Pros and cons of public vs private EMS and tax funded vs nontax EMS?

[LoveHateEMS]

Public EMS: a government service provided by a county or municipality, either fire based or third service (separate from fire)

Private EMS: provided by a for profit company or a private, non-profit organization like a rescue squad or "life saving crew"

I am asking the pros and cons relating to the PUBLIC, not individual employee experiences.

And what about tax funding? Would it be more beneficial to have a tax funded EMS, either partially (supplementary) or fully?

Not everyone will use EMS in their lifetime.
But Medicare will hardly pay out either for ones that do.


Personally, I like public EMS because I feel i have more control of situations because I work for the government (the authoritative, don't mess with me or undermind me attitude because I am a government public safety official). Other than that, I can't find a good reason it would be better, per se, for the public's interest.

 

[EpiEMS]

Medical care (except for public health measures) is excludable (we can prevent people who don't pay from having access) & rivalrous (consumption by me prevents consumption by you). In theory, one might argue that medical care (again, excluding public health measures) is a pure private good - heck, there aren't even many positive externalities.

However, we - as a society - choose to provide care to pretty much everybody, often regardless of ability to pay.

Since we've decided that providing emergency care to everybody is what we ought to do (more or less), and to avoid the well-document problems of private EMS (e.g. unnecessary transports, poor employment practices, etc.) related to the incentives of private EMS providers, public provision of EMS (i.e. municipal EMS, whether fully career or career/volunteer hybrid) seems pretty sensible to me. That said, I would be sympathetic to hospital-based EMS, at least, more so than I am to AMR and their ilk.

This thread has kinda been done to death, though...

 

[VentMonkey]

Personally, I like public EMS because I feel i have more control of situations because I work for the government (the authoritative, don't mess with me or undermind me attitude because I am a government public safety official).

What @EpiEMS said, but could share with the group what it is, specifically, you mean by this?

This sounds completely arrogant and foolhardy, but I could be misinterpreting what it is you are getting at.

 

[Flying]

OP, why do you ask whether the public will benefit or not, then prefer one option because it stokes your own ego more? That doesn't logically follow.

 

[NysEms2117]

Personally, I like public EMS because I feel i have more control of situations because I work for the government (the authoritative, don't mess with me or undermind me attitude because I am a government public safety official). Other than that, I can't find a good reason it would be better, per se, for the public's interest.

you should be ashamed of yourself. Remember your title mr "government public safety official" It is CIVIL SERVANT. You serve the people, not yourself. You need to rethink your title and why you got it. If i came across you i would most certainly "mess" with you, because you give us all a bad name. And for the record, no i am not usually like this, just when people hit that right spot.
*coming from somebody who is a civil servant full time and part time (Parole officer, and county sheriff EMS unit).

 

[VentMonkey]

Also, at 22 what kind of experience do you have with both the public and private sectors?

I can tell you all of my experiences are with the private for-profits. It is what it is. Not all is well, but not all is bad either. I find pessimism is extremely contagious, to include myself.

The way I see the big picture is- overall I have my health, my family, and a career-field that gives me those choices.

 

[Bullets]

I work for both, and there a good things about both

Municipal 3rd service
Good: Steady funding source, entrenched position as a provider, better benefits,
Bad: New equipment appropriation can be painfully slow since any expenditure is based on the entire municipal budget. Capital expenses must be approved by the township committee and put out to bid. Hiring and firing staff can be difficult due to litigation issues and unions present in the municipal government

Private 3rd party
Good: Easier purchasing process, easier hiring and firing, less government oversight, easier to expand into new service areas, easier to expand and contract the service and adjust operational times
Bad: Less reliable cash flow based solely on billing. Contract could be lost due to government changes, variable issues with municipal services (PD/FD)