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Home > Topics > Ambulances / Emergency Vehicles
December 05, 2013
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EMS News in Focus
by Arthur Hsieh

Sick? It’ll cost you

Ambulance transports aren’t funded by the government — they’re funded by those transported

By Arthur Hsieh

Normally, this kind of reporting might make me cringe. In this case, I’ll make an exception.

As we see from a New York Times story that examines the high cost to patients transported by ambulance, many people don’t realize that their EMS is not tax-supported. And it may come as a disappointment to some that nothing comes for free.

Even in volunteer organizations, there is a cost to provide medical transport — station maintenance, vehicle upkeep and replacement, medical equipment; even if the department members volunteer all of their time and even spend their own money (I know many of you do), it costs more than all of that to perform the service. So these reports are de facto public service announcements. EMS is public safety, yes, but it is also health care. The idea of getting something for nothing doesn’t fly from that perspective.

And please, no crying over the high cost of EMS transport. What happens there has been happening since the 1970s throughout the U.S. health care system, snowballing when we implemented universal health care (read: 1986’s EMTALA). Patients who can afford to pay have to cover those who cannot, plain and simple. And while $6 billion is a lot of money, it’s a drop in the $2.6 trillion health care expenditure bucket (2010 statistic) And still, it’s not enough to cover the actual operating costs. 

There is no simple solution to this issue. It’s the reason why the Affordable Care Act has been so controversial — it’s hard to foresee how this paradigm shift will affect the cost of health care for the next generation of Americans. Still, it’s a step in the direction that is needed. At the very least, more and more folks are finally realizing how important — and expensive — health care is in the U.S. Being aware of a problem is the first step in finding the solution.

About the author

EMS1 Editor in Chief Art Hsieh, MA, NREMT-P currently teaches at the Public Safety Training Center, Santa Rosa Junior College in the Emergency Care Program. In the profession since 1982, Art has worked as a line medic and chief officer in the private, third service and fire-based EMS. He has directed both primary and EMS continuing education programs. Art is a published textbook author, has presented at conferences nationwide, and continues to provide patient care at a rural hospital-based ALS system. Contact Art at Art.Hsieh@ems1.com.
Comments
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Michael Huff Michael Huff Friday, December 06, 2013 12:19:18 PM As a member of an all-volunteer ambulance service, I applaud this article. It should be in every OPED in every newspaper. As a rural service, we often don't have enough runs to keep the lights on, and when we do make a run, people DO complain about the costs. One thing we do not charge for, and will never charge for is the response to, or transport of a deceased patient. We cannot morally charge the family.

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