From EMS1: Private vs. public ambulance services: What's the difference?

For our look at public and private goods:  

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In the fire service, the career versus volunteer battle is a never-ending debate. And, in a similar vein, the discussion of private versus public ambulance services is often met with animosity.

In Costa Mesa, Calif., city officials voted against a public-private model, stating that they wanted to maintain the city's current ambulance transportation service. The plan would have assigned ambulance transport to the fire department for patients with serious injuries, and to a private company for non-life threatening cases.

D.C. Fire and EMS introduced a similar plan, which passed unanimously among city council members. The plan allows private companies to handle low-level transports, while D.C. Fire and EMS ambulances handle more emergent cases. Putting aside any pro-public or pro-private arguments, here's a breakdown of the differences between private and public ambulance services.

AMBULANCE SERVICE SYSTEMS IN THE U.S.

According to the National Association of Emergency Medical Technicians, the breakdown of ambulance service systems in the U.S. includes:

- Fire department with cross-trained EMS personnel: 40%
- Fire department with separate EMS personnel: 9%
- Government or third service: 14.5%
- Private company: 18%
- Hospital-based service: 7%
- Other: 8%
- Public utility model: 2%
- Police department with cross-trained EMS personnel: 0.5%
- Police department with separate EMS personnel: 1%

PUBLIC AMBULANCE SERVICES

Public ambulance services, according to Elite Ambulance, are supported through both user fees and tax revenue. Taxpayers fund public ambulance services, like those provided by fire departments, regardless of whether or not they actually use the service.

PRIVATE AMBULANCE SERVICES

On the opposite spectrum, user fees solely fund private ambulance services; taxpayers do not fund these agencies. Therefore, patients are only billed when they use the services.

Generally, public ambulance services typically respond to 911 calls and private providers perform interfacility, discharge and other scheduled, non-emergency transports. However, there are private services that contract with municipalities to provide 911 response and there are public services that perform interfacility, discharge and other scheduled, non-emergency transports.