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Tuesday, April 11, 2017

Uber, I’ve Fallen and I Can’t Get Up

Can the market provide better alternatives to government-run ambulances?

There is a growing trend of late, where individuals seeking emergency medical attention have opted to use ridesharing services to transport themselves to the emergency room instead of relying on a traditional government ambulance.

While this market alternative has been a huge money saver for those whose ailments have provided the “luxury” of being able to wait a few extra minutes before reaching the hospital—one trip in an ambulance has been known to cost upwards of $1,500— medical “experts” are now warning that individuals may not be capable of choosing their own means of transportation and should instead stick to what the government has provided.

“If you go to the wrong hospital because of self-transport or Uber or Lyft – that hospital will then call 911. And that difference of 30 minutes or more could mean the difference between life and death,” Los Angeles City Fire Department medical director, Dr. Marc Eckstein stated.

Dr. Eckstein’s statements are understandable especially when considering his role as medical director and his trust in the system he oversees. After all, ambulances are equipped with EMTs and medical supplies that could potentially mean the difference between life and death while in transport to the hospital.

If for example, someone suspects they may be having a heart attack, it may be in their best interest to call an ambulance instead of waiting 15 minutes for an Uber. Either way, that choice is still the individual’s to make and having Uber as an option for others is truly a market win.

However, Uber did make the following statement:

“We’re grateful our service has helped people get to where they’re going when they need it most. However, it’s important to note that Uber is not a substitute for law enforcement or medical professionals. In the event of any medical emergency, we encourage people to call 911.”

But while Uber and Lyft might not be the greatest alternatives for those who need lifesaving treatment immediately, it would likewise be false to claim that federally funded ambulances are the only suitable game in town when it comes to emergency medical situations.  

Who Will Build the Roads and Provide the Ambulances?

Aside from the never-ending inquiries about who will build the roads if the state ceased to exist, another commonly posed “gotcha” question intended to stump the liberty- minded is interrogation over the use of state-sponsored emergency services.

“You individualists all claim to be against government intervention until you find yourselves in a situation where you need to call 9-1-1 for an ambulance,” they might scoff, thinking as though they have finally managed to unravel the very seams that hold the sentiments of liberalism together.

Unfortunately for those who see the state as the sole solution to every problem, they neglect to acknowledge the plethora of information that surrounds them daily, proving that just because the government does offer a service, doesn’t mean they should, nor does it mean they are the most competent at doing so.

“Help! I’ve Fallen and I Can’t Get Up”

Between commercials for “The Clapper” and “Crystal Pepsi,” Americans in the 1990s knew that at least once an evening during their regularly scheduled programs, they were going to hear that famous phrase as their televisions displayed a fragile elderly man dramatically falling down stairs.

In 2016 alone, the private emergency service, Life Alert, saved as many as 4,600 lives.

Just when it appeared that all was lost for the elderly in crisis, a button is pushed on a  medallion worn around his neck and the magical words are uttered: “Help! I’ve fallen and I can’t get up!”

Suddenly, an operator on the other end of the line assures the man that help is on the way. There is an over-acted sigh of relief from our senior citizen that signifies that everything is going to be okay.

Life Alert accidentally became a household name because of the significance its tagline had on 1990s popular culture. But while it was quickly becoming a favorite phrase of the decade, the “personal emergency response and home medical alert company” was also saving hundreds of thousands of elderly lives performing the same services performed by an ambulance, but at only a fraction of the cost.  

In 2016 alone, the company claims it can take credit for saving as many as 4,600 lives.

Life Alert, and other similar companies, charge a monthly rate for their services starting somewhere around $50 on average. An entire year’s worth of monthly payments for this type of emergency service is still less than half the cost of a ride in a traditional ambulance and offers more services such as home invasion protection.

Today, Life Alert is just one of many private emergency services that provide prompt aid to Americans.  

At the end of the day ambulances are state entities and as such, operate through the use of force.

However, unless the person in need of emergency assistance is already aware of a specific private service option, it is unlikely that they will stop to do that research during a time of crisis. Life Alert was fortunate enough to get a boost in recognition thanks to the popularity of its commercials, but few other private emergency services have been able to become household names, which is one of the many reasons why the the government still holds a comfortable monopoly over the paramedic industry.

Additionally, when children are taught repeatedly in government schools that all they need to do is dial “9-1-1” if there is an emergency, it becomes difficult to remind people that there are other—much cheaper options available.  

Governments Always Resort to Force

In addition to the typical ambulance experience being costly, to say the least, there is also the most problematic issue which is at the end of the day these services are state entities and as such, operate through the use of force.

In 1997, the National Center for Biotechnology Information (NCBI) was curious about the rising number of ambulance services being used for seemingly simple cases, specifically in instances involving children. After conducting a study on the matter, the NCBI found that within the sample group provided:

“Most (61%; 56/92) transports were considered medically unnecessary.”

While this particular study was limited to pediatric cases, its findings raise a larger question as to why ambulances are used so often in instances where they are unnecessary?

The specific statutes vary from state to state, but because paramedics are government agents, once an ambulance is called, whether warranted or not, the EMT on the scene actually has the authority to force a person to ride in the ambulance against their will and stick them with the bill later.

While the government asserts that you do have the right to refuse medical services from an EMT, that request is not as simple as it sounds and usually involves requesting an opt-out form from the paramedic, something few people even know exists.

In many emergency—or non-emergency— situations, 9-1-1 is often contacted by a bystander or third party member and not someone involved first-hand with the crisis in question. When the paramedics arrive on a scene, they are intervening based on the information given to them by the caller and not by the actual facts behind the emergency.

The ability to freely take risks and innovate becomes extremely restricted as bureaucracy grows. 

For those living with epilepsy, this is a situation dealt with all too often. While epilepsy is an extremely serious condition that should not be taken lightly, many of those who suffer from frequent seizures have dealt with their condition long enough to understand when a trip to the emergency room is needed, and when it is not.

However, that doesn’t stop nosy neighbors from calling 9-1-1 every time they suspect their neighbor could be in trouble. Since seizures are such a serious concern and each paramedic has to worry about their own job being put at risk if something serious were to occur after leaving the scene, in many instances, even if a false seizure was accidentally reported, epilepsy patients are forced to ride in the ambulance and foot the bill.

There can be no denying the lifesaving work performed each day by government-funded ambulances and paramedics. However, one of the most undeniable qualities of the market is the freedom and ability to constantly improve its consumer products and services. The ability to freely take risks and innovate becomes extremely restricted as bureaucracy —inherent and inseparable from any government entity—gets in the way.


  • Brittany is a writer for the Pacific Legal Foundation. She is a co-host of “The Way The World Works,” a Tuttle Twins podcast for families.