For HAA pilots, just curious how as to much BS is flown vs critical, medically necessary, etc.?  3/4 of what I fly is ridiculous.  I don't think HAA in it's current form is sustainable.

What would you know about business feasibility. Just focus on your task, flying. 

Why are you second guessing the medical decision. It's often about the golden hour, getting the patient to a higher lever of care so it can be determined how bad things really are. Quite often it's not that bad, but would you want to take a chance of not flying your family member because they 'may be' OK?

I bet you like when the Med Crew get in your cock-pit and tell you when to fly?

Well said except for the bit about med crews getting in to the cockpit etc.

Medical director says many times using the aircraft just accomplishes the task. Vacating a bed. Today's patients are like produce. Very time limited and day 1-5 is where the money is made.

The entire nation is short in transportation assets. 

Ride the wave.

The big adjustment is coming. 3-5 years you will see a 50 percent reduction in the number of aircraft nationwide. 

20 years of growth is over.

this is the answer. 

the flight request comes in. you the pilot decide if it can be done legally and safely, if yes, accept, if no turn down. if you accept and the medical crew refuses on whatever grounds they offer, drop it, forget it, go back to bed. 

for whatever reason, this simple concept seems difficult or impossible for some pilots to accept. very strange. 

are a large portion of flights medically unnecessary? yes. do the flights put financial burdens on families? yes. one day there may be nuremberg trials of capitalism and we pilots may be in the dock. at that time our defense can only be, "i was just following orders--just doing my job." history shows that defense failed--will it succeed for us if and when we are all called to account? your guess is as good as mine. meanwhile, up to our necks in the system, we press on. 

The BS transfers are what pay to make the aircraft available for when it's really needed.

The BS transfers are what pay to make the aircraft available for when it's really needed.

Exactly. Something like three-quarters of scene flights are no-pays.

The IFTs are generally reviewed with compensation in the process. The patient can die in the original facility as well as some 'higher care facility'; and it's cheaper if that happens.

You want government healthcare? I don't, I was raised as a military dependent and I can say that's when the healthcare was good, it was as good as any. But when it was bad, one had no choice but make the best of it. That's pretty much what you're advocating.

If you want actual medical necessity as the defining criteria, you're going to have to accept a government body over-seeing flight requests, not medical experts.

stop using the word emergent as it has nothing to do with something being an emergency. it's something stupid med crews says to make themselves sound smart. second, I don't know why anyone would say it's unsustainable since it's been sustaining itself for a helluva long time and it's not about to change

unethical and unsustainable