An American Medical Response ambulance
An American Medical Response ambulance in San Diego. Megan Wood / inewsource

Public-private partnerships have been a staple in the U.S. economy throughout modern history. Not only does private sector support typically result in higher quality services, but it also almost always leads to lower costs for American taxpayers. 

Unfortunately, and unsurprisingly, we are seeing the benefits of the private sector being threatened in the state of California, specifically in the Emergency Medical Services transport industry. 

Many of the largest EMS systems, state and nationwide, are run by private emergency ambulance companies, and most have provided these services for over 50 years at no cost to the city or county they serve. Despite this, fire departments in the state have recently been pursuing what’s known as the “Alliance Model,” which aims to give fire departments the decision-making power of a full EMS agency, but without the oversight of an EMS agency, resulting in virtually shutting out the private sector from being able to compete. 

Luckily, though the city of San Diego was contemplating a switch to this structure, they ultimately decided to continue with their private sector model, not only to maintain efficient response times but to also keep the costs of needed equipment off of taxpayers. Now it’s time for the rest of the state to follow suit. 

While proponents of the Alliance Model are touting it as a public-private partnership, that is simply not the case. As laid out in a recent study by the Reason Foundation, the Alliance Model “eliminates competition from any bidding process that emerges from it.”

The study also noted that “without a more transparent and competitive process, the Alliance model, despite being labeled as a public-private partnership, fails to even attempt to harness the very force—competition—that’s essential in making [public-private partnerships] valuable for taxpayers and governments.”

Not only are these local county governments trying to pull the wool over the eyes of their citizens by labeling it as a public-private partnership, but as they often do, the costs are falling on the shoulders of taxpayers. Between overblown pensions, local tax increases, and first-responder fees, fire departments are draining city budgets and indebting their local communities.

Some Californian cities, including Vallejo and San Bernardino, have been forced into bankruptcy because of the skyrocketing costs of the fire departments. 

What many taxpayers don’t realize is that revenue generated through fire departments operating all emergency services, including ambulance transport, does not go back into the local economy. Instead, it is being used to pad bloated and overpromised firefighter pensions. So, while we keep charging Californians high costs, they aren’t receiving an uptick in quality of service, and they keep getting duped by bureaucratic overreach. 

History has taught us many times over that private sector involvement is crucial for innovation, higher quality services, and lower costs, yet California seems to have an issue learning from this history. Rather than bolstering our EMS services with private sector competition and innovation, we are backing them into a corner and hemorrhaging city budgets.

It’s time California took a look in the mirror and fixed this issue before it becomes even worse. 

David Vincent, Ph.D, is an executive in the local life sciences industry and a former volunteer firefighter.

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