Tension between public, private emergency responders disturbing

Feuding emergency responders? Say it ain't so.

Actually, John Wilson, general manager of American Medical Response and Medic West Ambulance, says it is so, although not yet to the point of that 1976 comedy "Mother, Jugs & Speed," in which competing ambulance services wrangled over who would transport customers in Los Angeles.

Here it's not rival companies. It is public vs. private sector.

Ever since the North Las Vegas Fire Department sought to transport more people to make more money and save firefighters' jobs, Wilson said, the fire departments in every jurisdiction are looking for retribution. If they get there first, some fire department responders are hustling to transport patients without waiting for the private responder.

"Firefighters are trying to find equipment missing in order to write us up," Wilson said. "They're trying to build a case."

But when asked whether patient care is suffering, Wilson said that 98 percent of the time, responders are doing a good job. Since North Las Vegas pulled an agenda item this month that would have allowed fire departments to take more of the transport business, "it has calmed down dramatically," he said.

About 65 percent of the time, when his ambulances are called out, they end up transporting someone. But he said in the city of Las Vegas, his company's transport rate has dropped about 10 percent. He believes it's because the Las Vegas Fire Department is scooping up business to bill the insurance companies and make more money.

The charge for an ambulance run? About $900.

Wilson said that one out of three patients his companies transport has no insurance and that the collection rate for those is less than 10 cents on the dollar.

His companies pay about $1 million a year in franchise fees to have the contracts in Clark County, Las Vegas, North Las Vegas and Henderson (although the Henderson Fire Department handles most of its own emergency medical services calls).

Emergency Medical Services Corp., a publicly traded company, is the parent company for AMR, which is union, and MedicWest, which is nonunion.

When two trucks, two paramedics and two EMTs respond to a medical emergency, I'm told that benefits the patient, which is reassuring.

But at what cost?

There's an obvious personnel cost difference, Wilson said. The cost of salary and benefits for his paramedics is about $70,000. The cost for paramedics who are public employees is about $155,000 in salary and benefits.

Any claim that the paramedics working for the fire departments are better trained is questionable because, Wilson said, when the fire departments want to hire, they draw heavily from AMR and MedicWest.

Why not leave a private company to become a public-sector employee? After all, the pay and benefits are 2½-times better, Jeremy Aguero of Applied Analysis said.

Fire departments in the valley spend far more time answering potentially profitable emergency calls than they do fighting fires. Officials say 90 percent of the Las Vegas Fire Department calls are medical emergencies; in Clark County, 72 percent of the Fire Department's calls are medical, and in North Las Vegas, it is 75 percent to 80 percent.

Those are rescue calls, and anyone who has made such a call is grateful to see quality people show up to help, whether they are public employees or private. They are heroes when they stabilize patients and rush them to hospital emergency rooms. They save lives and should be honored for that.

If Wilson is correct and there are a small number of people seeking retaliation against the private emergency service providers, each fire department chief out there should make sure it's not happening on his watch. That's a potential patient care issue. Only in a Bill Cosby-Raquel Welch movie is that cause for yucks.

Jane Ann Morrison's column appears Monday, Thursday and Saturday. E-mail her at Jane@reviewjournal.com or call (702) 383-0275. She also blogs at lvrj.com/blogs/morrison.