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5. Indian River Memorial Hospital's approach would create <br />an absolute monopoly at taxpayers' expense. The para- <br />medics, if employed by IRMH, would take all patients <br />to IRMH. The hospital is currently attempting to change <br />legislation whereby its physicians would receive full <br />payment for indigent care (see attached), in addition <br />to the tax monies that the hospital receives. <br />Although the hospital assures us that the ambulance service would <br />be a separate corporation and the hospital would have little in- <br />fluence over its operation and based on past history, I can assure <br />you this will not occur. <br />We, therefore, support the Indian River County proposal and urge <br />others to do 'So. <br />Sincerely, <br />Mitchell B. Smith <br />Executive Director <br />Mr. Smith expressed his belief that the County system would <br />keep intact much of the existing delivery system. He confirmed <br />that there is friction between the two hospitals, and that the <br />paramedics will take patients to their hospital out of allegi- <br />ance, which is normal. He stated that when the ALS system was <br />developed, Humana was not contacted about protocol. Mr. Smith <br />stressed his support of the County proposal, which he believed <br />was much more financially conservative. <br />William Koolage came before the Board representing the <br />A.A.R.P., Vero Beach Chapter. He reviewed the history of <br />employing the paramedics, the friction between the Fire Depart- <br />ment and Volunteer Ambulance Squad, etc. He expressed their <br />support for the county taking over and having a unified EMS and <br />gave in detail the reasons for his belief that the Hospital wants <br />control not simply for altruistic reasons but because of the <br />financial advantages control of the system would bring to the <br />Hospital. He stated that those individuals who represent <br />administration for the Hospital District are employees of <br />Hospital, Inc., and are on the payroll of Sun Health, and the <br />control of the paramedics not only will assure by-passing Humana <br />Hospital, but the majority of those people brought to Indian <br />River Memorial Hospital will be admitted as in -patients. He felt <br />17 <br />DEC 2 01988 <br />BOOK i5 PAGE 416 <br />