THE UNAFFORDABILITY OF THE AMBULANCE
It is the middle of the night, and someone just dialed 911. “It’s an emergency!” says the desperate caller. The dispatcher puts the call out… But the response takes a while, even longer than the worried caller expects.
Depending on where you are in New York State, and WHO may be available, the ambulance may be all-volunteer, or it may be a 24-hour paid service. That part does not really matter, not at that point at least, so long as the patient gets the medical help he (or she) needs.
After the initial crisis, including the amount of time for response, survival and the bill for service, there are probably a lot of comments, some heated, some merely distraught. If the responding service was all-volunteer, there may be questions “WHY is the bill so high?” If the response service is supported by paid members or funded by the local municipality, why didn’t they arrive more quickly?
Every community in New York State offers 911 and the appropriate response, but sometimes the local volunteer service has limited operating hours and the paid service that covers must travel further and maybe negotiate rugged roads. In New York City, the state’s largest city, there are more than 70 EMS agencies including municipal, volunteer, and hospital run ambulance services. Some smaller towns in New York State are dependent on small volunteer outfits or county wide services that take time to travel to the scene.
While several volunteer services offer limited operating hours, the paid services are sometimes short-staffed as well. Unfortunately careers in EMS are rarely profitable. The NYS EMS workforce has lost several members over the years, some due to aging out, and many more due to low wages and the cost of living. The high cost of living in NYS, and the salaries of paid responders, are opposite in comparison to the rest of the country. The costs of new rigs, maintenance and insurance hinder even the all-volunteer outfits.
In addition to the high costs of ambulance maintenance, equipment and insurance, the cost of living in NYS is more than 30% of the rest of the county (with NYC averaging 75% more), and yet the salary of paid NYS-EMS can average less than $25 per hour. Most EMS providers, especially in urban areas like NYC, need to work more than one job to make ends meet. Many paid and volunteer ambulance corps find themselves short-staffed due to a shortage of providers.
Unfortunately, the shortage of providers as well as the cost of ambulance maintenance and operating costs put the average citizen at a disadvantage. Then private health insurance and Medicare rarely cover most of the ensuing bills. The costs of running the squad, whether paid or volunteer providers, put more of a drain on the operations.
Perhaps if the state were to finally acknowledge and designate our EMS responders and the companies they rode with as ESSENTIAL SERVICES, then funding, faster insurance reimbursements, better agency coordination, higher wages, and lower employee turnover might be possible.
I'm a former NYS EMT and still part of an EMS & FD family. I like to think I can write ;)
