Editorial: Quality vs. cost in ambulance debate | TahoeDailyTribune.com

Editorial: Quality vs. cost in ambulance debate

Tribune editorial staff

The time has come to reconsider El Dorado County’s contract with Lake Tahoe Ambulance. Although contract renewal is a year away, this issue is far too crucial to be left to the usual last-minute shuffle.

The latest labor squabbles have impact beyond the size of employee paychecks and benefits in only one way – accountability.

Basically, in 1992, the LTA contract called for the county to pay LTA $765,000 per year plus a percentage of the number of calls and the costs for such things as bandages and IV tubing. That has gone up each year with a cost-of-living increase. In 1997-98, that base amount is $856,239, almost a $100,000 increase or about a 12-percent hike.

Employees claim they haven’t seen a raise in all those five years. That may be true based on the one selling point LTA used when defending itself against a proposal by the Lake Valley Fire District. The selling point was the cheaper cost of labor and a promise to keep those costs down.

LTA is a private company that, with the exception of a one-year period five years ago, has provided paramedic service on the California side of the South Shore – including the city of South Lake Tahoe – for decades.

But in that time, a number of problems have cropped up. Many the company has resolved. Certainly response time is a source of great pride for the LTA.

But one of the biggest criticisms about LTA service is paramedics’ apparent reluctance to access patients in remote areas. The claim is such procedures aren’t covered under LTA’s insurance contract.

However, this is Lake Tahoe. A large number of ambulance calls require care in remote areas or on ski slopes. There have been some positive changes in that regard, but there is still tension between the ambulance service and ski areas over this issue. That tension has been exacerbated with the increase in taxes ski resorts are paying for ambulance service.

The other criticism is the high cost patients pay for ambulances. The cost for a run in the city, not including mileage and medical supplies, starts at $450. That’s just half or less the amount of money LTA actually gets for each run. Seems a bit steep just to go a couple of blocks. Eight years ago, a run for one critical care baby from the Barton Memorial Hospital to the airport was $800, and that didn’t include medical supplies.

When the Lake Valley Fire District presented a plan to combine the fire and ambulance service, the city, in particular, balked. The reasoning was fire readiness. Basically, city fire stations are manned with three firefighters. If another firefighter is added to the force, then two men can go out on the ambulance call. But should a fire break out at the same time, that leaves only two firefighters per truck. That was not acceptable to the city, even though the county has been handling fire trucks with just two people for a number of years.

The real issue is quality vs. cost. Can this community afford to pay exorbitant rates under the guise of fire readiness?

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