BasicMed changes in 2024 FAA Reauthorization Act

MauleSkinner said:
A BasicMed Pilot is largely an “unknown” from a medical perspective. Allowing an unknown into some of the most highly-regulated airspace would be a difference.
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No, I checked in the mirror. I know that guy. It's still me.
We let guys fly on their Drivers License. I get it, they are (currently) limited to 1,320 lbs and 10,000 ft. This will certainly change in the next few years.
But a guy with a Tecnam and a full load of fuel flying into a kennel full of fluffy kittens and puppies is going to have the same outcome as a guy doing it in a Bonanza.
Assuming the guy in the Bonanza bothered to get a medical at all in the last 15 years.
 
MauleSkinner said:
A BasicMed Pilot is largely an “unknown” from a medical perspective. Allowing an unknown into some of the most highly-regulated airspace would be a difference.
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FAA published a study that shows no difference in mishap rate of BasicMed versus holders of conventional medical certificates. BM has been around for over 5 years now.
 
Lindberg said:
Why is an arbitrary limit of FL250 better than the current limit? How did you pick that number and what justifies it?
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I picked a number that covers a lot of SE piston aircraft. I would be fine with 290 also.

Another thing is, get 250 now, in 5 years ask for 290.

Or in a few years, ask to have BasicMed become the 3rd class. That would solve many issues, including the international one.

However, on Social Flight, Mark Baker stated that ICAO is working on recognizing BasicMed and that it should be within 2 years.
 
Pinecone said:
....ask to have BasicMed become the 3rd class.
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DING DING DING!! We have a winner!

Yes, that’s the right answer. Let any physician do the exam/approval. Keep the FAA out of it. I think it used to be this way.
 
Pinecone said:
Or in a few years, ask to have BasicMed become the 3rd class. That would solve many issues, including the international one.
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Although FAA maintains the 3rd Class is an internationally compliant medical, ICAO and most countries do not agree and first or second class is all there is, generally with more requirements than either of those classes in the US. However If ICAO were to recognize BasicMed that might be an advantage over the current international situation in that ICAO signatory countries would likely have to recognize it in a way they do not recognize the 3rd class now.

In Europe you can almost guarantee that EASA and/or the national CAAs and doctors would find a way to scuttle international implementation of BasicMed. That however would be their local issue to work out over time because the international framework would be in place, unlike with 3rd Class.
 
Pinecone said:
I picked a number that covers a lot of SE piston aircraft. I would be fine with 290 also.

Another thing is, get 250 now, in 5 years ask for 290.

Or in a few years, ask to have BasicMed become the 3rd class. That would solve many issues, including the international one.

However, on Social Flight, Mark Baker stated that ICAO is working on recognizing BasicMed and that it should be within 2 years.
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"Because I want it," or, "It meets my needs," doesn't really justify a legislative proposal. If a Congressional aide seriously engages with your proposal and asks why that number, he's looking for some concrete justification for that specific number.
 
Lindberg said:
"Because I want it," or, "It meets my needs," doesn't really justify a legislative proposal. If a Congressional aide seriously engages with your proposal and asks why that number, he's looking for some concrete justification.
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For a proposal to replace 3rd Class with BasicMed, it reduces the burden on pilots and vastly increases the availability of doctors that we can see to satisfy the requirements. And I'm sure there's a cost savings on their end too due to less administrative work. But I'm sure that Leidos or Northrup or whatever contractor hosts MedXpress wouldn't like it.

Also I'm not sure I've seen a logical explanation as to why I can fly a SportCruiser or a Bristell without a medical but I can't fly a 152.
 
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They need to also allow a pilot under BasicMed to act as a safety pilot.
 
Tusayan said:
Although FAA maintains the 3rd Class is an internationally compliant medical, ICAO and most countries do not agree and first or second class is all there is, generally with more requirements than either of those classes in the US. However If ICAO were to recognize BasicMed that might be an advantage over the current international situation in that ICAO signatory countries would likely have to recognize it in a way they do not recognize the 3rd class now.

In Europe you can almost guarantee that EASA and/or the national CAAs and doctors would find a way to scuttle international implementation of BasicMed. That however would be their local issue to work out over time because the international framework would be in place, unlike with 3rd Class.
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If you read ICAO Annex 1, the US implements an ICAO class 1 medical as the Class 1 and Class 2; ICAO intends a Class 1 medical as the standard for commercial operations; the US Class 3 satisfies the ICAO Class 2, which ICAO intends is for private pilots/non-commercial operations. The ICAO Class 3 is for Air Traffic Controllers.

The challenge with getting ICAO to accept BasicMed as a medical certificate is in the bureaucracy. ICAO requires the issuing physician be designated a medical examiner and is licensed by the licensing authority (FAA for the US) to conduct the medical exam.

I *think* for ICAO to adopt a BasicMed type certification. Likely in the US, we could get away with stating those physicians allowed to conduct a DOT physical would also be designated as, and limited to being a BM medical examiner.
 
TCABM said:
If you read ICAO Annex 1, the US implements an ICAO class 1 medical as the Class 1 and Class 2; ICAO intends a Class 1 medical as the standard for commercial operations; the US Class 3 satisfies the ICAO Class 2, which ICAO intends is for private pilots/non-commercial operations. The ICAO Class 3 is for Air Traffic Controllers.
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That’s the FAA position, yes, and it’s a sensible one that I think was carefully developed by FAA to avoid the draconian medical system for non-scheduled commercial and private pilots that’s implemented in most countries under ICAO standards, while at the same time allowing FAA to claim they are ICAO compliant.

A wrinkle in that cunning plan applicable to FAA private pilots flying overseas is that unlike ICAO-compliant medicals for private pilots in most other countries, FAA 3rd Class medicals (and of course BasicMed) do not include ECG (heart) testing. If you fly in some of those countries on an FAA certificate with a 3rd class Medical, you may find that the local CAA’s position is that you are not compliant with ICAO requirements. The non-ICAO medical class definitions used by FAA (the medical with 3rd class written on it is per FAA an ICAO 2nd Class medical) also causes confusion in this regard.

ICAO implementation of a slightly updated FAA BasicMed (with no reference to Class A airspace) as a new international medical category, with BasicMed also replacing the 3rd Class in the US would help eliminate the situation above and benefit many pilots… even more so many private pilots flying on non-FAA medicals outside of the US who would no longer have to deal with ECG testing and some other associated nonsense.

The next step after that would be FAA Sport Pilot medical regs replacing BasicMed in the US, and a couple of decades later ICAO might do that too.
 
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TCABM said:
Class A (IFR only operations) can start at whatever altitude, to include at the surface, a country chooses to adopt.

I can’t tell you the history of FL180 as a decision for the US, but the TUC table is informative.
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This is why I could see them holding the Class A (18K') limitation. Even though you'd need to be on oxygen at any level in the chart, it's what happens when the oxygen stops and you don't realize it very quickly after flow decreases. Same with a pressurization failure. At least if you were at 18K you might have a shot at noticing your blood-saturization dropping/oxygen flow has stopped in a 20-30 minute time span. At 28K, you have less than 3 minutes before you lose consciousness, which isn't much room to restore the oxygen flow (assuming you can even fix it in-flight), or initiate a rapid descent to buy more time. I can at least see the reasoning in why they would keep the 18K limitation, despite the overall risk of a problem being quite small.
 
MtPJimB said:
They need to also allow a pilot under BasicMed to act as a safety pilot.
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Come out from under your rock.

1) You could always be safety pilot under BM, but only if acting as PIC. Which is how many people do it, so both can log PIC.

2) These was changed last year.
 
SoonerAviator said:
This is why I could see them holding the Class A (18K') limitation. Even though you'd need to be on oxygen at any level in the chart, it's what happens when the oxygen stops and you don't realize it very quickly after flow decreases. Same with a pressurization failure. At least if you were at 18K you might have a shot at noticing your blood-saturization dropping/oxygen flow has stopped in a 20-30 minute time span. At 28K, you have less than 3 minutes before you lose consciousness, which isn't much room to restore the oxygen flow (assuming you can even fix it in-flight), or initiate a rapid descent to buy more time. I can at least see the reasoning in why they would keep the 18K limitation, despite the overall risk of a problem being quite small.
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And exactly WHAT in the 3rd class medical exam covers this issue? In determining whether you have a greater or lesser risk? Or even in the 2nd class or 1st class physical?????

My PCP does a simple pulmonary function test every year for my annual physical (which he will sign off the BasicMed from), which gives him some idea of my lung capacity and any breathing obstruction.
 
Pinecone said:
And exactly WHAT in the 3rd class medical exam covers this issue? In determining whether you have a greater or lesser risk? Or even in the 2nd class or 1st class physical?????

My PCP does a simple pulmonary function test every year for my annual physical (which he will sign off the BasicMed from), which gives him some idea of my lung capacity and any breathing obstruction.
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Which is why it has nothing to do with why the limit exists.
 
Pinecone said:
And exactly WHAT in the 3rd class medical exam covers this issue? In determining whether you have a greater or lesser risk? Or even in the 2nd class or 1st class physical?????

My PCP does a simple pulmonary function test every year for my annual physical (which he will sign off the BasicMed from), which gives him some idea of my lung capacity and any breathing obstruction.
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Doesn't have anything to do with what gets discovered on a 3rd class exam. I just said I can see the FAA limiting people under BasicMed to airspace below Class A under the guise that the TUC for higher altitudes presents an increased risk that they don't want to incur, without it having anything to do with physiological fitness. I don't agree with it, but I can see them keeping that restriction in-place.
 
On what basis?

Just because you feel like it should? There is NO reason to limit them based on the exams.
 
Pinecone said:
On what basis?

Just because you feel like it should? There is NO reason to limit them based on the exams.
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On what basis do I think the FAA will be reluctant to relax the altitude restriction on a policy they probably didn't want to enact to begin with? They're the FAA. They don't like relinquishing control.
 
MauleSkinner said:
A BasicMed Pilot is largely an “unknown” from a medical perspective. Allowing an unknown into some of the most highly-regulated airspace would be a difference.
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More so than a Bravo or DC SFRA? The basic premise of any medical certificate is incapacitation endangering large numbers of non aviation public. Thus the seat requirement. I don’t understand the 18k limit if there is no similar limit to Bravo or SFRA etc.
 
The overwhelming majority of BMed pilots in the US aren't going beyond the Bahamas or Canada. Maybe instead of trying to get the whole ICAO on board just try to work on Canada first. Might be a lot easier.
 
SoonerAviator said:
On what basis do I think the FAA will be reluctant to relax the altitude restriction on a policy they probably didn't want to enact to begin with? They're the FAA. They don't like relinquishing control.
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That is why this is not petitioning the FAA for changes, but Congress, who attaches following the requirements they set to the funding that the FAA gets.

This is attacking the issue via the same way that got BasicMed in the first place.
 
Todd82 said:
The overwhelming majority of BMed pilots in the US aren't going beyond the Bahamas or Canada. Maybe instead of trying to get the whole ICAO on board just try to work on Canada first. Might be a lot easier.
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According to the interview with Mark Baker, Canada is waiting on the ICAO approval to make it easier for them to approve, "we have to ICAO approves."
 
Tokirbymd said:
More so than a Bravo or DC SFRA? The basic premise of any medical certificate is incapacitation endangering large numbers of non aviation public. Thus the seat requirement. I don’t understand the 18k limit if there is no similar limit to Bravo or SFRA etc.
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Exactly. Class A airspace is not crowded. Especially the low 20s. I fly in the teens and the only people I normally hear in the low 20s are climbing or descending through it. There are some shorter airline routes that stop there, but typically not for very long, more of a climb, barely level off, descend.
 
Baked Potato said:
Really I would like them to also get rid of the initial 3rd Class requirement before being eligible for BasicMed.
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Basic Med seems to be working reasonably well under the current process. I kinda believe a person with one hand, one eye, diabetes and color blindness should properly have these issues resolved by the Class 3 process before flying under an exam conducted by a lchiropractor and their drivers license / basic med.

The basic med disqualifying conditions are:
  • A mental health disorder, limited to an established medical history or clinical diagnosis of—
    • A personality disorder that is severe enough to have repeatedly manifested itself by overt acts;
    • A psychosis, defined as a case in which an individual —
      • Has manifested delusions, hallucinations, grossly bizarre or disorganized behavior, or other commonly accepted symptoms of psychosis; or
      • May reasonably be expected to manifest delusions, hallucinations, grossly bizarre or disorganized behavior, or other commonly accepted symptoms of psychosis;
    • A bipolar disorder; or
    • A substance dependence within the previous 2 years, as defined in §67.307(a)(4) of 14 Code of Federal Regulations
  • A neurological disorder, limited to an established medical history or clinical diagnosis of any of the following:
    • Epilepsy;
    • Disturbance of consciousness without satisfactory medical explanation of the cause; or
    • A transient loss of control of nervous system functions without satisfactory medical explanation of the cause.
  • A cardiovascular condition, limited to a one-time special issuance for each diagnosis of the following:
    • Myocardial infarction;
    • Coronary heart disease that has required treatment;
    • Cardiac valve replacement; or
    • Heart replacement.
 
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Clip4 said:
I kinda believe a person with one hand, one eye, diabetes and color blindness should properly have these issues resolved by the Class 3 process before flying under an exam conducted by a lchiropractor and their drivers license / basic med.
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How come? What's the desired effect of all that administrative medicine?
 
Clip4 said:
The basic med disqualifying conditions are:
  • A mental health disorder, limited to an established medical history or clinical diagnosis of—
    • A personality disorder that is severe enough to have repeatedly manifested itself by overt acts;
    • A psychosis, defined as a case in which an individual —
      • Has manifested delusions, hallucinations, grossly bizarre or disorganized behavior, or other commonly accepted symptoms of psychosis; or
      • May reasonably be expected to manifest delusions, hallucinations, grossly bizarre or disorganized behavior, or other commonly accepted symptoms of psychosis;
    • A bipolar disorder; or
    • A substance dependence within the previous 2 years, as defined in §67.307(a)(4) of 14 Code of Federal Regulations
  • A neurological disorder, limited to an established medical history or clinical diagnosis of any of the following:
    • Epilepsy;
    • Disturbance of consciousness without satisfactory medical explanation of the cause; or
    • A transient loss of control of nervous system functions without satisfactory medical explanation of the cause.
  • A cardiovascular condition, limited to a one-time special issuance for each diagnosis of the following:
    • Myocardial infarction;
    • Coronary heart disease that has required treatment;
    • Cardiac valve replacement; or
    • Heart replacement.
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I think we're conflating two things: the ability for someone to be eligible for BasicMed vs someone who can actually pass it.

Remember that the "disqualifying conditions" for BasicMed, in essence, also include all of the conditions for a 3rd Class medical, since one must have that before being eligible for BasicMed. And to some otherwise very healthy people (of body and mind), the requirements for the FAA medicals are very burdensome to overcome due to the all-encompasing nature of the questions.
 
OneCharlieTango said:
How come? What's the desired effect of all that administrative medicine?
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I kinda think when you certificated under an private pilot certificate with IR and a couple CFI endorsements to strap on a 6000# airplane with 5 passengers on board doing 325 knots true in IMC at night an initial class 3 exam isn’t overly burdensome.
 
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Has there ever been anything said with someone on BasicMed getting put on a SSRI? I mean the way I read it, if it was for something small like basic anxiety it’s not a issue. If you get diagnosed with bipolar disorder or something of the such, then you need a SI.

This whole medical thing needs to be figured out. I own a flight school so I see the range of people that come in. Some people function better than “normal” people on light medication. I say “normal” as a joke because what is normal these days. So many pilots are flying without them that could benefit, or from meds from out of country or not on their prescription and are just fine because of it. Seems so out of touch for the thousands, and months it takes to obtain a SI for it. So confusing.
 
Skymac said:
Seems so out of touch for the thousands, and months it takes to obtain a SI for it. So confusing.
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And also add in the uncertainty.

My situation, for example - I've talked to three AMEs. Mine would be very expensive, and likely doable, but I've been told that it's "not exactly a slam dunk". So I could spend thousands of dollars and wait months (or years?) for a SI that may or may not come, and risk being grounded completely.

And the irony is that I'm one of the healthiest people I know. So... according to the FAA, the strength of my driver's license says that I can legally fly a Vans RV-12, but the thought of being PiC of a Cessna 152 is completely out of bounds. Does this current situation make sense?

A lot of us are being punished for things that happened when we were children, decades ago, in a medical environment that was very different than it is now.
 
Skymac said:
Has there ever been anything said with someone on BasicMed getting put on a SSRI? I mean the way I read it, if it was for something small like basic anxiety it’s not a issue. If you get diagnosed with bipolar disorder or something of the such, then you need a SI.
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Well, It‘s been discussed on POA a time or two. I believe your interpretation is correct, but in any given case the decision will be made by the airman and the examining Basic Med physician.
 
Skymac said:
Has there ever been anything said with someone on BasicMed getting put on a SSRI? I mean the way I read it, if it was for something small like basic anxiety it’s not a issue. If you get diagnosed with bipolar disorder or something of the such, then you need a SI.

This whole medical thing needs to be figured out. I own a flight school so I see the range of people that come in. Some people function better than “normal” people on light medication. I say “normal” as a joke because what is normal these days. So many pilots are flying without them that could benefit, or from meds from out of country or not on their prescription and are just fine because of it. Seems so out of touch for the thousands, and months it takes to obtain a SI for it. So confusing.
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Any medication, including SSRI, will be evaluated by the state licensed physician. And based on their medical judgment they may sign off on the CMEC and allow for flight under Basicmed.

The exception would be if the med was indicated due to:
  • A mental health disorder, limited to an established medical history or clinical diagnosis of—
    • A personality disorder that is severe enough to have repeatedly manifested itself by overt acts;
    • A psychosis, defined as a case in which an individual —
      • Has manifested delusions, hallucinations, grossly bizarre or disorganized behavior, or other commonly accepted symptoms of psychosis; or
      • May reasonably be expected to manifest delusions, hallucinations, grossly bizarre or disorganized behavior, or other commonly accepted symptoms of psychosis;
    • A bipolar disorder; or
    • A substance dependence within the previous 2 years, as defined in §67.307(a)(4) of 14 Code of Federal Regulations
Then no, they need an SI. Otherwise the examining physician will decide.
 
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