ambulance competitor and jacking up cost to taxpayersAccording to a Las Vegas Review-Journal story on March 5, 2014, Las
Vegas Fire Chief Willie McDonald is on a jihad to crush his
department’s private-sector competitor and he doesn’t care how many
citizens’ lives he jeopardizes to do so!
At issue is the current public safety system in which both a Las Vegas
fire department ambulance and a private American Medical Response
(AMR) ambulance are dispatched to respond to a medical emergency call.
Once the emergency itself is stabilized, the question then arises as
to which ambulance transports the patient to the hospital.
Now, this whole thing is a little confusing, so bear with me…
The fire department ambulance personnel are paid with taxpayer
dollars. AMR’s personnel are paid by the private ambulance company
from payments it receives either from insurance companies or the
individual patient who is transported to the hospital.
If the Las Vegas fire department guys transport the patient to the
hospital, the fire department gets the money from the patient’s
insurance company even though the fire department personnel are
already compensated with taxpayer dollars. So it’s an extra windfall
for the department.
If the patient doesn’t have insurance covering the emergency medical
transport, the fire department doesn’t lose anything because it’s
funded with taxpayer dollars.
On the other hand, if AMR transports the patient to the hospital, then
AMR gets reimbursed by the insurance company and the company uses
those private insurance payments to pay its emergency medical
But if the patient doesn’t have insurance and otherwise can’t pay for
the ambulance service provide by AMR, AMR eats the cost.
In other words, no taxpayer dollars are involved here whatsoever. It’s
just the price of doing business.
In reality — and this is even better for taxpayers — the RJ reports
that AMR pays the city a $400,000 franchise fee EVERY YEAR just for
the privilege of responding to medical emergencies to save the lives
of Las Vegas citizens who might not even be able to pay for the
What’s at issue here is a debate on whether to turn ALL of the
emergency medical transports over to the taxpayer-funded fire
department ambulance crews or the privately-funded AMR crews.
According to the RJ, taxpayers could save some $18 MILLION by getting
the fire department out of the transport biz, while the fire
department would pocket an additional $14 million windfall by putting
its private sector competitor out of business.
Which brings us to Chief Willie’s stunning announcement before the Las
Vegas city council last week that he was unilaterally taking complete
control of emergency medical calls and “re-establishing (the fire
department’s) role as the primary responder” by not dispatching AMR
ambulances to medical emergencies unless absolutely needed.
This is nothing short of a spectacular money grab by a government
agency already funded by taxpayer dollars. It’s not only a shocking
power play but a reckless one, as citizens lives could well be
jeopardized by this move. Here’s why…
According to the RJ story, the Las Vegas fire department has 22
ambulances serving the city. AMR has 70. The fire department’s
ambulances are parked at stationary fire houses while AMR’s ambulances
roam the city and are shifted from place to place by an AMR dispatcher
depending on service calls.
Now consider this scenario…
Let’s say an AMR ambulance happens to be at a Dunkin’ Donuts when
someone in the Mercedes-Benz car dealership next door has a heart
attack after seeing the sticker price for the new SLR McLaren Roadster
What Chief Willie intends to do is dispatch his ambulance from a fire
station much further away rather than send the AMR ambulance which is
sitting right next door!
When seconds count in a medical emergency, Chief Willie is willing to
risk the life of that poor Mercedes Benz customer just to scarf up
some additional cash to stuff into his department’s budget that is
already funded by taxpayer dollars.
And here’s how Chief Willie’s plot is even worse…
The fire department’s ambulances and personnel are actually trained to
a greater degree to handle extraordinary and catastophic medical
emergencies. For example, they are trained and equipped to use “jaws
of life” tools to extract people trapped in an automobile accident.
AMR’s personnel don’t handle rescue calls such as that.
So let’s say instead of AMR taking the Mercedes Benz heart attack
victim to the hospital, the fire department’s rescue ambulance
personnel do. And let’s say while they’re heading for the hospital
with the heart attack victim, another emergency call comes in to
rescue some hippie-wannabe who is helplessly trapped in a Prius that
was rear-ended by a 4-year-old on Big Wheel.
But the fire department’s specialized rescue team can’t respond
because it’s tied up!
This whole scandalous situation is nothing more than a turf war in
which Chief Willie is perfectly content to screw taxpayers while
putting citizens’ lives at risk. It’s time for the council to hose the
chief down and remind him that his job is public safety, not public
Chuck Muth is president of Citizen Outreach, a non-profit public
policy grassroots advocacy organization. He may be reached at