EDITORIAL: Freezing out the franchisee

What’s the point in allowing a private ambulance company to service a municipality, if that company can’t respond to emergencies? Apparently, the residents of Henderson are about to find out.

As reported by the Review-Journal’s Colton Lochhead earlier this month, the city of Henderson wants to franchise out its nonemergency ambulance services to a private company. The city has used private companies to handle such services for years, but Fire Chief Matthew Morris said those relationships had always been loose and without a formal agreement. Such an agreement, Mr. Morris said, will allow the city to outline “clear expectations for what they do, and we can hold them accountable.”

In other words, city government can impose more regulations — most notably, only allowing the prospective franchisee to respond to nonemergency calls, which is not exactly what you think of when you think of an ambulance service — and collect a nice franchise fee. The private company would handle auxiliary services, such as hospital-to-hospital transfers, or driving patients from a doctor’s office to a hospital or their homes.

Meanwhile, the fire department would continue in its role as the lone emergency call responder, for incidents such as vehicle crashes, shootings, heart attacks and other major medical calls.

Here’s what this is really about: money. Along with the franchise fee, this proposal would allow the city to cherry-pick emergency transports from which it can get the greatest reimbursement and the patients most likely to pay. Further, unlike the prospective franchisee, fire department ambulance crews won’t have to sit around and wait for business. This sets up an arrangement in which a franchisee ambulance could be present at the intersection of a car accident, but the city takes the call and if necessary the patient transport, even if the fire department vehicle is a mile away and the franchisee mere seconds.

We’re already seeing cherry-picking play out in Las Vegas, where American Medical Response pays the city an $800,000 annual franchise fee. But at least AMR can respond to less serious emergency calls. Henderson isn’t even prepared to allow that of its franchisee, so what can the city possibly expect said franchisee to pay for rights that provide such a restricted opportunity to recoup that investment?

Rather than stop at nonemergency calls, the city of Henderson should go all the way and privatize ambulance service in all situations. The private sector has proven it can do this job in its entirety, at significant savings to taxpayers, and it would certainly make any franchise fee more justifiable. As is the case with many other public services, there is no reason for government to be in the ambulance business.