provide for the common defense, promote the general welfare, and secure the blessings of liberty for ourselves and posterity, do ordain and establish this Constitution for the United States of America.
“promote the general welfare” That's the key. Progressives in every industrialized country in the world except ours, have succeeded in building universal health care systems, to promote their general welfare, and they spend less and get better results than we do. National Polls show that a strong majority of us want it. Our excellent Ambulance service, staffed largely by dedicated volunteers, and paid for by us, is a critical part of our health care system. We democratically decided to form this service and fund it through our taxes. The way our ambulance service is funded makes it a single payer, universal health care service. Our entire system should be funded this way, and yet some in our local government want to go 180 degrees in the opposite direction.
About 1500 residents of our the Fire District served by our ambulance, have no health insurance. Perhaps that many again, are underinsured. If you are lucky enough to have good health insurance, think about your neighbors. Some of them aren’t as lucky. One of them is very likely to need ambulatory care one day soon, and say to themselves, maybe it’s nothing, I’ll be all right, I can’t afford to call the ambulance, and they will suffer dire consequences. How can we rationalize that?
This is all about community, and that we are here to help one another. We need to be able to look at the world through the eyes of our neighbors, especially those less fortunate than us. We are not a lose collection of rugged libertarian individualists. We are a community, and we are obligated to help one another. That is what motivates volunteers to join the Fire Company, and the ambulance corps. If we corrupt the system by entering into a relationship with the multibillion dollar health insurance industry, we will see a rapid decline in volunteerism. We will be shooting ourselves in the foot.
got it in just under the gun!
0-31-06 Bob Howarth, Reynolds Rd. -Ulysses - strongly opposed to billing. The Trumansburg ambulance people saved his life! He doesn't mind paying taxes for it!
0-32-32 Randy Haas 303 Pennsylvania volunteer fire and ems service. Strongly opposed to billing. This is the only mention of privatization - I think he is absolutely correct as I have written in my first post on this blog. He draws an eerie parallel between Alden NY and WWII Germany.
0-36-42 Ron McLean, 3 Whig St.- former member of the Fire Department. Strongly opposed to billing. Reccomends forming a working committee of equal parts from Fire Dept, EMS, Village Board, and the community. Damn good idea.
0-39-30 - Mariane Archangeli - Lake St. Seconds Ron McLeans idea. Strongly opposed to billing.
0-41-45 Michelle Paollilo, Lake St. - Member of Fire Department since 1999 EMT since 2002. Strongly opposed to billing. "We are providing this service as a public good"
0-45-36 Geoffrey Hart, 31 Halsey St. - supporter of billing, naturally. Speaks of how wonderful volunteerism is but that it must function within a corporate structure. WTF? This user fee that we are talking about is a way to assist in maintaining high quality. Wait a minute Jeff, how come, with increasing privatization of health care over the last 30 years, we have fallen from near the top of the World Health Organization's list of countries in order of quality of health care, to number 39? "I fear than in 10 - 15 years from now if we do not introduce a user fee, we will be entirely what some people call privatized --- we'll have to hire Bangs or some other corporation to provide the entire service." Hey Jeff, this plan is a giant step towards privatization, not a way to avoid it! That's the plan! You know that don't you? This scheme "will allow this great quality of volunteerism to survive into the forseeable future ---- the contribution of the volunteers is valued greatly and it will not be diminished (ignore what all the volunteers are saying tonight!)--- volunteers stand out like lights in the darkness (he stole that from George HW Bush)
0-49-54 Justine Kolb, 49 Congress St. - (Chris Thomas's significant other) "I would have loved socialized medicine, I think it would be wonderful, it would be utopia to have that in our country, but we don't have it" (so let's privatize?) "I love the fact, that I live in a Village where they are considering the people that don't have insurance" (yet she ignores the testimony of many of the volunteers that point out the harm that will likely befall them) "And I want to ask you (the volunteers) would you please stay, and give us that dedicated care, because I would much rather have you come to my house, than someone I don't know" (because I desperately need to see my $25/year cost shifted to other budgets, and I know that you are all speaking about how much you detest this change, but it'll be ok, trust me)
0-52-29 Robert Lodder, 12 Prospect St. - against billing. Spoke about the two incidents when the Trumansburg ambulance delivered needed assistance to his family.
0-56-55 Deloris Higareda, Bradley St. - wanted clarification on the cost of the ambulance per Village resident. I've written about this at the top of this post. " It's important to make it very clear to people that they will not have to pay, if they don't have the insurance, the money, whatever, I think that's extremely important" Again it is not part of the plan to make this very clear.
1-02-09 Pete Meskill (Sheriff) Seneca Rd East) strongly opposed to billing. He reiterates that volunteers will walk away.
1-06-52 Patricia Bonzall , 339 Pennsylvania Ave. - "everybody today is in a me syndrome" good point. At one point in "Sicko" Michael Moore turns to the camera and asks are we a part of a me society or a we society? Those of us afflicted with the me syndrome are more concerned with how are tax dollars are spent, than the well being of our neighbors. "It's for the people, by the people, let's keep it that way"
1-10-53 Barnie Bines?, 47 Cayuga - Hadn't decided before the meeting. "I'm coming down on the side of the community now, I would like to keep the system the way it is now"
1-12-42 Jim Mason, Larchmont Dr, - volunteer fire fighter. He was involved in the inception of the ambulance service. Strongly opposed to billing.
1-17-21 Ben Curtis - Cayuga St - supporter of privatization. "I was particularly impressed with Mr. Harts comments" "I want to remind people that there are people in our community that have a hard time paying for property tax" Yes but taxes are the price of admittance to a civilized society. We can't avoid them unless we want to live by ourselves on an island. Remember his party platform "Privatization Plank: Support an aggressive program, of privatizing government functions wherever and whenever possible."
1-20-56 Jackie Wright, Searsburg - Ambulance volunteer - strongly opposed to billing - she points out that when we bill Medicaid or Medicare, it will come right back to us in the form of higher taxes that support those government programs. "who came to you complaining about their EMS taxes, or Fire taxes, did anybody in this room, raise your hand, complain about your taxes. There's two people out of 100, that are complaining about this service" (Libertarians) Jackie tells of a call where an elderly woman had fallen. She wouldn't let them touch her, for fear of a bill. She said she would lay there on the floor until her son could get there in two hours. Jackie was able to convince her that there would be no bill. How the hell can we consider taking away Jackie's ability to persuade her to accept the help? Are we nuts?
1-24-45 Didn't catch the name - Searsburg Rd. "I'd like to rebut a couple of points made tonight - National Health Care - that could be 30,40,50 years the way Washington and Albany run" wrong - it'll be never with an attitude like that. He doesn't like taxes, and he doesn't think any volunteers will leave. hmmm....
1-27-41 Didn't catch the name Swamp College Rd. "our fire protection tax was 99 cents per thousand" good deal!
1-28-53 Deloris Something Ulysses - strongly opposed to billing, she had to use the service several times this year. They saved her fathers life twice!
1-30-40 Blair OBrien - ??
1-32-00 Tammy Ward 2380 W. Seneca - volunteer - strongly opposed - she has had to beg people to accept her help for fear of a bill. She said that it's illegal to tell someone they won't have to pay, once you go billing! Did you catch that? it's illegal to tell someone they won't have to pay, once you go billing! It sounds like the volunteers have been told - it's illegal to tell someone they won't have to pay, once you go billing! Can we put to rest this "non aggressive collections" argument? When someone is in crisis, and they ask, "will there be a bill?" The ambulance personnel are not allowed to tell them that they won't have to pay! "I had to beg my own mother to take an ambulance ride, because she was afraid she was going to have to pay, and I know a lot of you people here don't want that to be your family member, that we can't beg to go, that we can't help, because they're afraid they're going to end up with a bill, because they are so honorable, that they will pay that to deprive themselves of basic needs."
1-35-16 Charles Heath, Iradell Rd - career firefighter with the City of Ithaca and volunteer with Trumansburg Fire Dept. "I'm not in favor of billing at this time"
1-36-59 Ruth Kahn - Rt 228 Her husband (deceased) was a long time member of the Fire Dept. It starts pouring outside, you can hardly hear Ruth, and she's kind of rambling, but I know Ruth as a member of Back To Democracy, and I know she would be opposed to billing.
Meeting Adjourned,
By my count there were 7 people who spoke in favor of billing, and 18 who spoke up against it. Of the 18 who spoke against billing, 9 are current or past members of the Fire Dept. and/or Ambulance Corps. No volunteers spoke in favor of billing. One would think that this would be the final nail in the coffin, and that they would drop the billing plan, but our local government has surprised me before. WD5 appeared dead several times, but keeps rising from the dead. The Village held a special informational meeting on WD5 and passed a resolution , more or less in support of it, after the majority in the room spoke against it. The moral of the story is to be involved, and keep an eye on them. I am lobbying the Town Board to pass a resolution against billing, since they provide 65% of the funds for the Fire Department, Ambulance/EMS.
