John Oliver Can't Believe EMS Isn't an Essential Service in Over Half the Country

”You know our health care system is f—-ed up when both patients and providers are relying on the same crowdfunding,“ Oliver says


Last Week Tonight with John Oliver EMS

John Oliver’s was blown away this week by some disturbing facts about the lack of federal oversight in how emergency medical services are funded and run.

Oliver dedicated his August 1 episode of “Last week Tonight” to discussing why exactly ambulance rides and emergency medical treatment is so expensive. In a nutshell, Oliver said its former president Ronald Reagan’s fault — he “eliminated direct federal funding and oversight” in the mid-1970s and that meant “shifting responsibility to the states” which, well, hasn’t gone great.

Oliver said he was shocked to learn that over half the country doesn’t consider EMS an essential service, according to the National Association of State EMS Officials. This means those working in and running emergency medical services providers have a much harder time accessing state funding and other resources needed to keep themselves open.

“Unlike other first responders, in 39 states EMS is not considered an essential service, meaning local governments don’t have to provide it to their citizens, which means EMS has much less access to federal funding,” Oliver said, bewildered.

He then pointed out that a quick search on crowd-funding sites like GoFundMe will bring up a number of EMS companies trying to raise funds to upgrade or buy equipment to stay in business, the same way people seeking medical care often try to crowd-fund their medical bills after treatment.

“You know our health care system is f—-ed up when both patients and providers are relying on the same crowd-funding,” Oliver said. “Finding out that EMS is not deemed essential is like finding out that most states don’t consider geese to be birds. That’s what they are. They have beaks, wings, feathers, they rain s–t from the sky, Sully Sullenberger is their Jeffrey Dahmer; they’re f—–g birds, I didn’t realize anyone was even disputing that!”

EMS systems’ operations vary greatly depending on what state you’re in, and while most are handled by a local or state fire department, a growing number of emergency medical services are actually run by private companies — 25% of them, according to a 2016 New York Times report. As of 2020, there were roughly 19,000 private firms running EMS businesses, each with its own policies and insurance mandates. And as Oliver noted, when an EMS provider loses staff or goes bankrupt, rural communities can sometimes lose access to ambulances.

To make things worse, there’s nothing the federal government is doing to support EMS workers or regulate providers to standardize costs. “There is no single federal agency overseeing or supporting EMS in the same way that, for instance, fire departments have the U.S. Fire Administration,” Oliver said. “The fact they are so underfunded can start to explain why they cost so much. EMS services can choose to be out of network, which means they generally can set their rates however they want.”

Oliver also pointed out that for all the recent talk during the pandemic about supporting emergency medical personnel, what they really need is adequate pay and benefits, which many don’t have. The average pay of an EMS worker is around $36,000 annually, well below the average member of a police force, which is closer to $48,000. Many EMS companies also don’t offer their first responders health benefits, and insurance is critical in a job that, as Oliver pointed out, has an injury rate of three times the national average. EMS workers are also ten times more likely to be suicidal compared to other jobs, Oliver said.

“Look, last year everyone was anxious to show just how much they supported EMTs,” Oliver said. Well now is the time to f—–g prove it and make big changes on their behalf.”

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