EMS Economics

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Comment by Skip Kirkwood on October 5, 2009 at 8:17pm

I am of a mindset that EMS is caught in a vicious downward spiral, because we exist in, and continue to try to make do in, a failed, impossible economic model.

The reimbursement-based fee for service model worked OK, in some communities, in the 1970s and 80s, when the demand was for simple ambulance transport and nothing else. Unfortunately, those who benefitted from such a system promoted (and educated elected officials and municipal managers) that there was something wrong about using public money to build and operate an EMS system.

Now, that we can't raise prices (because our biggest customer, the federal government, takes their discount at the point of a gun) to cover costs, and because if you do the "right thing" for your community you actually REDUCE transports, we're stuck. We've got to break out of this cycle, and stop worring about a 2% Medicare rate increase, and start getting our COMMUNITIES to fund EMS just like they fund cops, fire, schools, libraries, parks, etc., etc. - using LOCAL COMMUNITY dollars to do so. If we get some back from reimbursement, OK, but let's END UP there, not START there!