In response to NY City Decides to Cut Back on Ambulances is this defense of Mayor Bloomberg from John.
Take this out of EMS for a second.
If this were livery cabs, and the only way to get a cab was to call a central, municipally administrated phone number, would it be too much to expect private cab owners who are given runs by the dispatchers to pay into the cost of running the system?
If EMS were to run as a taxi service, we would expect payment at the time of transport and we would expect a much higher percentage of patients would pay. There are so many flaws in John‘s analogy. I leave it to you to giggle amongst yourselves as you consider the possibilities. I have always believed that we should partner with pizza delivery, but so have many others.
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Back to EMS now.
The city gives the non FD-ambulances the GPS, the radios, and the telemetry support needed by law to run an ambulance in the NYC 911 system, and gets no re numeration. If any of that equipment breaks, the city fixes it, usually before its own stuff. FD dispatches the calls, and then gets no money for the call, the ER visit or the possible admit, which gets billed by the hospital based ambulances, or the privately contracted ambulances. It not too much to ask you to pay for the part of the system you use?
Wait a second, a response to John‘s comment by NYCMedic07 suggests that even your claims that the hospitals do not pay anything for their radios is similarly not coming close to reality. Here is what NYCMedic07 wrote in response to John.
The city DOES NOT pay for the radios, GPS, or Turn Out gear that they require Voluntary (hospital-based) ambulances to have in order to operate in the 911 system. That expense is borne solely by the hospital at cost. An ambulance mounted GPS-capable MDT runs between 10-12k, portable radios 3k, turnout-PPE gear 1k/person. Its all done by one or two private contractors, one being All-Tech on Avenue U in Brooklyn NY (the FDNY actually sends some of their own vehicles there as well for radio installations) All this is paid for by the hospitals as per the latest FDNY contracts.
Private conversations I have had, with people more familiar with NYC, have agreed with NYCMedic07.
John may believe some of what he writes. He may even believe all of what he writes. Reality does not appear to agree with John.
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While I appreciate Rogue Medic’s take on the situation, my perspective on the situation is quite different than RM’s claim that the department is looking to eliminate ambulances. Quite the contrary, if the non-municipal ambulances drop out of the system, the city is mandated to cover the tours.
John also does not seem to be strong on reading comprehension. My point is that the hospitals will stop providing ambulances to treat and transport the city’s patients, if the costs make this a big money loser for the hospitals. Unintended consequence, John, and a bit of my sarcasm.
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This isn’t about ambulances, this is about money.
Then just give people money to not go to the hospital by ambulance. That might work and might even cost the city less money.
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The same way the suppression side has been looked at to charge for responses to car accidents and other non-suppression life safety operations.
Also a popular plan.
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The city and the FD, and the non-municipal ambulance providers play this “sky is falling game” with their employees all the time when it comes to bargaining, and compensation. Why is the muni-EMS pay so disparate with other uniformed unions?? Because the city says “if you don’t do what we want, we let the privates into 911″. The privates close EMS departments, and hospitals the moment the bottom line is in the red.
Please provide evidence that none of the hospitals are currently running deficits in their EMS divisions.
Please provide evidence that any hospital has ever closed an EMS department the moment the bottom line is in the red.
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The city hasn’t laid off an EMT in the 17 years I’ve been here, can the Voluntaries say the same?
Hasn’t the city failed to hire to cover tours that they have promised to cover?
Here is more of what NYCMedic07 wrote in response to John.
And by the way, FDNY can’t staff their current ambulances because of attrition and low-pay, so good luck finding 400 more EMT/medics to work in an over-abused and grossly underpaid service.
You can read the rest of NYCMedic07‘s comment, which provides more details about the actual costs, here.
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I’m not saying that the Big Red One is all hearts and flowers, but if we, the people who work on the streets, were in one bargaining group, we would eliminate management’s ability to play games, and push for the ability to provide quality patient care in the City, and simultaneously earn a living wage.
That sounds like something that is worth doing.
It seems as if this plan by Mayor Bloomberg to hit the hospitals with large fees may result in all of EMS having the same employer, and therefore the same bargaining group.
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In another comment on the same post, John finished up with –
Its all about the money. Always.
People always take the highest paying job?
Always?
People always work in the highest paying field?
Always?
People never donate time or money to charitable causes?
Never?
John has an overly simplistic view of the world. Perhaps he has spent a bit too much time curled up with a book by Marx. Of course, Karl wrote that it is all about the violence. Karl Marx is not my kind of guy. He is not the kind of guy who should appeal to any non-violent people.
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For more on the plan by Mayor Bloomberg to institute a new fee for hospitals that help NYC provide EMS, read Do You Wonder How Many FDNY Dispatchers It Takes To Dispatch An Ambulance? from The Social Medic.
Continued in Excellent Coverage of Mayor Bloomberg’s Attempt to Blackmail Voluntary Hospitals.
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Ok let’s get the record straight here, I just want to say I work for the private hospital EMS in NYC’s 911 system. The city does not just give the hospitals the computers in the ambulaces, they are leased from the city, some of the hospitals buy their own equipment and do not lease from the city. Some hospitals also have their own telemetry Doctors and do not use the cities. Lets not get it twisted here the city does already make money by leasing to hospitals who did not buy their own equipment. They charge for transports just like hospitals do. When hospital ambulances are out of service 2 hrs or more the city fines the hospital and the unit does not get credit for the tour. Ask the fire department about their little scheme they have going with these HAZ-TAC Ambulances when they go out of service because of no one certified to work on the ambulance they put the unit showing (ILO) of another unit. Instead of running the unit down now there is 2 units in the system. The city is not being truthful here and only telling the public what they want them to know. ENOUGH IS ENOUGH ALREADY FDNY CANNOT HANDLE IT THEY CAN’T EVEN HANDLE WHAT THEY HAVE NOW!