How can ambulance journeys be 1000’s and their drivers be paid shit? What stops an independent ambulance service simultaneously paying higher wages and charging patients less?
How can ambulance journeys be 1000’s and their drivers be paid shit? What stops an independent ambulance service simultaneously paying higher wages and charging patients less?
Simple answer: They can’t. There’s a lot more expenses than you realize.
Then you have inadequate Medicare/Medicaid reimbursement rates which means almost every run you do for a patient insured under Medicare or Medicaid will be a net loss, along with most municipalities unwillingness to adequately fund the EMS system with taxpayer dollars, if they fund it at all.
Also, when you pay for your ambulance ride, you aren’t just paying for that ride. It’s not just the hour the crew was with you. You’re paying for the fully stocked ambulance $250k+ depending on service level, fuel (I put over $100 of fuel in my rig every day), restocking the supplies, the station (either rent or mortgage+ utilities), training, maintenance costs on the ambulance and equipment, and salaries of all the personnel who do administrative, logistics, and fleet services. For a true 100% municipal based EMS system the government and taxes absorb a lot of those costs, but a private third party EMS system has to pay all of those out of reimbursement rates. They may get some money from the municipalities they cover, but it’s usually a drop in the bucket. One township in the coverage area where I used to run would only give $2,000 a year and demanded a fully staffed ALS (paramedic + EMT) ambulance on duty 24-7. That didn’t even cover salaries for a week, let alone any other costs.
There’s a lot of politics that go into EMS in the US, especially when municipalities bounce their coverage off to private systems. It ends up with a system where everyone loses. Communities get worse coverage, pay more individually for their EMS bills, and have weaker providers making less money because the better providers who can get hired in better systems tend to go where they can get paid more unless they have strong ties to the community and want to work there for personal reasons rather than financial reasons. I have an hour long commute because I’m willing to drive to an agency that pays me more than everything around where I live. I know people who drive 2 1/2 hours one way to make even better wages. I also know people who aren’t willing or can’t do that for family reasons and so they make less than 3/4 of what I do to do the exact same job.
Pretty sure the reason to use private companies as they won’t have to deal with unions if the employees were county employees like police and fire fighters. So they can pay less collect more money
How can ambulance journeys be 1000’s and their drivers be paid shit? What stops an independent ambulance service simultaneously paying higher wages and charging patients less?
Simple answer: They can’t. There’s a lot more expenses than you realize.
Then you have inadequate Medicare/Medicaid reimbursement rates which means almost every run you do for a patient insured under Medicare or Medicaid will be a net loss, along with most municipalities unwillingness to adequately fund the EMS system with taxpayer dollars, if they fund it at all.
Also, when you pay for your ambulance ride, you aren’t just paying for that ride. It’s not just the hour the crew was with you. You’re paying for the fully stocked ambulance $250k+ depending on service level, fuel (I put over $100 of fuel in my rig every day), restocking the supplies, the station (either rent or mortgage+ utilities), training, maintenance costs on the ambulance and equipment, and salaries of all the personnel who do administrative, logistics, and fleet services. For a true 100% municipal based EMS system the government and taxes absorb a lot of those costs, but a private third party EMS system has to pay all of those out of reimbursement rates. They may get some money from the municipalities they cover, but it’s usually a drop in the bucket. One township in the coverage area where I used to run would only give $2,000 a year and demanded a fully staffed ALS (paramedic + EMT) ambulance on duty 24-7. That didn’t even cover salaries for a week, let alone any other costs.
There’s a lot of politics that go into EMS in the US, especially when municipalities bounce their coverage off to private systems. It ends up with a system where everyone loses. Communities get worse coverage, pay more individually for their EMS bills, and have weaker providers making less money because the better providers who can get hired in better systems tend to go where they can get paid more unless they have strong ties to the community and want to work there for personal reasons rather than financial reasons. I have an hour long commute because I’m willing to drive to an agency that pays me more than everything around where I live. I know people who drive 2 1/2 hours one way to make even better wages. I also know people who aren’t willing or can’t do that for family reasons and so they make less than 3/4 of what I do to do the exact same job.
A detailed answer, thanks.
To get a fair price we should look at other countries, but it’s hard to see the level of public subsidy.
Looking here, Australia is the next comparison country. I think the most telling statistic is the cost per km. The US is x8 more expensive.
Pretty sure the reason to use private companies as they won’t have to deal with unions if the employees were county employees like police and fire fighters. So they can pay less collect more money
I can understand why current ambulance service owners want to charge more and pay less.
I don’t understand why rival services dont appear and give better wages for a cheaper service.
Where are the Uber ambulance companies?
Because people who don’t have money or insurance are already using Uber as an ambulance service. Uber is the Uber ambulance company.
I’m sure you gotta pay your local politician to make sure there is no competition