Posted Wednesday, June 22, 2005 12:38 PM | Contributed by Jeff
Virginia ride safety inspectors say that their ride safety inspection program is very strong, and that federal oversight is not necessary. Some also acknowledge that not all states have programs as strong as those in Virgina.
Read more from The Times-Dispatch.
We could argue a lot about Federal vs. state jurisdiction. I have mixed feelings.
Markey's proposal wouldn't do anything to change the current situation on inspection since the CPSC just investigates accidents, it doesn't inspect to make sure that rides are maintained properly. Most serious accidents on amusement rides are due to improper maintenance, rider misconduct, or operator error. The CPSC wouldn't really address any of these.
I do worry about something that I have seen in other fields when the Federal government becomes involved. The Federal inspectors inspect the paperwork, not the reality. The whole emphasis becomes one of having perfect paperwork, not on really doing things right. I do agree that documentation of inspections and maintenance is important, but I worry when the focus becomes the documentation rather than the inspecitons and maintenance themselves.
In support of what Jim has said…
I participate in a federal grant program/study called SHMO (Social Health Maintenance Organization). I actually work in the field and collect home health data through physical therapy. Specifically I look at cost/result analysis for a certain set of standards (hospitalization, broken hips, etc).
As usual for federal programs the intent is good. However, the emphasis on paperwork is such that I would estimate 80% of my time is spent pushing paper and 20% of the time is spent treating patients. The results have not been so good (mixed at best), but the taxpayer has been stuck with the bill for over 10 years now. SHMO is renewed by congress biannually. They could discontinue this program at any time since the results have not shown to be cost effective, but what do you think happens…? My side job is safe!
I guess what I’m trying to say is that just because the government gets involved does not mean it will work. In fact, it often gets worse. I’ll admit I’m generally biased against government intervention, but I have good reason to think this way based upon life experience and general observation. I think it is way too easy to assume that big brother knows better.*** This post was edited by Jeffrey R Smith 6/22/2005 9:18:15 PM ***
I think that, in an honest moment, even Markey wouldnt suggest that any particular accident would be prevented *solely* because of 'closing the loophole'. But rather, that by having all the data in one place, it is more easily analized and as I said above, trends become more apparent.
Now, I am of the mindset that the industry itself has a compelling interest in all accidents and thus, share this information among themselves. (See how KK's incident closed down TTD or how VertiGO's incident affected the ride @ SFMM). So I think that the industry does a fine job policing itself.
We have 100% coverage for fatalities with the media coverage today. While we don't have 100% coverage for lesser accidents, we do have good samples from a number of states that do require accident reporting. I don't think it's unreasonable to assume that other states follow the same basic patterns as those states that do require reporting.
I have to ask the question. If you spent 20% of your time on paperwork and 80% of your time treating patients, would the program be cost effective?
I'm sure everyone is familiar with the "Clean Water Act." Nice sounding program, good intentions. It's a Federal law that has recently been "upgraded" that is, many of the requirements (despite what you might be hearing) have been made stricter, particularly regarding stormwater. The law has been revised to require any site that will have more than one acre of earth disturbance to apply for a permit.
The original stormwater requirements were passed back in the early 90's, and passed down to the states to administer. Here in PA, the state turned around and handed it over to the counties. There was no funding available from either the federal or state level.
Now with the stricter requirements (originally the breakoff point was 5 acres) there have been an explosion of plans an applications to review. The govt agencies are all complaining they're overworked and undermanned, we now have to tell many more clients they're required to apply for permits, and our bills to them have gone up greatly to include all the extra work that must be added to complete the plans and submit the applications. The work that is submitted is also taking longer to be approved.
I have spoken with several people at the state level about concerns I have or problems I see or foresee happening. The only response I get is that it will be taken into consideration (by whom? when?).
The real kick in the ass is that the Chesapeake Bay Foundation just released a report saying that the condition of the bay continues to deteriorate and that the Susquehanna River watershed (PA's single largest watershed) is one of the most polluted in the country. So despite years of applications, reviews, fees, plans and permits, things have actually gotten worse instead of better. As was mentioned above, it's gotten more important to put something on paper that looks good instead of something that will actually work in the field.
OK, so what does that have to do with the price of tea in China? My concern would be that Federal oversight of ride safety would consist of the development of an extensive set of standards and regulations they would simply hand off to the states to implement. Factors like time and cost would have no place in the program-- it wouldn't be the Feds' problem. Don't forget it was the Feds who gave us something like a 36-page manual on how to use a hammer. And require Braille instructions at drive thru banking windows.
The short answer is probably not…but I cannot be sure.
Read the following for an explanation (not directly coaster-related but related to this thread in the sense that it shows how government involvement is not always a productive means to accomplishment)…
Read the last paragraph for the thread-related conclusion…
The original intent of the legislation, as I understand it, was to pilot-study the implementation of HMO (the hated word) structure to Medicare patients to see if this structure could indeed provide better quality medical care for the same or less money. Certain companies (many which have since dropped the program as they cannot turn a profit) agreed to take regular monthly Medicare payments from the government in return for agreeing to provide most medical services for those patients who voluntarily enrolled. This was not available in all cities as it was a pilot study.
In order to get senior citizens to option out of Medicare and enroll in a SHMO program the companies (Senior Dimensions in Las Vegas) had to offer additional benefits that were not available through regular Medicare. Most offered cheaper drug co-pays, doctor co-pays, etc as the enticement. My portion of the study comes through home health services that are provided to senior citizens as a “maintenance” program. This means the patients did not have to have any acute (recent) injury to get covered (free) therapy services through SHMO. The idea behind the study is that by providing therapy to older patients on a maintenance basis, you could save money long term as it is cheaper to pay a therapist (me) than it is to pay a hospital for broken hips, etc. I serve not only as the therapy provider, but I am the data collector. It is a blind study that I’m not supposed to know any results. They have been collecting this data for over 10-years.
Needless to say the results are readily available if you talk to the right people and they are a mixed bag. First and foremost---we have not---and never have saved money. We provided therapy services to patient after patient without regard to any discharge criteria. This gets very expensive. More and more patients found out about the program and dropped Medicare to enroll so they could get FREE services. Eventually the private companies who thought they could turn a profit found out that they could not afford the bill so many dropped the program. Private companies were under so much pressure from the “HMO is the devil” crowd that they could not effectively limit their costs through any reasonable service reductions as was intended. My company sponsor has held strong by changing the rules in the middle of the game (and using a fixed/capitated cost savings structure that most companies were afraid to try). We now provide something that is called “maintenance” therapy that is limited to 60 days. It is not written anywhere that patients should be d/c by then (60 days), but those therapists who keep patients longer magically find themselves out of a job. Guess when patients get d/c?
As to your specific question…I could work with the patients longer if I had less paperwork. There is no objective data that would show that this would be of benefit. Intuitively you would think extra therapy/exercise should benefit the patient through better lifestyle habits and therefore lead to less healthcare utilization. My counter-argument for this is the fact that the patients in the SHMO program to date have the same hospitalization rates as those who stayed in Medicare, even though they received extra therapy benefits. Therefore, the extra money spent on maintenance therapy does not seem to be having an objective effect on patient outcomes. Therefore I make an assumption/hypothesis that additional therapy in place of paperwork should not be expected to affect patient outcomes based upon available data. There are certain limited areas where the data shows positive statistical trends (falls and broken hips are two I remember), but the overall hospitalization and health care utilization rates have stayed the same.
The sad part of all of this is that the data collected is relatively useless. Each separate company in multiple cities and states collected the data as instructed by Congress. However, each company was providing different incentives and services to entice people to use their SHMO program. There were no controls on the implementation of services, so it is impossible to form any cause/effect relationship on the data with any real certainty. I relate this to the $500k Markey is suggesting we use to collect data at the federal level. The federal government is always collecting data, but the controls they use during the collection process are often so shabby or nonexistent, that the data collected tells you nothing. I see no reason to expect government to do any better job collecting data about amusement ride accidents.
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