Commentary

Ambulance Controversy Astonishing, Unneeded

Contracting process doesn't need to be complicated

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.

Adrian Moore

Adrian Moore, Ph.D., is vice president of policy at Reason Foundation, a non-profit think tank advancing free minds and free markets. Moore leads Reason's policy implementation efforts and conducts his own research on topics such as privatization, government and regulatory reform, air quality, transportation and urban growth, prisons and utilities.

Moore, who has testified before Congress on several occasions, regularly advises federal, state and local officials on ways to streamline government and reduce costs.

In 2008 and 2009, Moore served on Congress' National Surface Transportation Infrastructure Financing Commission. The commission offered "specific recommendations for increasing investment in transportation infrastructure while at the same time moving the Federal Government away from reliance on motor fuel taxes toward more direct fees charged to transportation infrastructure users." Since 2009 he has served on California's Public Infrastructure Advisory Commission.

Mr. Moore is co-author of the book Mobility First: A New Vision for Transportation in a Globally Competitive 21st Century (Rowman & Littlefield, 2008). Texas Gov. Rick Perry said, "Speaking from our experiences in Texas, Sam Staley and Adrian Moore get it right in Mobility First." World Bank urban planner Alain Bartaud called it "a must read for urban managers of large cities in the United States and around the world."

Moore is also co-author of Curb Rights: A Foundation for Free Enterprise in Urban Transit, published in 1997 by the Brookings Institution Press, as well as dozens of policy studies. His work has been published in the Wall Street Journal, Los Angeles Times, Boston Globe, Houston Chronicle, Atlanta Journal-Constitution, Orange County Register, as well as in, Public Policy and Management, Transportation Research Part A, Urban Affairs Review, Economic Affairs, and numerous other publications.

In 2002, Moore was awarded a World Outsourcing Achievement Award by PricewaterhouseCoopers and Michael F. Corbett & Associates Ltd. for his work showing governments how to use public-private partnerships and the private sector to save taxpayer money and improve the efficiency of their agencies.

Prior to joining Reason, Moore served 10 years in the Army on active duty and reserves. As an noncommissioned officer he was accepted to Officers Candidate School and commissioned as an Infantry officer. He served in posts in the United States and Germany and left the military as a Captain after commanding a Heavy Material Supply company.

Mr. Moore earned a Ph.D. in Economics from the University of California, Irvine. He holds a Master's in Economics from the University of California, Irvine and a Master's in History from California State University, Chico.