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The Future of Emergency Medical System: Public or Private?

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The Future of Emergency Medical System: Public or Private?

The people in every community across the country rely on a system that few are actually aware of and that most hope to never use. It’s activated during medical and trauma emergencies, responding on scene to provide life saving interventions and rapid transport to health care facilities. This is the emergency medical system (EMS). EMS is a relatively young industry having only formally been around since the 1970s when congress passed the EMS Systems Act of 1973(Shah). At the time, pre-hospital care was either non-existent, operated by the local hospital system, or run by a group of volunteers (Shah). The industry has come a long way since its creation and is ever evolving. As it became apparent that this could be a moneymaking field, many private companies entered the industry, taking over care from hospital systems and providing quality care to a city’s residents through multi-year contracts of service.
Another industry undergoing changes in tangent with private EMS is city funded Fire & Rescue services, an industry with very high operation and labor costs. Statistically, there are fewer fires each year with slightly over 1 million structural fires in the US in 1977, there were only 484,500 in 2011, a drop of over 50% (NFPA, see appendix for graph), yet a city cannot just release its firefighters. In order to justify the expense of keeping firefighters on the payroll, many cities across the country have implemented cross-training programs for EMS, also taking note of the moneymaking potential, turning many firefighters into EMTs and paramedics to handle 911 calls(Sundance). The degree of implementation varies across the country, but it has already caused many conflicts with privately run EMS. This can lead to many compromises in patient care.
These two converging industries raise a few questions about

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