Helicopter setting off on a rescue mission
Helicopter setting off on a rescue mission - 
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Renita Jablonski: The National Safety Transportation Board usually focuses on commercial airline crashes. This week, they've been looking at air ambulances. In question are companies that send out choppers to rescue people and airlift them to a hospital. Jill Barshay has this look at how medicine and business collide.

Jill Barshay: As fans of the TV show MASH know, medical evacuation has been around for over half a century. But it's only recently grown to a $2.5 billion civilian business.

In the last 10 years, the number of helicopter ambulances has doubled, but the number of accidents has skyrocketed. Last year, 28 people died in medivac crashes.

Thomas Judge: This has everybody's attention. We have an accident set of numbers that's completely unacceptable.

Thomas Judge runs a nonprofit medical evacuation program in Maine. He says it's not clear what's causing all these accidents, but he believes money is a factor. Helicopter companies charge $10,000 or more for each mission. If they don't pick up patients, they don't get paid.

Judge: They're under pressure to find, you know, flights because the revenue for the system is based on flights. That now we're making a decision that's not based on medicine, we're making a decision that's based on business.

Business concerns are also why many firms are not buying costly safety equipment.

Dr. Kevin Hutton is with the Association of Air Medical Services, the industry trade group. He says helicopters are expensive, and profit margins are thin.

Dr. Kevin Hutton: Any time we adapt, any time we add a safety technology, any time we do anything that's going to cost us additional money, we have no way of getting reimbursed for that right now.

Dr. Hutton predicts new safety costs will force air ambulance companies to retreat from some rural communities. If that happens, it could affect the health of people who live in small towns. Many of their hospitals don't have neurosurgeons or cardiac specialists, and they rely on air ambulances.

In New York, I'm Jill Barshay for Marketplace.