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Reason Foundation

Gambling With EMS

Tyler Millhouse
July 16, 2010, 7:05pm

It's no secret that unions are consistent opponents of privatization.  Public employee unions offer high wages and generous pension plans--benefits members fear losing through privatization.  However, with ongoing deficits and staggering pension obligations, state and local governments are being forced to find new, more efficient means of service delivery.  Indeed, many state and local officials around the nation have commissioned critical analyses of government services. [See recent New Jersey report here]

However, for one local union, the review process itself poses a threat.  Following a lengthy contract dispute with Firefighters Local 1285, the City of Las Vegas has agreed not to commission studies on privatizing its emergency medical services.  The informal two-year agreement accompanied the contract, approved 5-1 by the city council.  City Manager Betsy Fretwell argued that the agreement, "tells the firefighters we have faith in them."

While faith is not uncommon in medical emergencies, perhaps Ms. Fretwell's faith in the public sector is misplaced.  Contracting for emergency medical services can improve response time and limit long-term contract obligations.  Reason Foundation's FAQ on EMS Privatization illustrates the benefits of competition among EMS providers:

So many cities privatize EMS precisely because the stakes are so high. EMS is too vital to shield from competition. . . consider the limitations cities already endure under the alternative. The real leap of faith is to commit to one provider, forever, regardless of performance...

Privatization allows cities to benefit from a level of technology, specialization, and expertise only available in the private sector. Competition provides us with ever-improving drugs and medical devices. It makes sense that it would also provide us with better EMS.

The bottom line is that privatizing EMS is not a matter of trust-it's a matter of contract. A city doesn't hand a contract to a private provider and walk away with fingers crossed, hoping that the firm will make good on its performance promises. Under privatization, elected officials still maintain crucial oversight roles. Officials shop for the best EMS provider, and set performance standards. 

Clearly, privatization is not foolproof.  Cities must carefully examine privatization options and execute them responsibly.  However, this is not possible without public servants informed by reliable research.  Unfortunately, the firefighters union and city officials have put the interest of public employees above the good of the community, endangering the fiscal and physical health of Las Vegas citizens.

 



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