With many sticky issues facing the City Council, including a tremendous budget challenge, the political dogfight over Hall Ambulance’s request for a rate increase is astonishing. This is not rocket science. Local governments manage ambulance services all over the state every year with little controversy.
Consider each piece of this controversy.
First, the great fuss over the fact that Mayor Harvey Hall owns Hall Ambulance. The Attorney General has established that there is no conflict of interest. In fact, up and down California mayors and council members are local businessmen and have to recuse themselves when the council votes on issues that effect their businesses. Members of the Bakersfield City Council frequently do likewise. What makes the Hall Ambulance rate case so special?
Second, Hall Ambulance is asking for a fairly large increase – higher than the rates in cities similar to Bakersfield. There is a reason why. People understand that cuts in federal reimbursements for ambulance services are very large, so there is a big funding hole that has to be filled locally.
What everyone is missing is that Hall Ambulance is the first major company in California to request a rate adjustment in response to the federal cuts. So comparing the rates Hall Ambulance asked for with the rates other cities are allowing now is a false comparison. Most other cities in California will soon see requests for rate increases as well.
Third, it is a bad idea to hire an expensive consultant to determine if a rate increase is needed. The way this is done in city after city, year after year, including Bakersfield in the past, is that staff examines existing rates, historical trends, local data on runs and services, reimbursement and payment rates and flows, finds out what is going on in similar communities, etc., and makes a reasonable, educated assessment of the merits of a change in rates.
Finally, competition in emergency medical services is a good thing, but it is also all or nothing. The request by Liberty Ambulance to serve non-emergency calls in Bakersfield is disastrous.
Many emergency calls are not paid for, but Hall Ambulance answers anyway. The system works because the company can make enough off of non-emergency calls to cover the loss on un-reimbursed emergency calls. You can have competition, but not just for the profitable part of the business.
The city must either have a competition for the whole contract to serve the city, or keep things as they are.
The issues the city is wrestling with are the same as those all over California. The only difference in each of these issues is the politics. They are ugly and a waste of our city leaders’ and staff’s time.
Enough of the Greek tragedy. The City Council should direct staff to do a rate evaluation exactly the way it has in the past, let Hall recuse himself as is always done in such situations, and make a decision.
Adrian Moore is Vice President of Reason Foundation.