Ambulance finances are slim
A story on the Mississippi Today website provides insight on yet another growing concern in the medical care field: the cost of operating an ambulance service.
Featuring Franklin County paramedic Tyler Blalock, whose company Rapid Rural Response has provided ambulance service there since 2012, the story illustrates both the benefits and the risks of hiring a small firm for the emergency transportation.
The main benefits are that Blalock’s company is small and local. County supervisors chose him for the service precisely because of his personal touch and his familiarity with residents in Franklin County, population 8,000.
Blalock told Mississippi Today that he can only compete with larger, more profit-oriented ambulance operators by placing a priority on patient care. But he conceded that there will be no such care if he’s losing money.
The risk is that there are plenty of forces aligned against small ambulance services. Naturally, these forces involve money.
The story said the average reimbursement for ambulance calls ranges from $200 to $300, but research indicates these rates are at least 6 percent less than the actual costs of the service. More than 70 percent of ambulance calls are made below cost, which makes profit margins more difficult for smaller companies.
Part of the problem is that Medicare, Medicaid and most private insurers classify ambulance services as a “transport supply” instead of medical treatment, under which reimbursements would be larger.
Emergency medical services providers have a good point when they contend that today’s ambulance crews provide a lot of care in the bus while en route to a hospital. Thus it is both transportation and medical treatment.
Another issue is service cutbacks at rural hospitals, along with a few that have closed. This puts greater demands on larger hospitals, especially the University of Mississippi Medical Center in Jackson, where many ambulances with seriously ill or injured patients arrive. When it takes significantly longer for a hospital to accept these patients, the ambulance companies lose money because their vehicle must wait there until the patient is admitted.
Low profit margins in ambulance services have been a problem for a number of years. Blalock said he’s fighting this battle in Franklin County, but the good news is that he’s seen fit to expand his business into Lawrence County.
However, it does not take a crystal ball to see the potential for greater financial trouble ahead. Companies that don’t make much money are often unable to pay their employees, which leads to greater turnover and less experienced paramedics. The EMTs who literally have lives in their hands earn an average of $33,000 per year.
The state has a trauma fund, through which it assists counties for ambulance service. But it’s clear that more needs to be done before some parts of Mississippi find themselves without any ambulances at all.
Jack Ryan, Enterprise-Journal
College majors are changing
A chart of the majors being chosen by college students shows they are rapidly turning away from the humanities.
The Washington Post, using information from the National Center for Education Statistics, reported there were 25% fewer English majors in 2017 than there were in 2009. Students majoring in philosophy, religion, foreign language or education also were down between 16% and 22% during that time period. It’s worth noting that these declines are coming during a time when college enrollment is rising.
In terms of attracting more students, health care is the big winner: It had 97% more majors in 2017. The so-called STEM fields, meaning science, technology, engineering and math, were up between 55% and 88%. Perhaps most interesting is that homeland security majors were up by 42%.
It’s pretty easy to understand why more college students are avoiding the humanities: Because more of the jobs are in other fields, and nobody should blame students — or their parents who pay for the education — for gravitating toward studies more likely to produce employment.
The one exception to that trend might be education, where the job outlook probably is stable but students appear to be deciding they’d rather do something besides teach.
As for the list of rising majors, it’s no shock that medical care studies have nearly doubled. Somebody’s going to have to take care of the aging Baby Boomers, and the continued advances in medical technology make it likely that jobs in fields as-yet unconceived will be created.
If there is a surprise in the list of majors attracting more students, it’s homeland security. That doesn’t quite have the zing of a medical major or a STEM major. But the trend makes sense: The public has to worry about attacks from both foreign terrorists and unhinged Americans. It’s sad to say, but the rising number of threats are creating job opportunities.
The Post story that included the chart of rising and declining majors explored the issue from an interesting angle: Some prominent economists believe that more students should consider taking a couple of humanities classes as a complement to whatever else they’re studying.
This is a good point. It can only help a medical specialist, computer scientist or engineer if he or she can write clearly or has an appreciation for history. A Nobel Prize-winning economist’s new book opens with a story about how he learned more about the Great Depression in a college history course than he did in any of his financial courses.
This past August, at a meeting of economists from around the world, the chairman of Australia’s central bank urged his peers to talk less about numbers and to tell more stories “that people can understand,” such as how policies contribute to the economy and make a difference in people’s lives.
Some of this already is going on. Jamaica’s central bank has been the most creative, hiring reggae artists to sing to the public about the evils of high inflation. That may not go over in every country, but the idea of using the arts to explain economics makes sense. Perhaps the central bankers and economists should hire a few English majors to help them tell their stories.
Jack Ryan, Enterprise-Journal
This one’s a draw
As long as there are politicians, there will be politicians helping out their donors. It’s just a matter of degree.
In the Mississippi governor’s race, Jim Hood criticizes Tate Reeves for helping out his corporate buddies with tax-cutting legislation. Reeves counters by saying Hood funnels some of the state’s legal business to his trial-lawyer donors.
This issue is probably a wash. Both are guilty as charged.
Tim Kalich
Editor and Publisher
