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Sick? It’ll cost you

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

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.

Art Hsieh, MA, NRP teaches in Northern California at the Public Safety Training Center, Santa Rosa Junior College in the Emergency Care Program. An EMS provider since 1982, Art has served as a line medic, supervisor 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 textbook writer, author of “EMT Exam for Dummies,” has presented at conferences nationwide and continues to provide direct patient care regularly. Art is a member of the EMS1 Editorial Advisory Board.