In the US a lot of us grew up with the idea that when something really bad was happening you would dial 911 and people would appear very soon to help you.
I don't know whether this myth was ever true, but it certainly is not true today.
I have called 911 or its equivalent more than a dozen times on three continents. No magic helping people appear within five minutes. Or ten. Usually not twenty either. Sometimes not at all, even when they say they will come.
We pay fees for E911 service which includes location of cellular phones. But if you call 911 in Manhattan and tell them you are on 4th Street they will ask you if it's East or West 4th. They will even ask you this if you say you're on 3rd Avenue--an absurd question for a local resident but not for 911 dispatchers who are not locals and do not know local vernacular much less geography.
A few days ago the car I was in was robbed while we were driving in Chicago. I immediately called 911. They said they'd send someone so I told them where to find the driver. They called me back 20 minutes later and said they were not coming and that such a crime could be reported by phone only. The driver's phone had been stolen.
A fire alarm went off in a commercial building. I called 911. They didn't show up. Forty minutes later I called again. They sent the FD to my house. Not the fire.
911 is broken. Be prepared to take care of yourself.
I founded and ran a VoIP 9-1-1 company for a few years. 911 is run and financed at the very local level. There's around 9000 PSAPs (public safety answering points) in the US, most of them have a large amount of leeway in doing their own thing. (Some states have better state-level coordination.)
It's a not-excellently-paid job that is extremely stressful. It's extremely traumatic to hear someone dying, begging you for their life, and not being able to help (if, say, the location info fails and they don't know where they are). Add in low funding, and there can be long waits.
Location info sometimes fails, so it's ALWAYS a good idea to confirm location. In Canada an operator failed to do so, dispatched medical aid to the wrong location, and a kid died.
As to poor response in your experiments, I don't think that accurately represents the situation for everyone. It heavily depends on where you are and how busy they are. Certainly many people get very fast response times. 911 saves a huge amount of lives every year.
I've been in other countries that really don't have 9-1-1. First thing you notice is that every house is a mini-fortress. In Guatemala, I have a 24/7 rotation of guards, at least 4 all time. Because if an attack isn't prevented, there's going to be no helpful response. 911 is an amazing service and the lack of it is acutely noticed.
This doesn't sound right. I don't know as much about other cities but if you call 911 in Manhattan you're going to be connected to a call center at Metrotech in Brooklyn, a few blocks from where I am typing this, where a real live human who is almost certainly from NYC and lives here will answer your call, determine the precinct and sector and get the job to dispatch.
If someone is asking clarifying details it's likely because they are trained to do so, as people in real life emergencies tend to get flustered and make mistakes.
The 911 system in NYC is sophisticated, was revamped by the Bloomberg administration heavily in the wake of September 11th, and is very much part of the civil service here. Your story about calling 911 in NYC and getting an out of town call center is obvious fiction and makes me doubt the rest of your stories as a result.
> 911 is broken. Be prepared to take care of yourself.
For the past 30 years all around the world all cities are safer than ever. I don't see the catastrophic situation than you describe.
In any case if corporations are taking over basic services is a political issue that should be solved in elections and with political action.
"Be prepared to take care of yourself." is the wrong approach as it just asks people to renounce to their rights. You should defend your rights not happily renounce them.
This must be heavily dependent on where you live. I've called 911 three times in California. All three times the fire trucks showed up in less than five minutes.
As a counter anecdote, I lived in a bit of a rough neighborhood in Brooklyn for a while and called 911 several times for things happening on the street in front of my apartment building. Each time the dispatcher asked a couple of straightforward clarifying questions and the police/fire/ems showed up in minutes. I was extremely impressed and felt good about paying taxes for a well-functioning system.
I remember calling 911 exactly once, when I found that an elderly neighbor had fallen on his lawn, and was in distress, though not immediate danger. An ambulance arrived within 10 minutes, probably nearer 5 minutes.
My wife (among others) called 911 when neighbors were held up in front of their house across the was last December. The police were there in about 5 minutes. Somebody on the street called the police a couple of years ago upon hearing an explosion in one of the houses. The police were there very quickly, found a fire, and summoned the fire department, which also arrived quickly.
Be prepared to take care of myself? I am somewhat trained in rendering first aid, but have no experience in standing on a cherry-picker while operating a fire hose. I have discharged a firearm, but at no time recently, and don't think I would add to public safety by hunting armed robbers.
To add one more datapoint: my personal experience with 911 (called maybe 2-3 times for other people) has all been fast. Mostly responses within 5 minutes, and always within 10.
911 may have a local component and it could be your city being slow.
It depends on where you are. I've had excellent experience with the few times I've called, in Arapahoe and Jefferson Counties, Colorado.
I had an outright "please come right away" emergency with my kid, and an ambulance came right away.
I've called about suspicious activity in the neighborhood, and the sheriff came right away.
I even called because someone stole the registration tag from my car and taped it on their car (a neighbor living in the same apartment building) and they showed up, not at emergency speed but way before I would have been pissed.
The ambulance is part of the fire department here (and often it's a firetruck that shows up before the ambulance, all the same people). And we're not nuts like Chicago apparently is.
I have called 911 or its equivalent more than a dozen times on three continents. No magic helping people appear within five minutes
In what other countries did you try?
I called 911 in Canada many times as a ski patroller, and EMS were always on the way in less than 1 minute.
In Australia, when my Grandfather had a heart attack and teenage me had to call the equivalent (000), the ambulance was there extremely quickly (coming from a town about 12km away).
Complaints about 911 have a long history; I'll point out the 1990 hit rap song "911 is a joke" by Public Enemy. The video seems extremely dated now, though: https://www.youtube.com/watch?v=CPNK0VspQ0M
A few days ago the car I was in was robbed while we were driving in Chicago. I immediately called 911. They said they'd send someone so I told them where to find the driver. They called me back 20 minutes later and said they were not coming and that such a crime could be reported by phone only. The driver's phone had been stolen.
-
As a former Chicago resident I can say this is par for the course, in large part because that type of theft is extremely common.
As a general rule you cannot leave anything of value within site in your car or it will probably be gone by sunrise.
Two weeks ago I called 911 after hearing a loud car crash within a few blocks of my apartment. Took out my phone, placed the call, and listened to music for ~6 minutes before I was able to talk to someone. Once the 911 dispatcher took all of the information I had, the call was transferred (another ~3 minute wait). The original dispatcher introduced herself to my local dispatcher as "911 north".
> But if you call 911 in Manhattan and tell them you are on 4th Street they will ask you if it's East or West 4th.
Why is that an unreasonable question? People calling in emergencies are generally stressed and often very bad at accurately communicating where they are. A few clarifying questions, even if they don't make sense to you, can go a long way towards verifying the information they're being given.
The article's focus on the private equity boogeyman is misdirected, for reasons that become apparent if you read far enough:
> Private equity gained new power and responsibility as a direct result of the 2008 crisis. As cities and towns nationwide struggled to pay for basics like public infrastructure and ambulance services, private equity stepped in.
The budgets of state and local governments around the country are tapped out. Often, that's the result of problems that--though exacerbated by the financial collapse--have been in the making for decades.
The relevant question isn't whether private-equity backed police and fire services are better than well-funded public ones.[1] It's whether they're better than the poorly funded or unfunded ones that states and municipalities are able to afford given their budget constraints.
[1] Not only is that not the relevant question--it's one the article does not even answer. Nowhere does it provide any concrete analysis of the performance of private versus public fire or ambulance services.
> The budgets of state and local governments around the country are tapped out. Often, that's the result of problems that--though exacerbated by the financial collapse--have been in the making for decades.
Often it's the result of one party drastically cutting services and revenue, and taking the radical position that taxes, especially income taxes, can never go up.
There's more than enough blame to go around. Part of the issue is that private firms come in and pitch an option to cities and towns by which they can get out of their budget scrape by privatizing schools/fire/jails/traffic enforcement in return for granting a monopoly to a company and allowing them to charge new fees. This looks like an attractive option, rather than raising taxes, but I can't think of a time when I've heard of it working out.
> A man in the suburban South watched a chimney fire burn his house to the ground as he waited for the fire department, which billed him anyway and then sued him for $15,000 when he did not pay.
Is one typically billed when you have the fire department arrive? I thought it was a public good.
It's a good question, but many of these rural southern towns are very poor, and governed by conservative ideologues that have privatized all non-mandatory services.
These towns are required by federal law to provide school service to children within them, however, anything else like police, fire, and ambulance services are not required.
I think it's truly a shame that this has led to predatory practices by private companies who charge "fire insurance" rates of $500 a year, and charge exorbitant rates to people who might innocently dial 911 while their house is burning and don't have insurance.
For what it's worth, this is not normal practice in most civilized parts of the US (pretty much anywhere on the east and west coasts), but if you get far enough into the poor rural southern states, it really is like a 3rd world country.
A "public good" is, technically speaking, one which is "non-excludable and non-rivalrous". In a dense urban area, firefighting is clearly a public good, because to stop the building owned by Paying Client A burning down, you need to stop the building next door owned by Non-Paying Client B burning. You can't just stand around and make sure it doesn't spread across the property line to paying clients. Or to flip it around, paying firefighters to fight your fire benefits everyone around you.
In non-urban areas, at least if there's no serious risk of wildfires, firefighting is clearly not a public good. If your farmhouse start to burn, it's not going to threaten anyone but you, and paying firefighters to save it doesn't benefit anyone but you.
And in a (rare?) case of economic theory working in practice too, that's what we often observe: Rural fire departments often require fees to be paid, and won't fight fires if you haven't paid up.
(That being said: Just because rural firefighting isn't a public good doesn't mean it shouldn't be communally funded out of general taxation. Lots of what governments spend their money on aren't actual public goods.)
Crassus won a reputation for himself as a soldier in Sulla's campaigns in Italy (83), but fell out of favour because of his excessive greed in purchasing estates at knock-down prices during Sulla's proscriptions of his political opponents. Another source of his wealth was buying up property at risk from fire very cheaply and only then putting his private fire brigade into action. Other sources of his wealth were mines, and his business buying slaves, training them, and then re-selling them. In these ways he came to own most of Rome and increased his fortune from 300 talents to 7100 talents.
(A talent of silver is approximately 32kg, worth about 9 years of labour, so 7,100 talents would represent some 63,000 years of labour income. Very rough modern equivalent, about $2 billion, based on labour.)
I'm surprised nobody is mentioning the elephant at the dining table here. A 15k bill for saving your house is arguably fair. But in this case, there was a 15k bill for not saving the man's house. What form of corruption has brought about a legal system that enforces bills when the service was not provided?
> Is one typically billed when you have the fire department arrive? I thought it was a public good.
It's complicated. Unincorporated areas will often (depending on the state) leave firefighting to nearby municipalities, which will generally charge a periodic fee for coverage and bill property owners who do not pay the fee if/when they respond. Even some municipal corporations (e.g. towns, etc) do the same thing, though generally only in quite rural areas.
My impression is that it's generally pragmatic rather than ideological: most of us live in densely populated areas, but (in the US), most space is very sparsely populated.
Depends on where you live. In some areas you pay for something akin to fire insurance - a yearly fee that covers fire service. You don't have to pay, but the fire department isn't under any obligation to help you if you don't. And if you engage their services on an as-needed basis it's going to be very expensive.
The only alternatives to privatization I can see are:
1) force the population to collectively pay for these services
or
2) force specific individuals to provide these services for free
Option 1 is morally questionable and option 2 is a type of slavery, so it seems privatization isnt quite as bad as the alternatives. At least with a privatized service those who wish to opt out, can.
Free market enterprise requires, AFAIK, 'creative destruction' (business failure, freeing resources for new enterprises) and distribution of goods to those who can pay more.
Therefore, I don't think it's a good solution when the specifications are that the institution cannot fail (e.g., you can't have the police department go out of business or otherwise fail to provide services), and when its good should be distributed regardless of ability to pay (e.g., voting, fire protection, etc.).
So why not fix the problem at the demand side and not the supply side. If people can't afford essential-to-life services, isn't that the problem?
While I'm on the subject, centrally planning and allocating the services doesn't really solve the problem of whether it's worth the cost to have one ambulance to serve a town of five people who live in the middle of nowhere. Someone still has to make the decision. We can contrast the ways to make the decision.
In one proposal, the consumers of the services pay free market suppliers for emergency services. Various suppliers compete on features and price for servicing Buford, Wyoming (population 1). It turns out the resident of Buford, Wyoming needs to pay six figures per year to pay for his services. Either he's a Walton and it's not a big deal or he's a normal person and has to move somewhere that normal people can afford to live. Or maybe he signs a waiver stating he understands his home is outside the normal emergency services areas.
In another proposal, everyone gets emergency services no matter what. If a town can't afford it, they lobby up (county, state, nation) to a bureaucracy to get the subsidies they need. Eventually the money gets allocated as a line item in a pork barrel rider on the Save Kids with Cancer Act. From then on it's political suicide and a huge waste of political capital to cut the Buford, Wyoming Fire Department from the budget since, relatively speaking, there's not much to gain by being sensible at this level of detail. The guy in Buford, Wyoming gets a permanent six-figure-a-year subsidy for having absolutely no neighbors.
Hold on, you say, in proposal B you can have qualified bureaucrats (sorry, experts) picking which towns get services and which don't. In this case, we get to blame 'heartless republicans/democrats/whatever' instead of 'creative destruction'. People still have to decide some towns aren't worth it. But it's no longer people paying for what they use. It's someone you need to hire lobbyists to talk to.
Interesting that the article doesn't mention the fact that Rural Metro (the second largest commercial ambulance service in the country) was recently bought by Envision Healthcare Holdings, the parent company of American Medical Response (AMR), the largest commercial ambulance service in the country. Rural Metro operations across the country are now in the process of getting their green/yellow ambulances painted AMR red.
It remains to be seen what impact this has on EMS in the US, but many folks in the industry were surprised that the sale went through as easily as it did. They were already #1 and #2 by a wide margin, the new combined company is staggeringly huge, with no real national competitor (granted, it does have local competition in most markets).
The US should look at Germany, once again: we do have private companies managing medical services - usually awarded in 3-5 year contracts, and e.g. in case of Munich, there are multiple companies in addition to the various NGOs (Malteser, Red Cross, Johanniter). All of them have to provide a standardized set of equipment and education for the personnel.
Oh, and there's a law that mandates that on long-term average, every caller has to be served in 10 minutes from call. This is called "Hilfsfrist" and is mandatory for firefighters, ambulances and cops.
911 responders are always in government hands, though.
Amen, but I am starting to think that this is a cultural thing... civil law vs common law, rhinian capitalism vs Anglo-Saxon capitalism. German private does not mean American private, and that is good in my opinion. A lot of people moan about regulations and strong unions(like with the train conducters recently), but forget how important they are society wide
Back when I was contracting I got a gig to install and update 911 in cities within about a 50 miles radius. I was appalled at the state of 911 once I saw it from the inside, even with the new system I was installing, which was running on Windows Server 2003 and was obviously poorly secured and tossed together by someone in Dallas who knew .net and knew the old boy system to get the contract.
This is one more reason why I try to explain to people that you need to be prepared to take of a problem yourself, because cops and ambulances will just show up and either take you to the hospital or draw chalk around your body.
Self defense is an inherent natural right and its one more reason the right to bear arms is so important.
That's actually not uncommon. Many of the early ambulance services in the US were run by funeral homes, as they already had vehicles capable of moving people lying down.
That being said, Bang's is far from a "Wall Street" operation. Like the vast majority of ambulance companies, it's a pretty small mom n' pop shop.
[+] [-] jzwinck|9 years ago|reply
I don't know whether this myth was ever true, but it certainly is not true today.
I have called 911 or its equivalent more than a dozen times on three continents. No magic helping people appear within five minutes. Or ten. Usually not twenty either. Sometimes not at all, even when they say they will come.
We pay fees for E911 service which includes location of cellular phones. But if you call 911 in Manhattan and tell them you are on 4th Street they will ask you if it's East or West 4th. They will even ask you this if you say you're on 3rd Avenue--an absurd question for a local resident but not for 911 dispatchers who are not locals and do not know local vernacular much less geography.
A few days ago the car I was in was robbed while we were driving in Chicago. I immediately called 911. They said they'd send someone so I told them where to find the driver. They called me back 20 minutes later and said they were not coming and that such a crime could be reported by phone only. The driver's phone had been stolen.
A fire alarm went off in a commercial building. I called 911. They didn't show up. Forty minutes later I called again. They sent the FD to my house. Not the fire.
911 is broken. Be prepared to take care of yourself.
[+] [-] MichaelGG|9 years ago|reply
It's a not-excellently-paid job that is extremely stressful. It's extremely traumatic to hear someone dying, begging you for their life, and not being able to help (if, say, the location info fails and they don't know where they are). Add in low funding, and there can be long waits.
Location info sometimes fails, so it's ALWAYS a good idea to confirm location. In Canada an operator failed to do so, dispatched medical aid to the wrong location, and a kid died.
As to poor response in your experiments, I don't think that accurately represents the situation for everyone. It heavily depends on where you are and how busy they are. Certainly many people get very fast response times. 911 saves a huge amount of lives every year.
I've been in other countries that really don't have 9-1-1. First thing you notice is that every house is a mini-fortress. In Guatemala, I have a 24/7 rotation of guards, at least 4 all time. Because if an attack isn't prevented, there's going to be no helpful response. 911 is an amazing service and the lack of it is acutely noticed.
[+] [-] CPLX|9 years ago|reply
If someone is asking clarifying details it's likely because they are trained to do so, as people in real life emergencies tend to get flustered and make mistakes.
The 911 system in NYC is sophisticated, was revamped by the Bloomberg administration heavily in the wake of September 11th, and is very much part of the civil service here. Your story about calling 911 in NYC and getting an out of town call center is obvious fiction and makes me doubt the rest of your stories as a result.
[+] [-] kartan|9 years ago|reply
For the past 30 years all around the world all cities are safer than ever. I don't see the catastrophic situation than you describe.
In any case if corporations are taking over basic services is a political issue that should be solved in elections and with political action.
"Be prepared to take care of yourself." is the wrong approach as it just asks people to renounce to their rights. You should defend your rights not happily renounce them.
[+] [-] gozur88|9 years ago|reply
[+] [-] macNchz|9 years ago|reply
[+] [-] cafard|9 years ago|reply
My wife (among others) called 911 when neighbors were held up in front of their house across the was last December. The police were there in about 5 minutes. Somebody on the street called the police a couple of years ago upon hearing an explosion in one of the houses. The police were there very quickly, found a fire, and summoned the fire department, which also arrived quickly.
Be prepared to take care of myself? I am somewhat trained in rendering first aid, but have no experience in standing on a cherry-picker while operating a fire hose. I have discharged a firearm, but at no time recently, and don't think I would add to public safety by hunting armed robbers.
[+] [-] fanzhang|9 years ago|reply
911 may have a local component and it could be your city being slow.
[+] [-] a3n|9 years ago|reply
I had an outright "please come right away" emergency with my kid, and an ambulance came right away.
I've called about suspicious activity in the neighborhood, and the sheriff came right away.
I even called because someone stole the registration tag from my car and taped it on their car (a neighbor living in the same apartment building) and they showed up, not at emergency speed but way before I would have been pissed.
The ambulance is part of the fire department here (and often it's a firetruck that shows up before the ambulance, all the same people). And we're not nuts like Chicago apparently is.
EDIT:
> Be prepared to take care of yourself.
I agree with that 100%.
[+] [-] grecy|9 years ago|reply
In what other countries did you try?
I called 911 in Canada many times as a ski patroller, and EMS were always on the way in less than 1 minute.
In Australia, when my Grandfather had a heart attack and teenage me had to call the equivalent (000), the ambulance was there extremely quickly (coming from a town about 12km away).
[+] [-] kens|9 years ago|reply
[+] [-] ciq_steve|9 years ago|reply
[+] [-] SoMuchToGrok|9 years ago|reply
Two weeks ago I called 911 after hearing a loud car crash within a few blocks of my apartment. Took out my phone, placed the call, and listened to music for ~6 minutes before I was able to talk to someone. Once the 911 dispatcher took all of the information I had, the call was transferred (another ~3 minute wait). The original dispatcher introduced herself to my local dispatcher as "911 north".
FWIW, this is a city in the top 30 by population.
[+] [-] takeda|9 years ago|reply
[+] [-] JshWright|9 years ago|reply
Why is that an unreasonable question? People calling in emergencies are generally stressed and often very bad at accurately communicating where they are. A few clarifying questions, even if they don't make sense to you, can go a long way towards verifying the information they're being given.
[+] [-] toephu2|9 years ago|reply
[+] [-] unknown|9 years ago|reply
[deleted]
[+] [-] unknown|9 years ago|reply
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[+] [-] rayiner|9 years ago|reply
> Private equity gained new power and responsibility as a direct result of the 2008 crisis. As cities and towns nationwide struggled to pay for basics like public infrastructure and ambulance services, private equity stepped in.
The budgets of state and local governments around the country are tapped out. Often, that's the result of problems that--though exacerbated by the financial collapse--have been in the making for decades.
The relevant question isn't whether private-equity backed police and fire services are better than well-funded public ones.[1] It's whether they're better than the poorly funded or unfunded ones that states and municipalities are able to afford given their budget constraints.
[1] Not only is that not the relevant question--it's one the article does not even answer. Nowhere does it provide any concrete analysis of the performance of private versus public fire or ambulance services.
[+] [-] hackuser|9 years ago|reply
Often it's the result of one party drastically cutting services and revenue, and taking the radical position that taxes, especially income taxes, can never go up.
[+] [-] URSpider94|9 years ago|reply
[+] [-] arcanus|9 years ago|reply
Is one typically billed when you have the fire department arrive? I thought it was a public good.
[+] [-] illumin8|9 years ago|reply
These towns are required by federal law to provide school service to children within them, however, anything else like police, fire, and ambulance services are not required.
I think it's truly a shame that this has led to predatory practices by private companies who charge "fire insurance" rates of $500 a year, and charge exorbitant rates to people who might innocently dial 911 while their house is burning and don't have insurance.
For what it's worth, this is not normal practice in most civilized parts of the US (pretty much anywhere on the east and west coasts), but if you get far enough into the poor rural southern states, it really is like a 3rd world country.
[+] [-] Lazare|9 years ago|reply
In non-urban areas, at least if there's no serious risk of wildfires, firefighting is clearly not a public good. If your farmhouse start to burn, it's not going to threaten anyone but you, and paying firefighters to save it doesn't benefit anyone but you.
And in a (rare?) case of economic theory working in practice too, that's what we often observe: Rural fire departments often require fees to be paid, and won't fight fires if you haven't paid up.
(That being said: Just because rural firefighting isn't a public good doesn't mean it shouldn't be communally funded out of general taxation. Lots of what governments spend their money on aren't actual public goods.)
[+] [-] dredmorbius|9 years ago|reply
Crassus won a reputation for himself as a soldier in Sulla's campaigns in Italy (83), but fell out of favour because of his excessive greed in purchasing estates at knock-down prices during Sulla's proscriptions of his political opponents. Another source of his wealth was buying up property at risk from fire very cheaply and only then putting his private fire brigade into action. Other sources of his wealth were mines, and his business buying slaves, training them, and then re-selling them. In these ways he came to own most of Rome and increased his fortune from 300 talents to 7100 talents.
(A talent of silver is approximately 32kg, worth about 9 years of labour, so 7,100 talents would represent some 63,000 years of labour income. Very rough modern equivalent, about $2 billion, based on labour.)
[+] [-] rwallace|9 years ago|reply
[+] [-] mnarayan01|9 years ago|reply
It's complicated. Unincorporated areas will often (depending on the state) leave firefighting to nearby municipalities, which will generally charge a periodic fee for coverage and bill property owners who do not pay the fee if/when they respond. Even some municipal corporations (e.g. towns, etc) do the same thing, though generally only in quite rural areas.
My impression is that it's generally pragmatic rather than ideological: most of us live in densely populated areas, but (in the US), most space is very sparsely populated.
[+] [-] gozur88|9 years ago|reply
[+] [-] pmx|9 years ago|reply
[+] [-] a3n|9 years ago|reply
[+] [-] nkrisc|9 years ago|reply
[+] [-] hackuser|9 years ago|reply
[+] [-] pravda|9 years ago|reply
The difference is, if the firemen are government employees, they can vote themselves rich.
http://www.publicsectorinc.org/2014/06/firefighter-pay-shows...
[+] [-] stevendhansen|9 years ago|reply
1) force the population to collectively pay for these services or 2) force specific individuals to provide these services for free
Option 1 is morally questionable and option 2 is a type of slavery, so it seems privatization isnt quite as bad as the alternatives. At least with a privatized service those who wish to opt out, can.
[+] [-] hackuser|9 years ago|reply
Therefore, I don't think it's a good solution when the specifications are that the institution cannot fail (e.g., you can't have the police department go out of business or otherwise fail to provide services), and when its good should be distributed regardless of ability to pay (e.g., voting, fire protection, etc.).
[+] [-] humanrebar|9 years ago|reply
While I'm on the subject, centrally planning and allocating the services doesn't really solve the problem of whether it's worth the cost to have one ambulance to serve a town of five people who live in the middle of nowhere. Someone still has to make the decision. We can contrast the ways to make the decision.
In one proposal, the consumers of the services pay free market suppliers for emergency services. Various suppliers compete on features and price for servicing Buford, Wyoming (population 1). It turns out the resident of Buford, Wyoming needs to pay six figures per year to pay for his services. Either he's a Walton and it's not a big deal or he's a normal person and has to move somewhere that normal people can afford to live. Or maybe he signs a waiver stating he understands his home is outside the normal emergency services areas.
In another proposal, everyone gets emergency services no matter what. If a town can't afford it, they lobby up (county, state, nation) to a bureaucracy to get the subsidies they need. Eventually the money gets allocated as a line item in a pork barrel rider on the Save Kids with Cancer Act. From then on it's political suicide and a huge waste of political capital to cut the Buford, Wyoming Fire Department from the budget since, relatively speaking, there's not much to gain by being sensible at this level of detail. The guy in Buford, Wyoming gets a permanent six-figure-a-year subsidy for having absolutely no neighbors.
Hold on, you say, in proposal B you can have qualified bureaucrats (sorry, experts) picking which towns get services and which don't. In this case, we get to blame 'heartless republicans/democrats/whatever' instead of 'creative destruction'. People still have to decide some towns aren't worth it. But it's no longer people paying for what they use. It's someone you need to hire lobbyists to talk to.
[+] [-] JshWright|9 years ago|reply
It remains to be seen what impact this has on EMS in the US, but many folks in the industry were surprised that the sale went through as easily as it did. They were already #1 and #2 by a wide margin, the new combined company is staggeringly huge, with no real national competitor (granted, it does have local competition in most markets).
[+] [-] mschuster91|9 years ago|reply
The US should look at Germany, once again: we do have private companies managing medical services - usually awarded in 3-5 year contracts, and e.g. in case of Munich, there are multiple companies in addition to the various NGOs (Malteser, Red Cross, Johanniter). All of them have to provide a standardized set of equipment and education for the personnel.
Oh, and there's a law that mandates that on long-term average, every caller has to be served in 10 minutes from call. This is called "Hilfsfrist" and is mandatory for firefighters, ambulances and cops.
911 responders are always in government hands, though.
[+] [-] wojcech|9 years ago|reply
[+] [-] arca_vorago|9 years ago|reply
This is one more reason why I try to explain to people that you need to be prepared to take of a problem yourself, because cops and ambulances will just show up and either take you to the hospital or draw chalk around your body.
Self defense is an inherent natural right and its one more reason the right to bear arms is so important.
[+] [-] unknown|9 years ago|reply
[deleted]
[+] [-] xivzgrev|9 years ago|reply
"Many homeowners in Rural/Metro’s jurisdiction did not realize they had to pay for fire protection separately"
[+] [-] njbooher|9 years ago|reply
[+] [-] JshWright|9 years ago|reply
That being said, Bang's is far from a "Wall Street" operation. Like the vast majority of ambulance companies, it's a pretty small mom n' pop shop.
[+] [-] doctorstupid|9 years ago|reply