The Default Solution is Always More

My wife announced that there wasn’t enough money in the checking account again. The obvious solution to her was that I simply needed to add more money to it each month and that the problem would then go away. Any attempts on my part to question where the money is being spent is considered completely offensive simply on face value. There are so many details that I would just not understand. After all, I simply need to know that we are talking about meeting the needs of our family. How could I even consider not addressing those needs? Do I want a child to go without an education? Without shoes or food? It could happen she warns, if the funds are not provided. Oh, and I can’t reduce the family size either by letting any of the kids (or even my wife) go. Alright, maybe I took that analogy to an extreme there at the end, but replace my wife with the fire chief or union leaders, my kids with union firefighters, and make me a politician or simply the public and the story is replayed all over the country and even across the world. ”If we don’t have more money, someone could die!”

I was thinking about this economic routine when I read the article City asked to boost fire resources in wake of slowing response times. I was prepared to blast it as another of the “how can you put a price on a life” stories. But to my surprise, “city administrators” in this case started discussing “restructuring” – they even got to specific issues by pointing out that it was “chute time” that was slowing down even though the actual travel times were improving. However, the familiar refrain still finally appeared, the Alderwoman in this particular story “plans to bring forward a notice of motion asking the city to look at what she calls a general lack of resources within the department.”

While I cannot diagnose why the response time compliance in this specific situation went steadily down from 64.7 percent in 2007 to just 54.7 percent last year, I also cannot concur automatically that it is by default a lack of money. Even the Deputy Fire Chief “expects a number of factors have played into the slowed turnout times since 2007,” before admitting “but he welcomes additional resources into the department, including more firefighters.”

Again, I admit that I don’t know all of the details surrounding the specific question in this next case asking Should City Merge Emergency Operations? But the first thing that struck me was that the city was looking to take over a nonprofit ambulance service in order to save money. I understand that the city is a major contributor to this service and that the fire department attends one third of their calls yet the city is the one complaining of the duplication of effort. The assumption is that the entire amount of support currently being given to the volunteers would be considered savings and could mean a new fully equipped ambulance after a merger. It seems to me that the money that was being used for operations would still be needed even after the fact.

A final article I read on the topic was New Toronto Fire Chief Says Merger with EMS Eyed. In this story, the City Fire Chief acknowledged that the existing fire model was broken saying “The status quo … is not an option. It just isn’t.” Part of his initial attack of the problem was reducing the number of firefighters to save money while an official service review is conducted. Once that review is completed,”every single truck in every single location” will be examined to determine the most “efficient” route forward. It was exciting to hear an administrator keeping the options (outside of the status quo) open. But the next line in the story asked about the recommendation of an accounting firm to merge with the more profitable EMS agency. Then I began to hear that common refrain begin again when the chief responded, ”I’m not opposed to anything that improves service for citizens.” However, he changed the melody a little by saying ”You’ve got to build a model that fits this city. We need a ‘Made in Toronto’ solution.” there was no talk of “quantitative easing” or government agencies “too big to fail.” It was, I hope, straight talk about finding real solutions in a bad economy. It may still be the money in the end, but let’s keep those options open until then. And I hope more agencies look at “locally grown” solutions before defaulting to money or taking over EMS.

Oh, and just for the record, I would never really compare my wife to a union boss. It was just an analogy, Sweetheart.

1 Comment

Leave a Reply

Your email address will not be published. Required fields are marked *

background image Blogger Img

High Performance EMS

High Performance Emergency Medical Services (HP-EMS) systems provide effective clinical care promoting positive patient outcomes and community wellness while maintaining a focus on improving economic efficiency of the system.  This site is dedicated as a community seeking to increase agency performance by promoting useful information regarding the developing trends and improvements in the efficiency of delivering basic and advanced medical care in the field.

JEMS Talk: Google Hangout

Comments
Jeffrey Hammerstein
Stop Dissing Response Times and Start Dissecting the Argument
I think that the position someone takes on this issue depends entirely on the circumstances of the particular EMS system they have in mind when they consider the question. If we're comparing a 7 minute response time to a 70 minute response time (or infinite as mentioned above), then of course it matters. That's a…
2015-07-03 11:44:45
Dave Shrader
Stop Dissing Response Times and Start Dissecting the Argument
I had meetings recently with a client in an underserved County. They have multiple tax supported volunteer organizations, and a City FD as EMS providers. The system is totally Balkanized with each agency doing it’s own thing. One agency failed to even respond to 66% of its calls last year. So, 66% of the time,…
2015-07-03 08:08:44
Matt Zavadsky
What Higher EMS Pay Requires
This article is spot on - the rapidly changing healthcare finance environment is a game changer for us - IF, and ONLY IF, we can prove that we bring value to the payer... Does our care make a difference in the patient's experience of care, outcome and cost of care... By assessing our patient satisfaction,…
2015-06-17 08:38:01
Steven Lichtenberg
What Higher EMS Pay Requires
The biggest issue in pay scales is one you hit on directly. Payment for service rendered is solely based on transports. Refusals/DNR/DOA etc are not reimbursed. Once Medicare determines that we are in fact medical professionals and not "ambulance drivers" and pays for care rendered we have a chance. Community paramedicine is one mechanism for…
2015-06-16 21:47:53
daleloberger
What Higher EMS Pay Requires
Thank you for making the comment, Kim. I suspect you may have missed my meaning in that statement though. The passionate folks in EMS are some of the hardest working people I know. My complaint is certainly not that "we" don't put enough into our jobs to deserve better pay, it is that we must…
2015-06-16 18:13:18

Dale Loberger's Discussions


Follow Dale Loberger

FireEMS Blogs eNewsletter

Sign-up to receive our free monthly eNewsletter

LATEST EMS NEWS

HOT FORUM DISCUSSIONS