County commission defers item to add ambulance firms

By Jennifer Miller
   To solve a problem health care officials identify as slow ambulance response, backers of a proposed county ordinance say adding more company names to a system monopolized by three private firms will get people to emergency rooms faster and possibly save lives.
   Alarmed opponents said the change will trigger an unfavorable "sink-or-swim" environment for private ambulance companies and drive up county-set service rates.
   A survey of seven counties nationwide shows that at a price range of $175-$290, Miami-Dade County has the lowest patient rates for ambulance services.
   Miami-Dade county commissioners, saying they needed health officials to do a cost analysis before making a decision, deferred the issue Tuesday.
   Proponents of the ordinance argued opening doors to more companies will not drive up costs and would give patients more freedom to choose the best provider.
   The survey that highlighted the county's low rates indicated Miami-Dade also has the worst private units-to-population ratio at 1 ambulance for 27,000 people.
   "Let applicants go forward," said a spokesperson for Broward-based AMC Ambulance, which she said has sought the opportunity to provide ambulance service in Miami-Dade since 1994. "The elderly and ill are waiting three to four hours to get to the hospital. The results are clear. We need the ordinance."
   Meanwhile, representatives from the county's three private ambulance firms — Florida Medi-Van, Medi-Car and Randle Eastern — said the system works fine as is.
   "If it ain't broke, don't fix it," said Miguel De Grandy, a lobbyist for American Medical Response, which owns Randle Eastern and Medi-Car. "Over-competition in many markets drives up costs and results in less calls for individual companies. Flaws with the ordinance may lead to detrimental consequences in what is today a first-class ambulance rescue system."
   American Medical Response, with 73 ambulances, controls 92% of the county's private ambulance business.
   The other 8% of the market is under the wing of Florida Medi-Van, a six-ambulance company, operating under county law since 1990.
   Isabel Gomez, president of Florida Medi-Van, said the company may go out of business if the ordinance passes.
   "My company's future is in great limbo. Since 1997 we've had a decrease in call volume. We used to get 45-50 calls a day and today we get between 30 and 35," Ms. Gomez said.
   "I'm not asking for sympathy. I'm just asking you to re-consider the ordinance."
   Commissioners Dennis C. Moss and Barbara Carey-Shuler said a slow increase in the number of ambulance companies in the market could prevent established businesses from losing revenue.
   The intent of the ordinance is not to affect existing companies, backers said, but to address the needs of those using private ambulance services.
   Commissioners said they plan to advertise the issue before the public. They said the bottom line is the community needs access to ambulances.