With EMS delivery, there is no "right" answer
What seems like publishing coincidence, these two editorials really strike to the heart of how EMS is selected in delivered in this country. Both editorials essentially praise the local leaders for choosing the appropriate mix and type of service provider in their communities, using the "cooler heads" approach to their decision making. I think that there are a couple of key points that come out of these columns:
1) There is no one way to deliver EMS in this country. At least for now, multiple factors that occur at the local, regional and maybe state level affect how EMS systems are designed, implemented and maintained. Throw in the age-old argument of whether EMS is public safety, healthcare, public health or some amalgamation (translation: bastardization) of the three, and the result is that when you've seen one EMS system, you've seen…just one EMS system.
2) The cost of providing EMS is quite real and can't be ignored. Money is tight in this country, and especially so for government. The argument of equal or better service at lower cost is awfully compelling to officials and taxpayers trying to figure out how to contain costs. I'm not saying it's right or wrong, good or bad; it just is.
3) As a corollary to #2, EMS will need to continue to "prove" its value to the community, beyond the need for emergent medical transportation. The entity that delivers the service really isn't an issue — it's how the service is delivered that is crucial. In these cases, both successful organizations were able to demonstrate their edge over their competitors. Time will tell if they can maintain that edge.