Recently the Mayor of our fair city explained the financial difficulties we are in. Like so many cities we are spending more than we take in. There are so many good sounding projects just waiting for the city to fund them, yet even if they sound like a good thing to be doing, no one seems to care whether they are cost effective.
Let’s take for example our ambulance service, wonderful idea and for a small town like Mesquite with a large retiree population, it is seemingly irreplaceable. Fast and efficient they are and lifesaving in many cases. They are a real asset to our community. But sometimes a good idea morphs into something that gets out of hand.
A couple of ambulances and local door to hospital service and even some lifesaving emergency care and keeping firefighters busy while waiting for something to happen were the ideas. But let’s look at what has happened; we now have four $250,000 vehicles and a large crew of emergency techs to cover every eventuality. They do a great job, are fast, well trained and very professional. So what’s the problem?
The problem is that it is not run like a business but more like a free service. There are many ambulance services run by private companies that actually make money. Some fire departments have seen a huge new business they can be engaged in that will keep their firefighters busy and raise their perceived value to their service area. Not a bad idea if you run it efficiently, but what if you don’t? Large amounts of money are wasted.
It might be a good idea if our mayor and city council looked at our “business” of ambulance service. I understand that they collect just 31% of their billing. How many businesses would survive by only collecting from about 1/3 of the customers? Somehow this thing has gotten out of hand. Now we all know the firefighters are not bill collectors but somebody is and we need to hire them. Any service company that only collects 31% of the billing they handle needs to be replaced, especial y when Medicare is involved in many of the billings. Makes you wonder if it’s that same old company out of Salt Lake City still doing the billing.
Even if we are willing to accept a very low collection rate, we need to look where we can cut back on our business losses. Sending someone out in a real emergency seems to be the core of the business and makes sense. It’s a real plus when we can get people to the hospital as quickly as possible and render emergence help if needed. So what is the problem?
Somehow we have drifted from the core business and expanded into the transportation business. I’m not talking about emergency service; I’m talking about non-emergency medical transportation to Las Vegas and St George. Think of the resources involved, a $250,000 vehicle driven a long distance by two well-trained firefighters for no reason except it’s an expansion of our money losing service. Unfortunately, while these two firefighters are on the road, others now have to be available and sometimes at overtime rates.
There are many companies that will transport medical patients under non-emergency conditions, people who just need to be transferred to another location for additional treatment. Those companies also know how to get paid for their services. Maybe if we shift out of the non-emergency transportation business, we will not wear out our nice new ambulances, not have to staff up because people are on the road and then stop losing money.
Please remember were not talking about cutting emergency service to the hospital here or another location, we’re talking about getting out of the money losing non-emergency transportation business. Maybe next time we will only be replacing 1 vehicle instead of four. We should see overtime pay drop and maybe through attrition, staffing levels reduced, of course that is dependent on the fire department acting like a well-run business.