In most US places I’ve lived in, the emergency ambulances are operated by a private company like AMR. The police and fire department are part of the government. Usually the fire department goes to medical calls along with the private ambulance. In a few places, there were both government ambulances run by the fire department and private ambulances, often with both responding to calls.
Does it not make just as much sense to have emergency medical services offered by the government directly as it does for fire service? Both are things we need rarely but urgently. Both are services that are expensive to offer. Both require specialized skills and equipment. Both can easily cause unnecessary loss of life if done improperly. So why are they not treated the same?
The bitch of it is that in most places, only a single ambulance company covers any particular area, meaning it’s already practically a monopoly. I honestly don’t understand why emergency ambulance service is not a government function.
It might just be inertia, since the government was quite slow to catch on to the whole idea of ambulances and EMS in the first place, meaning that private industry had to fill the void. Once companies got established providing a service that the government should have been doing all along, it sort of just becomes a “this is how we’ve always done it” situation.
Once a culture decides that fires and crime are problems in general, the idea of some blazes not being fought and some criminals not being pursued is contrary to public policy, which means those services can no longer be scarce. That pretty much eliminates profit margins for anyone who can’t value-add, like a private security firm can.
Ask yourself why you didn’t call for the military to be privatized and run on a purely opt-in basis.
The answer to the OP is: The system we have works well enough inertia holds it where it is.
Emergency ambulances here are part of the fire department. Private companies run transport ambulances and a couple of hospitals have neonatal ambulances.
Same here. I’m not aware of any private emergency ambulance services in my general area. I’ve seen some for special purposes, like SnakesCatLady says above. But if you call 911 anywhere within about a 100 mile radius of my large metropolitan area, you will be getting a city or county run EMS ambulance. I’ve been lucky to not require their services myself, but my impression is that they are very good at what they do.
I’ll third that- everywhere I’ve lived, the ambulance/EMS are either part of the local fire department, or part of some institution (universities primarily).
Even in rural/semi-rural areas, the ambulances are run by the local fire departments (some are volunteer) and/or the county.
The only private ambulances you see around here are used for transporting people between hospitals and other places like nursing homes.
The Austin EMS is a city run service. The ambulances co-locate with the Fire Dept. There are several private ambulance services in the area but they are not first-responders.
I guess this just goes to show how naive I am on some aspects of US healthcare.
First, I wrapped my head around the concept of some people not being able to afford healthcare. For some reason I still thought that things such as childbirth would be free. Not so, but even now I sort of imagined that the ambulance taking you to hospital would be free…I am very wrong once again aren’t I?
Ambulances aren’t healthcare. They’re emergency first responders. Not at all related.
In SE Michigan, we have lots of private ambulance services. They’re regulated, so it’s a tossup between true libertarian ideals and leftist cradle-to-grave government. As long as we’re forced to accept compromises, this seems like a not-unfair one.
Ambulance travel isn’t even free in (parts of?) Canada. For instance, in Ontario I believe there’s a co-payment unless you’re travelling from one hospital to another (on doctor’s orders).
Where I live, Adelaide South Australia, the history of ambulance services is pretty interesting. From early days with four separate groups, to the state government contracting out for provision of services to one group, to the current situation where the government essentially subsumed that service. What is interesting too, is that although run by the state government, services are not free. An emergency call out might cost you $600 to $800. They will at least bill you later. Most private medical policies cover the emergency callout, but won’t cover any additional services, like transport between hospitals, or indeed anything bar the initial callout.
Here in New York City the offical EMS is part of the Fire Department.
There are also a number of volunteer and private services (especially Hatzalah, a private/volunteer ambulance service that is tied to the Orthodox Jewish community). They drive proper, fully equipped ambulances with licensed EMTs, and have the ability to coordinate with FDNY-EMS during large-scale emergencies.
When I lived in rural Virginia, the ambulance service was completely volunteer, but the county would pay for your training if you wanted to become an EMT and serve on the volunteer roster.
I’ve only ever seen private ambulances that do transportation between hospitals, everywhere I have lived in the US, the ambulance that responds to emergencies is attached to the fire department and free.
Just because it’s attached to the fire department doesn’t make it free. Some communities can - and will - bill you for the services. Some communities will only bill you if you use them what they consider to be too frequently or for too many ‘nuisance calls’. Some communities - and this can be seen in my area - contract with private companies to provide ambulance/paramedic service; you see the private ambulance guys parked with the city vehicles. (For example, the city of Kirkwood, Missouri does this.)