Last week the ABC affiliate WTVG reported that the private companies were being forced to cut their ambulance fleets and at least 16 people would be laid off because the fire department was going in to the ambulance business.

''Toledo says it will make 1 million dollars running its own ambulances, and save 20 city jobs.''

No where in the report did it mention start up costs, how it would address non-emergency responses, or responses outside city limit boundaries.

I'’m leery when I see reports like this because it follows a trend that several cities has taken over the last few years. Stockton, CA, Lincoln, NE, Grand Junction, CO, and the list will certainly grow.

I am not opposed to any public agency providing service, but the motivation behind it. An important fact to be noted is that none of these cities has yet to realize any profits and to the contrary, sizeable deficits have been created. It has always rubbed me that when a community needed EMS most communities turned their heads and let the private sector take the risks. Once these communities see EMS as a potential source of revenue they take on a whole new attitude, but fail to address the non-emergent portion, or what to do about providing service outside the area of tax base.

EMS is not a cash cow, and nothing in the report was directed towards what was best for the community, and more importantly, what is best for the end user. The Patient.

Providing EMS in any community at any level costs money. That's a fact. Whether it is financed by tax dollars, user fees, subscriptions or donations. It's also a fact that any change in service involving a new provider involves start up costs for that provider, public or private. It's also a fact that reimbursement from Federal and State programs is on the decline and the payer mix will affect the bottom line.

Since I don't live in the local community and rely only on what gets reported I don’t have all the facts. That I am certain of. But, I would hope that all the logistics have been worked out and considerations given to the operation because there are many things to consider besides making a million dollars and saving 20 city jobs.  Who will respond to the non-emergency calls and responses outside the City boundaries?  How will the EMS System and performance be monitored and evaluated?  Best effort with what’s available or an industry established guideline?

A lot of things to considered before jumping in chasing after a carrot. Tax dollars are difficult to come by and those that spend them should be held accountable.