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October 10, 2008

The Future of Maryland Medevac

Kevin E. Dayhoff

The recent tragic crash of the Maryland State Police aviation command Medevac helicopter has unfortunately developed a subplot for those who wish to further a debate about the future of the vital air rescue service.


The debate began before grieving co-workers, friends, and family hardly had a chance to say goodbye to the three rescue workers and one patient who died.


Much can be said about the inhumanity of state elected leaders who would use such a tragedy for political expediency; however, for those who have observed Maryland politics for many decades, there is very little that can surprise any longer.


We live in a state with a national reputation for politicizing everything from algae to windmills – with all the accompanying mediocrity that is associated with the enormous egos of politicians who are rarely held accountable for their mendacious, meddlesome behavior.


Ever since Maryland modeled its Medevac rescue system from the lessons learned on the battlefields of the Vietnam War, it has been copied all over the world with varying success, although arguably, the Maryland system remains the premier service.


Since the Medevac rescue missions began in Maryland in 1970, 120,000 trauma patients have received the benefits of getting the best chance of survival in what is termed the “golden hour.”


In 2007 alone, the Medevac rescue unit flew 4,500 patients to safety in Maryland.


Not one single patient has been billed.


For those who know what it is like to travel in a helicopter, there is no such thing as a “routine trip.” In a highly congested state known for its fickle weather, every successful mission is a testimony to the skill, expertise, and emphasis on safety that has become accepted as “routine” for the Maryland State Police and the state’s emergency medical providers. It enjoys a reputation as being among the nation’s finest.


According to a Washington Post news account, the Maryland Medevac service maintains “helicopters in eight locations across Maryland so they can reach any corner of the state within 18 minutes.”


It is a critical public safety service for those in the more rural areas of the state.


The crash on September 27 came at a time when concerns have been raised over the age of the 18-year-old fleet. How will the state fund the estimated $110 million it will cost to replace?


The funding concerns are only exacerbated by a national economy in turmoil and a state budget that has remained obstinately in a structural deficit as a result of spending that has spiraled out-of-control.


This has given traction for those who wish to see the service privatized. A recent Washington Post article noted that because “the patients being transported Sept. 27 might not have been seriously injured, some critics say the incident is emblematic of a tendency to overuse Medevac flights and put lives at risk unnecessarily.”


Please re-read the previous sentence. Let’s try to overlook the inhumanity of critics who would suggest that the three rescue workers died in vain while heroically trying to save lives.


The life and death decisions by trained professionals on the scene of an accident happen in split seconds. Critics who seek political advantage from such a tragedy have months to develop their talking points.


If the system is being overused, then change the “fly out” protocols based on a comprehensive study of many past experiences and not days after a particular tragedy.


Others have used the tragedy to point out that the Maryland Medevac system is the only “state-operated” service in the country.


Yeah, right. Let’s be clear. If there are suggestions that a “state-operated” system is being overused – where the life and death decisions are made by trained personnel who have nothing to gain financially from their decisions – then what, pray tell, would result if a for-profit service got into the mix?


If it is the cost of the service that concerns the politicians, then perhaps the overall cost to the greater community needs to be entered into the formula. In a recent anecdotal account shared with me, a Marylander recalls being billed by a Medevac provider in Pennsylvania over $15,000 for a 56-mile trip.


Multiply that example by 4,500 helicopter rides a year and it becomes a staggering additional “tax” upon the residents of Maryland, who already live in one of the most expensive states in the country.


At a time when many citizens have lost confidence in the ability of government to do anything efficiently and effectively, the Maryland State Police aviation command performs its lifesaving function superbly.


The Washington Post reports that despite “funding concerns and aging equipment, the department has held one of the best safety records in the country. Its last crash was on Jan. 19, 1986, when two officers encountered severe fog and crashed in West Baltimore after transporting a shooting victim to a hospital.


“In all, there has been one airplane and three fatal helicopter crashes since the unit was formed in 1961.


“By contrast, crashes involving private air ambulances have soared in recent years, with 55 crashes from 2002 to 2005, according to a 2006 congressional report.”


And there is the rub.  Why in the world would we ever want to place our public safety in the hands of “private air ambulances” with such a track record?


Politicians who are utilizing the cost of the Maryland “state-operated” air rescue service should think through their argument carefully. We have already had our quality of life impacted in Maryland by the reckless tax and spend practices of the Maryland General Assembly.


When those reckless tax and spend practices begin to impact upon our public safety – then maybe, just maybe – Marylanders might begin to reflect upon the wisdom of returning these people to their elected office.


Kevin Dayhoff writes from Westminster: E-mail him at:


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