Somebody call an ambulance 

A few years back, my daughter, then 16, was driving home from a friend's house. It was late at night, she was tired and distracted, and turning into our tree-lined driveway, she collided with a car parked just inside the driveway. A neighbor, up late, heard the crash and called 911. The fire department arrived a few minutes later, and by the time my spouse and I realized that something was going on in front of our house, they had everything under control.

A little later, American Medical Response arrived, loaded my daughter on the ambulance and transported her 11 blocks to Memorial Hospital. She was fine; the docs released her, and we drove home.

End of story? Not quite. A few weeks later, we got a bill from AMR for several hundred bucks.

Think about it. As city taxpayers, we support a highly professional, appropriately funded fire department. Every firefighter is a qualified paramedic. Every fire station is fully staffed, 24/7. If you get in an accident, or have a heart attack at work, or are the victim of a crime, chances are that the firefighters will be the first to show up.

And though the department does 90 percent of the work, all of the compensation generated by the system flows to the private sector.

Because we've privatized ambulance services, the fire department is forbidden, except in cases of dire emergency, to transport injured folks to the hospital. AMR has the exclusive right to operate an ambulance service in the city of Colorado Springs.

Not to put to fine a point on it, the existing system is nuts. City taxpayers have invested tens of millions of dollars to create an extraordinarily competent fire department. With little additional investment, the department would be far better equipped than any conceivable private contractor to do hospital transport. In such a system, all of the fee dollars that now flow to AMR would return to the city, to help finance public safety.

Other cities use their fire departments for emergency medical transport. Phoenix, for example, has been operating its own emergency system since 1985. The enterprise has been highly profitable, returning many millions of dollars to that city's treasury.

So why don't we try it?

The reason is simple. In 1995, Colorado Springs and El Paso County created by intergovernmental agreement an entity called the Emergency Services Agency. The agency was empowered to contract with a single designated provider of emergency medical transport. They chose AMR, awarding that firm a five-year contract, which expires this year.

In Colorado Springs, AMR appears to have an extraordinarily cozy relationship with the Emergency Services Agency. Listen, for example, to a little speech that Colorado Springs Fire Chief Manual Navarro -- who is also an agency board member -- gave a few years ago: "We need to make sure that [agency] customers and taxpayers get the best deal ... doesn't it make sense for us to cooperate [with private sector providers] and find the best deal?"

If you want to hear more, ask AMR for a copy of their promotional video, "Keeping the Promise." Yup, Navarro's little speech was strictly plugola, aimed at potential AMR clients.

Did the city council, back in 1995, realize just how much power they'd given to Emergency Services Agency? Did they realize that this obscure organization would make, and subsequently extend, multi-year contracts that might not be in the city's best interest?

To the best of my recollection -- I was on council at the time -- we just wanted the ambulance provider problem to go away. It seemed like a good idea to pass the buck and let the pros deal with it.

So what we have is a comfortable little deal, which works out fine for AMR, and for city bureaucrats who don't like change.

But now, in the middle of an economic downturn, it'd be nice to find new revenue sources, particularly since the fire department has been asked to cut $1.8 million from its budget. Judging from Phoenix's experience, that's about the amount we could expect to realize from operating our own emergency transport.

But it's not gonna happen anytime soon. You see, last December the Emergency Services Agency extended its alliance through 2007. So should you need emergency transport, be prepared to pay AMR a base rate of $506.84, plus procedure add-ons ($89.42 for defibrillation, for example).

And if thinking about the bill stresses you out, they'll be glad to give you a Valium.

For an additional $8.72, that is.

-- jhazlehurst@csindy.com


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