EDITORIAL: Dump wrongheaded ambulance policy


In sports, there is always one ultimate arbiter: the scoreboard. When the clock hits zero or the last out is recorded, nothing else matters.

The same standard applies in the ongoing hospital transport feud between the Las Vegas Fire Department and American Medical Response, a private ambulance company.

As the Review-Journal’s Jane Ann Morrison reported Tuesday, the scoreboard shows the Fire Department is cherry-picking patients who live in affluent ZIP codes, thereby transporting people more likely to be insured and able to pay the ambulance bill, leaving AMR with the majority of transport patients less likely to be insured or able to pay.

In March, Fire Chief Willie McDonald implemented the new transport policy, moving from an automatic dual-response system under which department and AMR paramedics raced to all emergency calls, to one in which the department responds and calls AMR only when the company is needed. Mr. McDonald’s immediate goal was to handle 50 percent of transports, up from 30 percent, with the ultimate goal of moving 75 percent of patients to generate more revenue for the city.

The scoreboard, based on a study from Applied Analysis and paid for by AMR, shows the Fire Department has a preference for transports from “areas with higher incomes, less diversity, higher rates of insurance and ultimately, higher expected emergency medical services collection rates.” The analysis looked at the entire city and demographics in two ZIP codes. In 89134, which includes Sun City Summerlin and is 81 percent white, the Fire Department took 63 percent of 182 transports, leaving AMR 37 percent. In 89110, which is 63 percent Hispanic, the Fire Department took 17 percent of 255 hospital transports, leaving AMR 83 percent. In 89134, the payment collection rate was 45 percent. In 89110, it was 21 percent.

So the Fire Department, with the support of city management and the City Council, is having AMR pay a $400,000 annual franchise fee to the city for the exclusive right to lose its shirt. A private company generating tax and franchise revenue for the city, while also creating taxpaying jobs, is being told to get lost — preferably in a neighborhood where it can’t possibly make any money.

Mr. McDonald, in a Wednesday report from Ms. Morrison, said the claims in the study are “completely false,” but he also said he hadn’t read the study, despite it being widely available since Monday. “We respond to 100 percent of the calls in the city and treat every person with respect and courtesy,” Mr. McDonald said. But responding to calls and transporting patients are two very different things. Furthermore, Ms. Morrison noted the new system has led to increased delays in response times for the patients AMR is told to transport. That’s outrageous.

The city of Las Vegas is clearly in this for the money, but crowding out AMR ultimately would be far more expensive to the public. The Fire Department has only 22 ambulances, while AMR has 69. The only way the Fire Department can meet its transport goals is to soak taxpayers by adding more ambulances (which are way more expensive than AMR’s units) and more extremely well-compensated firefighters — while losing AMR’s franchise fee, taxes and taxpaying jobs.

Mr. McDonald has deliberately and cynically attacked the livelihoods of men and women who work alongside his firefighters — and compromised public safety in the process. The City Council needs to rein him in and end his destructive experiment right now. As AMR spokesman Ron Cunningham said, “The data is the data.” You can’t argue with the scoreboard.

 

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