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Thread: Medevac helicopter crash tragedy in Ohio.

  1. #21
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    Quote Originally Posted by Evan View Post
    Now, on the other hand, if you want to only charge me $1500, you can pick me up in your 407.
    What's the price point above which you require a twin? Also, what's the price point above which you will only accept a Sea Dragon?

    Thanks in advance.

  2. #22
    Senior Member Evan's Avatar
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    Quote Originally Posted by ATLcrew View Post
    What's the price point above which you require a twin?
    $1501.00

    You're very welcome.

  3. #23
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    Quote Originally Posted by Evan View Post
    $1501.00

    You're very welcome.
    Much appreciation. I won't ask where you pull that number from, firstly because I have a pretty good guess as to its origins, and secondly because it's not immediately germane.

    Now, let's talk about this "lifeflight" industry of which you speak, and which you describe as yet another example of aviation, as a business sector, robbing you dry. Keep in mind that the $25,000 bill includes not only the flight, but any medical care the patient receives during that flight, and considering that most airlifted patients are critical trauma cases, odds are there is an ALS ticket generated, and the price is in line with what similar care would cost on the ground. Which brings me to my next point. If a private carrier is contracted to provide 911 emergency transport, they are REQUIRED to respond when requested (provided the weather is legal), regardless of the patient's ability to pay. In other words, same as an ambulance. Now, our local Medevac helicopter operation is run by our county Sheriff's Office, and they do bill for that part of the service, and their collection rate is something like 35%. I doubt it's much better for private carriers who bill the patients directly. Those who get paid by the relevant government fare somewhat better, but my point is very few people actually pay those bills out of pocket. Insurance companies often cover most of the bill, which then opens up the whole can of worms on why health insurance is so expensive, but that's a whole separate conversation. The rest ends up covered by the taxpayers one way or another.

    So, I guess my question would be why you want me to pay more taxes for a problem that may or may not exist. Now, if you can show me some definitive data that shows that in those single-engine "for profit" medevac helicopter crashes a second engine would have saved the day, I'll be glad to revisit the topic. But if the gist of your argument is that those bastards charge way too much for just one engine, that's not a safety-related argument, but an emotional (and I suppose a financial) one.

  4. #24
    Senior Member 3WE's Avatar
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    Quote Originally Posted by ATLcrew View Post
    What's the price point above which you require a twin? Also, what's the price point above which you will only accept a Sea Dragon?

    Thanks in advance.
    I’d also ask Evan for his thoughts on the ticket price structure of Air Choice One versus Cape Airways and how we might adjust for the reliability of one PT-6 vs two Lycomental IO-lotsacubicinches-236As?
    Les règles de l'aviation de base découragent de longues périodes de dur tirer vers le haut.

  5. #25
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    Quote Originally Posted by ATLcrew View Post
    Now, let's talk about this "lifeflight" industry of which you speak, and which you describe as yet another example of aviation, as a business sector, robbing you dry.
    Since when am I describing aviation as "a business sector, robbing us dry"? Remember, I'm the one willing to pay a bit more for added safety (and dignity). My gripe with the industry is that it is becoming too profit-driven at the expense of these things (see: Race to The Bottom). But that doesn't apply to this discussion. Competitive pricing doesn't exist here.

    I'm also not aware of ground ambulance services charging $15,000 to $25,000, on average, for less than an hour of service. When my father had a full cardiac arrest, the total ambulance service bill was under $1500.

    Take the Bell 429. You have an operating expense around $1000/hour, or, factoring in all variable and fixed expenses associated with operations, around $2,500/hour. So let's be generous and say $3500/hour. Expediency being the point, many, if not most, of these bills are for an hour or less of actual service. I'm sorry, but I fail to see the ecomomic barrier to operating a Cat A, medevac helicopter there.

    But allow me to point out the folly of your main point. You say:

    if you can show me some definitive data that shows that in those single-engine "for profit" medevac helicopter crashes a second engine would have saved the day, I'll be glad to revisit the topic.
    This is not how aviation safety should work. It should not be a series of hindsight improvements. It should be "won't happen", not "won't happen again". It should rely on vision and deductive reasoning to prevent accidents before they happen, and it does. The industry recognizes that a vulnerability exists for single-engine ops in a critical but often necessary phase of flight, i.e. the 'dead man's curve', for which a fatal outcome is likely and for which only a second engine having a sufficient power rating can overcome. They also know that crashes have occurred due to this vulnerablily, but more importantly, they know that the potential for tragedy exists. So what do they do about this? Do they wave it off as an 'emotional' concern? No, they respond by developing aircraft to meet this demand. The Gemini xl had redundancy far beyond what sceptics looking at statistics might have deemed necessary, including separate transmissions, separate freewheels and separate fuel systems. It was designed with low altitude OGE hover ops in mind, such as winching and rappelling, placing a higher value on human life than sceptics might have done. It was the product of preventative vision. You might say it was overdesigned, but then you are probably not hanging beneath it over a mountainside on a regular basis.

    Many years later, that effort has evolved into the 429, which also has fail-passive OEI capability, and which has been a successful product in the market. Now, ask yourself: why would customers be willing to pay close to $7M and around twice the operating costs for a light helicopter with not much more interior room than a very dependable 407? Because their 407's keep going down in flames? Or because they are placing value on safety from a preventative, visionary standpoint?

  6. #26
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    Quote Originally Posted by Evan View Post
    This is not how aviation safety should work.
    Perhaps. But that's how it DOES work.

  7. #27
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    Quote Originally Posted by ATLcrew View Post
    Perhaps. But that's how it DOES work.
    Right. So that's why we have three or even four, dual-channel flight computers on modern airliners? Because of crashes where the third or fourth one saved the day?
    You don't need a body count to justify precautions and redundancies. You just have to care about human lives and have some ability to think ahead.
    It's called aviation safety, not aviation patchwork.

  8. #28
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    Quote Originally Posted by Evan View Post
    You don't need a body count to justify precautions and redundancies. You just have to care about human lives and have some ability to think ahead.
    It's called aviation safety, not aviation patchwork.
    So, why aren't you demanding exclusively Sea Dragons then? (for those who don't know, the helicopter in question has THREE engines).

  9. #29
    Senior Member 3WE's Avatar
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    Three engines...four...

    Ideally we need parachutes and padding systems to make crashes much more survivable...why not that?
    Les règles de l'aviation de base découragent de longues périodes de dur tirer vers le haut.

  10. #30
    Senior Member Evan's Avatar
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    Quote Originally Posted by ATLcrew View Post
    So, why aren't you demanding exclusively Sea Dragons then? (for those who don't know, the helicopter in question has THREE engines).
    Same reason we have ETOPS. Two engines are sufficient to be reasonably safe. You see, aviation safety isn't fanatical either.

  11. #31
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    Quote Originally Posted by 3WE View Post
    Three engines...four...

    Ideally we need parachutes and padding systems to make crashes much more survivable...why not that?
    The seats on our local MD902 medevac chopper are rated to survive a 47G impact. Trouble is, the cynic in me asks “What about the floor they are bolted to ?”
    If it 'ain't broken........ Don't try to mend it !


  12. #32
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    Quote Originally Posted by brianw999 View Post
    The seats on our local MD902 medevac chopper are rated to survive a 47G impact. Trouble is, the cynic in me asks “What about the floor they are bolted to ?”
    The seats can be rated for 47G, the floor can be rated for 47G, the skids can be rated for 47G, the belts can be rated for 47G, but you are NOT rated for 47G, so what's the point?

    Several years ago the FAA changed the crashworthiness standard for airplanes. Now they require FIRST that under certain pre-defined crash conditions the peak acceleration doesn't exceed certain limits and THEN that the seats and supporting structure can resist that.

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  13. #33
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    Quote Originally Posted by Evan View Post
    Take the Bell 429. You have an operating expense around $1000/hour, or, factoring in all variable and fixed expenses associated with operations, around $2,500/hour. So let's be generous and say $3500/hour. Expediency being the point, many, if not most, of these bills are for an hour or less of actual service. I'm sorry, but I fail to see the ecomomic barrier to operating a Cat A, medevac helicopter there.
    Your calculation of the cost of the flight hour is meaningless.


    Emergency resources are paid for availability and used for necessity.
    You may be paying $ 15K the ride. But the helicopter is bought and you are paying the cost of the money even when parked, you are paying the hangar and the insurance even when parked, you are paying the hourly share of the annual even when parked, and you are paying the pilots even when parked, and the list goes on. Emergency resources are typically much more available than used, because nobody knows when they will be needed and they need to have enough capacity to cover peaks in demand. Since most of the time the demand is not peak, then most of the time the resources are available but idle. And when they are used, only a fraction of times they are paid (and when they are, mostly they are paid months later, again cost of money, and not in full). The few full payments and some partial payments, all of them late, need to cover the cost of these flights, the cost of the other flights where they are not paid, and the cost of being available 24/7 when nobody is needs their service. The real problem is that the service is available 24/7 for EVERYBODY, even for those who don't happen to need it (but they might need it at any minute). So for me the question is whether this should be a public service paid for with taxes, and my answer is yes. Imagine if only the people using the service of the fire department needed to pay for it and pay a price that covers the purchase of equipment (fire trucks can be more expensive than a helicopter), the fire stations, and the wages of the firemen.

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  14. #34
    Senior Member Evan's Avatar
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    Quote Originally Posted by Gabriel View Post
    Your calculation of the cost of the flight hour is meaningless.
    The hourly figure I used is based on 300-350 hours per year, including hanger fees, insurance, pilots and training, everything. And then I padded it by $1000. Does that help?

    Looks, let's put our cards on the table here. Are you suggesting that 'lifeflight' operations in major markets cannot justify the expense of employing helicopters designed for the purpose, with OEI survivability in all phases of flight? Because that IS the issue. Why else should we allow these providers to operate on more vulnerable aircraft? Where the economics are a barrier, as I said in the beginning, any helo is better than no helo, but is that the case in markets charging bankruptcy-inducing rates for an hour of service? At $15-25K, the question is rhetorical.

  15. #35
    Senior Member TeeVee's Avatar
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    Gabe, in some places in the US medevac is offered by various govt agencies. but in smaller communities where there is no need for helos to begin with (and no money--even taxes--to pay for them), people have to rely on private air ambulance services which are monumentally expensive. i'm not at all familiar with how the private air ambulance services work, but i'm not sure if they respond directly to accident scenes. maybe the authorities have contact with them and when there is no govt service available they call the privates. i'm guessing in those situations, the services rarely get paid in full.

    i pay for medjet assist on an annual basis, but that only works once you're admitted to a hospital.

  16. #36
    Senior Member Gabriel's Avatar
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    Quote Originally Posted by Evan View Post
    The hourly figure I used is based on 300-350 hours per year, including hanger fees, insurance, pilots and training, everything. And then I padded it by $1000. Does that help?

    Looks, let's put our cards on the table here. Are you suggesting that 'lifeflight' operations in major markets cannot justify the expense of employing helicopters designed for the purpose, with OEI survivability in all phases of flight? Because that IS the issue. Why else should we allow these providers to operate on more vulnerable aircraft? Where the economics are a barrier, as I said in the beginning, any helo is better than no helo, but is that the case in markets charging bankruptcy-inducing rates for an hour of service? At $15-25K, the question is rhetorical.
    If these companies were making a lot of money with these prices, you would have ore companies offering the service and competition would bring the price down.
    I don't know what is the cost of a helicopter medevac operations, but I know what it is not. I am really wondering where did you get your cost sources from.

    I have never seen the breakdown of the cost of an actual air medevac operation, but I did rough estimates of other air operations myself. Let me do a "Feynman estimation" here in real time.

    Let's take 365 1-hour of medevac flights per year, just because you took a 300ish number (I believe a small medevac op will not make 1 flight per day on average).

    For 24/7 availability, you need minimum 2 helicopters (both because you may need to attend 2 accidents or to victims in the same accident at the same time, and because you cannot discontinue the service when one machine needs maintenance). A single turbine helicopter with medevac capability and their medical equipment is say 2.5 million dollars each. That's 5 million dollars investment. Taking a depreciation of 5 years, that's 1 million dollar per year, or $ 2,739 per medevac flight right off the bat.

    For 24/7 availability with capability to attend 2 victims at the same time, you need 8 crews. Not 8 pilots, 8 crews: 8 pilots, 16 paramedics, 8 ground technician/support crew. That's 40 ops guys/gals. Let's take a cost of 80K each (that's the company cost of paying a $ 60K-is annual salary, not just their salary). 80K * 40 / 365 = $ 8,767 per flight.

    Just because it is a nice round number (I think it is not enough), let me add $ 365K (1000 per flight) for fuel, hangar, office rental, insurance, maintenance (scheduled and unscheduled) and spare parts.
    Let's also throw in an administrative employee, a flight operations manager, a certified aviation mechanic, an operations quality manager, and a general manager (or CEO or whatever you want to call them). We don't need 8 of each, since they don't need to be available 24/7 for each helicopter (or at all). Let's take again $ 80 K each, which is probably way high for an admin but way low for the mangers. 80K * 5 / 365 = 1095 per medevac flight.

    Are you ok with profits? The owner invested 5 million (it has to be more, they will need a set of spares and tools and fixtures to begin with, as well as furnitures, uniforms, etc, etc...) for a high-tech live-or-death operations. If that doesn't leave him 10% of net profit (after tax), they will be putting their money somewhere else. 10% after tax requires about 15% before tax. 15% of 5 million is $ 765,000, or $ 2054 per flight.

    Let's add all this up: 2700+8700+1000+1100+2000= $15,500 per medevac flight.

    Wait, we are not done. Since we are taking 1 flight per day on average, let's take that as the daily cost of the operation. Let's say that on average they get paid 2 months after service, so they need a working capital of $15,500*60 = $930,000, let's take 12% annual (1% monthly) as the cost of capital and we have another $350 per day, and since I did not include other expenses, utilities, I don't know, cleaning services, whatever, let's make it just $500 per day and we reached a total bill of $16,000 per flight.

    Finally, the cherry of the cake, say that they get paid 50% of the bill on average (or let's say 33% in full, 33% 1/2, and 33% none), and suddenly you need to charge $ 32,000 per medevac flight to support operations.

    Was my calculation wrong? For sure!
    Was in one order of magnitude wrong? I doubt it.

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  17. #37
    Senior Member Gabriel's Avatar
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    Quote Originally Posted by TeeVee View Post
    Gabe, in some places in the US medevac is offered by various govt agencies.
    For free?

    I am living in the US since about 4 years ago, and one thing that shocked me since I arrived here is that schools and school buses are free but hospitals and ambulances are not only paid but waaaaaayyyyy too expensive.

    In my mind (call me socialist if you will) education (at lease basic education), security (including defense), health, and justice are among the few services that need to be AVAILABLE for everyone and everyone should pay for it being AVAILABLE, to for using it. And the best way to do it is via tax.

    The 5 years-old son of a drunk dad that crashed is not at fault and should not be indebted for life for being transported in a helicopter, and I (the next guy with buying power that gets air medevaced) am not at fault neither that the drunk dad also hit me or that they could not pay for the medevac of the boy so I have to pay for both.

    I want to pay to have it available. Hopefully never use it. And not pay if I end up needing to use it.

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  18. #38
    Senior Member Gabriel's Avatar
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    Quote Originally Posted by Evan View Post
    Are you suggesting that 'lifeflight' operations in major markets cannot justify the expense of employing helicopters designed for the purpose, with OEI survivability in all phases of flight? Because that IS the issue. Why else should we allow these providers to operate on more vulnerable aircraft? Where the economics are a barrier, as I said in the beginning, any helo is better than no helo, but is that the case in markets charging bankruptcy-inducing rates for an hour of service? At $15-25K, the question is rhetorical.
    And by the way, no I am not suggesting that medevacs ops cannot sustain those helicopters. Maybe they can. maybe it would not make a lot of difference to the operation cost and if they can't now, they could with a relatively small increase in price.

    Everybody estimates risks differently and has different tolerance to risk. I, in particular, if I am in such daring or delicate condition that I am in serious risk of dying and an airlift can greatly increase my odds of survival, would not mind being airlifted in a single turbine helicopter. For the following reasons:

    - The risk of engine failure is extremely low, and the fraction of fatal crashes due to engine failure in single-turbine helicopters is also small.
    - My exposure to that risk will be hopefully zero, or extremely low if not. I would consider the most unlikely guy in life if I need to be airlifted more than twice in my entire life.
    - I've already decided to assume somehow similar risks. I flew in a single-engine turbine helicopter once, in a zone where there was the prospect of an off-helipad emergency landing were awful. I have more than 250 take-offs in single-engine planes, about 1/3 of those taking off over an urban area without anything to put the plane down other than your favorite 1000 sqft backyard. If "ive already decided to take these risks only for joy (and paid for it), then I am more than willing to take the same risk in an emergency situation.

    The risk for the crew of the helicopter is different. I mean, the risk itself is the same, but their exposure is many orders of magnitude higher. However, the pilot of the medevac could be the pilot of some rich (but not super millionaire) guy flying a similar helicopter and exposed to similar risk. And neither the pilot nor the paramedics flying in the thing are forced to do that, so they are accepting the risk, of which they (especially the paramedics) should be made fully aware. And even then I don't feel fully comfortable with that, since rejecting or leaving a good job (and well paid) due to risks that, most likely, will never realize, are very hard decisions to take. If the union of the medevac paramedic, or of the medevac pilots would make a strike and riots demanding twin turbine to be made mandatory, I would not blame them, and I would also not oppose the government making such mandate, even if I personally am perfectly ok with the risk.

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  19. #39
    Senior Member brianw999's Avatar
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    MD 902 cost new.... $7.1M

    Operational costs...

    FINANCIAL
    Total Fixed Cost/Year $453,046
    Total Fixed Cost/Hour $1,227
    Total Fixed Cost/Unit Distance $10 /nm
    Total Misc Cost/Year $60,951
    Total Misc Cost/Hour $34
    Total Crew Cost/Year $268,320
    Total Fuel Cost/Hour $299
    Total Mx Cost/Hour $663
    Total Variable Cost/Year $367,958
    Total Variable Cost/Hour $997
    Total Variable Cost/Unit Distance $8 /nm

    Source.. https://www.bjtonline.com/aircraft/m...d-902-explorer

    ....and these figures don’t include the cost of conversion and equipping to medevac standard, and the cost of crew training which in the UK includes a doctor and critical care paramedic.
    Last edited by brianw999; 02-03-2019 at 10:19 AM.
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  20. #40
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    Quote Originally Posted by Evan View Post
    Same reason we have ETOPS. Two engines are sufficient to be reasonably safe. You see, aviation safety isn't fanatical either.
    I'm glad to hear you say that last part, Evan. It appears that experience and engineering advancements also suggest that single-turbine helicopters are also, as you so eloquently put it, "reasonably safe". So, here we are.

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