Heavy Government Hand Suffocates Rural EMT Services

Government-run health insurance is slowly but steadily draining our health care system of resources, skills and services. Medicare and Medicaid pay lower reimbursement rates than private insurance plans, and because of ridiculous state barriers to competition between health insurance plans more and more people end up either on Medicaid or without any insurance at all. Obamacare is only going to make things worse, both through more regulations and through expansion of government-run health insurance (i.e., Medicaid as well as the ready-to-be-launched public option). The consequences of this relentless expansion of government in our health care system is having many troubling consequences, one of which is that rural areas are being under-served with emergency medical services. This story from Oklahoma is a case in point:

The financial crisis for most ambulance districts in the state is worsening and will continue to deteriorate unless an additional reliable funding source can be found for them to stay in business, a legislative panel was told Thursday. A county property tax to raise money for rural ambulance districts authorized by a state law two years ago is insufficient to raise enough money to pay costs, several ambulance operators said. … Ambulance operators and local officials filled a committee room and spilled out into the hallway as they pleaded with members of a House of Representatives budget committee on public health and social services to find some type of additional funding source. About 60 ambulance services have gone out of business in the past 10 years. State Health Department records show 153 ambulance services operating in the state, excluding Oklahoma and Tulsa counties.

Residents in rural states across the country should take notice. There is a clear link between the financial problems of rural ambulance services and the presence of heavy-handed government in the health insurance business:

The plight of rural ambulance operators has been dismal for the past decade. A governor’s task force studied the issue five years ago. After 16 months, it came up with findings similar to woes mentioned Thursday: low Medicare and insurance reimbursement rates, a growing number of Oklahomans without health insurance and the fact that although emergency medical service workers require extensive training, pay is far below other public safety professionals — making recruitment and retention difficult.

Rural Oklahoma, like most other rural areas in the country, has a lower average household income. Therefore, a larger portion of families are on Medicaid in the rural areas. When the news article refers to “insurance reimbursement rates” it means, primarily, the tax-funded, government-run Medicaid.

The rate of uninsured has grown because of federal regulations on steroids under Obamacare. Insurance rates for private plans have gone up dramatically, leaving small, rural businesses with relatively small financial margins with no other option than to drop insurance coverage for their employees. Unless the employees can and will enroll in Medicaid, they go uninsured.

There is a model for rural ambulance and fire services that could survive even the heavy hand of the Obama administration. In Switzerland, a country with a private, moderately regulated health insurance market, local, non-profit emergency service societies provide rural areas with fire, rescue and EMT operations. For a low, annual fee every property owner becomes a member and services therefore become independent of what insurance plans residents happen to be on. Apparently, some counties in Oklahoma have tried to use property taxes as a funding base; it is possible that the problem therefore lies in the other end. The article hints that some operators of ambulance services may not be as financially astute as one has to be to run a for-profit operation. A non-profit solution may therefore be an alternative for Oklahoma as well as other rural states.