In the 2012 and 2013 run-up to a Bay County Commission vote on taking over ambulance service to the county’s only two hospitals, The News Herald used this space to call on the Commission to reconsider.
Our argument at the time was that while the commission had done its research on the financial risks associated with the service there was not yet a compelling reason for taking on the monumental burden of running an ambulance service.
It was a little like performing exploratory surgery on a patient that might be ill but wasn’t, in our view, sick enough to require an invasive procedure.
Bay County’s taxpayers got their first diagnosis on the ambulance service this week and the preliminary results are not good.
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Total expenditures for the ambulance service for fiscal year 2014, which ended Sept. 30, were $6.96 million, which is $1.81 million away from breaking even. However, there is $7.5 million in outstanding debts the county is trying to collect in net accounts receivable.
County officials suggested to The News Herald’s Editorial Board that given enough time, fiscal year 2014 could ultimately break even or possibly go into the black. That will ultimately depend on how much of the outstanding debt owed is paid back through the collection process.
During the preliminary discussions about taking over the service Bay County staff and an outside consultant they hired said that it would at least break even and possibly turn a profit. However, Bill Kinsaul, Bay County’s Clerk of Court, came to a different conclusion, saying that there was “a very high probability Bay County would experience a negative financial impact with the transition of EMS to Bay County.”
Again, it should be noted that the ambulance service could still break even or turn a profit both with fiscal year 2014 and going forward depending on how much can be recompensed through the collection process.
However, even the service’s strongest supporters would agree that this report is, at least, a yellow flag, and, at worst, a red flag of financial maladies that could grow worse if treatment is not swift.
There are several different options that could resolve the issue. The first one is to let the problem go untreated and see if the condition improves.
The second is to examine what changes, if any, could be made to the service that will improve the fiscal situation. We should note that, according to county leaders, the ambulance service itself seems to be in peak condition. Out of more than 20,000 patient transports only one person has called back to complain about the service they received, officials told The News Herald’s Editorial Board.
Finally, the county could look for a private operator to take over the service.
A private operator presents its own set of challenges. First, the county would have to find someone who would accept a contract that did not require any kind of subsidy from the taxpayers. After all, the point of privatization would be to limit the costs and exposure the taxpayers currently face.
Second, county officials would either have to ensure that the private operator provided the same quality service that is currently being offered or live with the idea that the service could degrade if a private operator cuts corners to make a profit.
The last, and final hurdle, is that a private operator —which might be one of the two area hospitals — would favor one hospital over the other. That’s the very situation the county was trying to avoid when it took over the service in the first place.
Sometimes in life, medicine and in government, there is no perfect solution. At this point we’re sure most taxpayers are simply hoping that the county can make this work and turn it into the rare government-run program that either breaks even or turns a profit.
If not, the county commission should perform an ambulanceectomy as soon as possible.