Rhetoric and rationalization should not overcome reason
I think the days of traditional relationships between public and private entities are also coming to a close
I'm not even sure where to begin with this one. There are several points in this article that beg for closer scrutiny by city officials who are responsible for their community's safety.
Rhetoric and rationalization should not overcome reason and reality in any equation regarding the provision of prehospital care.
First, the use of paramedics on first responder, non-transporting crews. To this date, the industry has not yet demonstrated its effectiveness.
It becomes a significant challenge for a department to maintain and control an ALS system, from stocking units to providing continuing education and QA/QI services.
In areas of short response by transport units - which, to me, means more like 30 minutes, not eight - I am not convinced that a well trained, advanced EMT equipped with only the essential, time-dependent therapies, could produce equivalent or even better outcomes.
Second, money will continue to be tight for municipalities, at least for another two years or more. Government budgets recover last when economies improve.
The idea of billing for non-transport services isn't novel or new; the reason why departments try to bill is because they are mostly non-reimburseable by most government and private insurance programs. You can draw your own conclusions on this issue.
Third, despite these criticisms, perhaps there are legitimate reasons for a review of the existing contracted transport provider. I think the days of traditional relationships between public and private entities are also coming to a close.
Cities really are looking to get the most out of their contracted providers, as well as their own services. I don't think that this will change either; like the rest of the country, we have learned to do more with less. We'll expand by developing new services and taking on additional responsibilities, but we won't be turning the clock back any time soon.