By NextBestFitPublicly funded EMS as essential service
Fund ambulances by budget like fire departments, not per trip.
EMS funded by budget like fire departments.
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Publicly funded EMS as essential service
Requires:
Global budgets for hospitalsU.S. prices are far higher than in other countriesChosenConcrete changes if chosen
What would actually have to change in law, agencies, payment rules, or systems.
- Fund EMS by budget like fire departments
- Ban ambulance bills for covered services
Effects
Each effect has its own page: the evidence, the case that it is or isn't a real cost, and whom it affects.
What it fixes
- Getting to care: transportation and ambulances
Budget funding for ambulances ends patient ambulance bills and allows deployment according to need rather than payer.
What it creates or worsens
- Raises spending or loosens control over it
Budget funding for ambulances shifts costs to local budgets.
- Reduces income or business for affected groups
Budget-funded ambulances reduce business for private ambulance companies.
Who's affected
Who gains
- Older adults
- Getting to care: transportation and ambulances: Lack of transportation causes missed appointments.
- People with ongoing or specialist care needs
- Getting to care: transportation and ambulances: Lack of transportation causes missed appointments.
- Rural residents
- Getting to care: transportation and ambulances: Closing rural emergency transport services reduce access to care.
Who loses
- Private ambulance operators
- Getting to care: transportation and ambulances: Out-of-network ground ambulance bills lack surprise-billing protections.
- Taxpayers and public budgets
- Raises spending or loosens control over it: Public budgets pay the added spending.
Other ways to soften the losses
- Buy out or contract with private ambulance companies
Where it has been tried
- Many European countries: Ambulances free at use.
- England, United Kingdom: England's NHS ambulance services handled 760,589 incidents in December 2023, including 380,793 transports to emergency departments.Sources: NHS England (2024)