In The Land of the Blind, The One-Eyed Man Is King

Think the health care reform debate is complicated?
Think the people making the policy that will result most likely in a government takeover of about 20 percent of the US economy give a flying fart about EMS?
I understand when laymen have trouble figuring out all the ramifications.
What does it mean when the "experts," people with PhDs who do nothing but ruminate daily on the health care reform debate, admit that they haven't thought even for a moment about health care reform's potential impacts on EMS?
And yet, this is exactly the case.
Last week I read a 10-page supplement to the Columbia Journalism Review written by a think-tank that philosophically stands squarely behind President Obama on health care reform.
The think tank advertises itself as "A private foundation working toward a high-performance health system."
When I read this group's piece I thought maybe I had found that touchstone, a group that made it's argument lucidly, plainly and convincingly.
Maybe, finally, I had found a way into the debate that made sense, could give me a reason to get behind reform.
But one nagging thought remained.
Nowhere in this 10-pager was there mention of EMS.
Nothing about how ambulance services would be re-paid for services rendered to Medicare/Medicaid patients despite the fact that almost every proposal for health care reform calls for Draconian cuts to the costs of Medicare/Medicaid.
How, I wondered, would EMS survive deep cuts to Medicare/Medicaid reimbursements if services to those folks were already burdensome financially at the current level of funding?
So I emailed the director of the think tank that wrote the piece and asked if she had any information on the subject.
She wrote back rapidly with the candid admission that she had no idea.
To her credit, this director spent part of her Friday night tracking down the contact information of people who might be able to answer my question, even though it was clear that I'm not a person of any particular importance and was asking the question mainly out of personal curiosity.
But it also points to the fact that EMS is NOT a part of this debate, and my fear is that when the entire US health system is overhauled and re-done, the EMS system could find itself with more demands and no way to meet them.