The Problem of Private Ambulance Services

Source: David Anderson, Current Affairs, August 13, 2018

Nationwide, there is one massive monopoly, American Medical Response, which is kind of like the McDonald’s of EMS, since they have branches all over that are fairly decentralized but still linked to the same capital distribution system. … The private ownership model for ambulances is fundamentally at odds with its own purpose. In the beginning they were useful insofar as they were an ad-hoc option in a society that gave no thought to whether or not speed was important in treating an illness or injury. However, this jumble of organizations across the nation creates big problems beyond figuring out billing logs. A key problem is the cost of doing business. A single ambulance can cost somewhere in the $500,000 to $1 million range, so any ambulance company’s first priority is to reduce overhead as much as possible. … They want to get the cheapest gear, the cheapest ambulances, and the cheapest workers. You will see EMS personnel make fast-food level wages, for what is ostensibly an extremely important job.

… For all the cost-cutting and neglect, you might at least expect ambulance services to be affordable. Yet as anyone who has taken one knows, consumers pay fat stacks of cash to keep this system running. … The usual justifications for free markets fail completely when it comes to ambulances, since there’s no practical way for “consumer choice” to improve services. When you’re bleeding to death, it’s hard to comparison shop—not that you’re even offered a choice. … Given the poor employment conditions, EMT culture should be fertile territory for left organizing. Unfortunately, the poor pay of EMTs has often been used as an argument against the improvement of other workers’ lives. … Capitalism struggles to fit emergency services into its overall structure. .. Good emergency medical services are going to be expensive and unprofitable. …