This kind of abuse is very hard to quantify due to HIPPA laws and the system of record keeping in hospitals and EMS. A patient who is brought into an ED is registered by their chief complaint. Since “full of shit” is not an acceptable ‘reason to be at the ED’ we have to put something else like “Drunk/EtOH/Intoxicated” or often “psych”. Often it is impossible to differentiate the legitimate reasons from the fake by those complaints. For example, “finger laceration” is a common chief complaint, but that phrase can mean anything from a paper cut to a finger hanging onto a hand by a thread of skin. Same goes for “flu-like symptoms”, “leg pain”, etc. The only way to figure out whats valid is too look at the actual medical record which is protected under HIPPA laws.

Secondly, EMTs and paramedics often get refusals from BS patients and its impossible to determine which were called in by attention seekers or people who may have honestly thought someone needed medical care like witnessing a car crash, but no one was hurt. We also will clear a call without getting patient info and call it a ‘police matter’ or ‘no EMS’. If there was a way to get the amount of ‘no ems’ or ‘police matter’ calls gone to that would be a better indicator, but once again not all are malicious.

All those factors contribute to a lack of quantifiable data in regards to this abuse, but I’ve gone to more than my fair share of calls that are a waste of resources and they are abundant and frequent. Here are two articles from other parts of the country that may shed more light and provide credibility to the issue.

http://www.ems1.com/ems-products/ambulances/articles/585783-Report-20-percent-of-911-calls-are-non-emergencies/

http://www.findingdulcinea.com/news/health/2009/april/9-Patients-Account-for-Nearly-2-700-Visits-to-the-Emergency-Room–Study-Finds-.html

Your “personal interviews” with EMTs are purely anecdotal. Until you can provide statistics proving that abuse and fraud is as widespread as you say it is (and I don’t think you can), then it doesn’t mean much.

The Massachusetts health care reforms have increased the number people with health coverage to over 97 percent – more than anywhere else in the country.

While I agree that there are further steps that need to be taken to address some of the other systemic reasons for increasing costs, it is important to remember that access to health care is one of those reasons. MassHealth was a critical step in the right direction towards reform.