Back in December, I wrote a column that asked what to do with the revenue generated by legalizing recreational marijuana, should New York opt to legalize it.
In response, a reader emailed me with a suggestion I thought was pretty good: Use the revenue to fund emergency medical services.
The reader noted that, in the Florida county where he spends his winters, the EMS personnel are county employees. In Saratoga County "where my primary residence is, there have been several mergers and other actions to keep EMS services available," he wrote.
Which is absurd.
Emergency medical services are important and necessary, and a good EMS provider might very well mean the difference between life and death. Viewed in that light, our reliance on a patchwork system of private, often poorly staffed providers is mystifying -- and inexcusable.
The worst case scenario is something like what's happening right now in Fulton County.
On Friday, the Ambulance Service of Fulton County was forced to shut down when the non-profit organization determined it could not make payroll or afford to pay for its insurance.
ASFC CEO Roy Sweet said that many factors contributed to the organization's insolvency, including too many low-paying Medicaid ambulance calls, which make up about half of ASFC's responses, and too many zero-payment calls from people who can't or won't pay for the service.
Under a contingency plan developed late last week, other local EMS providers are stepping in to ensure coverage, including the Greater Amsterdam Volunteer Ambulance Corps., the Johnstown Area Volunteer Ambulance Corp., Mohawk Valley Ambulance and the St Johnsville Volunteer Ambulance Corps.
This is a good short-term solution, but it doesn't provide a long-term answer, or solve any of the problems that caused the collapse of ASFC.
The problems at ASFC are not unique.
The ambulance industry is struggling, particularly in rural areas already experiencing a shortage of healthcare providers.
As a 2018 paper, titled "EMS Services in Rural America: Challenges and Opportunities," noted, "... rural Emergency Medical Services (EMS) often become the only guaranteed access to health services, and ultimately, the safety net for underserved rural communities. However, dwindling population, losses in the volunteer workforce and decreased reimbursement threaten continued access to these services. Nearly one-third of rural Emergency Medical Services are in immediate operational jeopardy. Therefore, action must be taken to secure access to, and the quality of, this vital service for rural Americans."
It is a vital service -- and we need to start treating it like one.
Many paramedics are poorly paid and work long, grueling hours, and unless there's a dramatic shift in how the EMS industry operates, it's hard to see this changing any time soon.
And that's unacceptable.
We need to make EMS a public service, with a more reliable source of funding.
If we don't, we're going to see more rural EMS providers go out of business, and more Americans suffer unnecessarily as a result.
Reach Gazette columnist Sara Foss at [email protected]. Opinions expressed here are her own and not necessarily the newspaper’s.