The U.S. spends more than any other country on health care. Why is EMS on life support?
"You may find that you live in an area where the lifeline to save a life is propped up by two families who [...] are literally selling cupcakes to put gas in the ambulance."
Some estimates say that each year, 240 million calls are made to 911, which equates to two out of three Americans per year requesting some type of emergency assistance. In 2018, about 31 million of those 911 calls required ambulance transport, or about 8 percent.
The vast majority of 911 calls do not require routing to a hospital for treatment, yet that is the only way that emergency medical service (EMS) agencies get paid. They receive no compensation, from anyone, if they treat and stabilize someone in place without taking them to a hospital.
The U.S. spends more money per capita on health care than any other OECD nation, most of which spend about half as much per person with better outcomes than the U.S. The federal government spent nearly $5 trillion on health care in 2023, the equivalent of nearly 20 percent of national GDP that year. On the state side, Medicaid is every state’s largest expense after public schools, and about 15 percent of all money generated in state taxes goes towards paying its share of Medicaid for residents.
This isn’t even going into the amount of money in the American economy that flows into private insurers. But in the midst of all of that money, Lisa Ward, a health care lobbyist and emergency medical technician in Denver, says that the number one fact that the public does not understand about the national EMS system is that there is a funding hole that none of these metrics reach.
“It’s not sustainable," she says. “People are panicked, and the general public has no concept. When you call 911, you just expect us to be there. There will be a day when no one is coming.”