Ambulance Wars

How Private Ambulance Crews Steer Patients Away From Public Hospitals

Internecine politics surrounding the emergency system have made its problems a particularly touchy subject—even for an ambitious mayoral hopeful. Several politically powerful groups have an interest in defending the growing role of non-city ambulances in the 911 system. These include the Greater New York Hospital Association; 1199, the large union that represents ambulance workers for those hospitals; and owners of private ambulance companies.

Nevertheless, politicians have been jockeying for position on the issue. Both Mark Green and Hevesi have endorsed a lawsuit against Fire Commissioner Thomas Von Essen and Giuliani, among others, which charges that the city inappropriately allowed private companies into the 911 system. Joining Local 2507, the union that represents Fire Department ambulance workers (and has its own stake in protecting its professional turf), the candidates are arguing that the private contractors, like MetroCare, should be ousted from EMS.

The mayor's other major initiative involving emergency services—to put ambulances under the control of the Fire Department in 1996—has also proven controversial. Former EMS medical director Lorraine Giordano, a physician, is worried about the Fire Department's medical standards. "I wanted to keep the 'medical' in EMS," said Giordano who lost her job in December 1999, after raising concerns about proposed cost-cutting measures. Fire Department spokesman Frank Gribbon responds, "The standards are set by the state. We've always adhered to them. We always will."

Whether patient steering will continue to happen is likely to be up to the next administration to decide. And even a mayor committed to healing our deeply divided emergency system may find it difficult. "As long as ambulance staff feel they have a responsibility to a public or private hospital, the system will always be out of balance," says Lynn.

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