Pre-hospital care and emergency medical services can make a significant impact on the

outcome of an emergency, but there are many costs to consider when dialing 911. I work at
Paramount Ambulance and have been an EMT since 2011.
When something unexpectedly comes up that concern your health what do you do? Call
911? Maybe call 563-690-9111? Or do you just hope into your car and have someone drive you
to the hospital real fast? All three of these options are most common during these scary
situations. Michael Moore filmed a woman who had an emergency situation and called 911. An
ambulance arrived and gave her the pre-hospital care that she needed and eventually brought her
to the hospital. Little did she know that an ambulance ride is not free and that some insurance
companies do NOT cover ambulance rides! Wouldnt you just assume that your insurance, if you
have it, should cover an emergency situation like this? I understand that ambulatory transfers
may not be covered by insurance and that some insurance companies only pay for medical
necessity transfers, but how does the average citizen with no medical knowledge differentiate
what is a medical necessity and what isnt?
Did you know that in the state of Iowa an ambulance is NOT required to show up to an
emergency 911 call (Reber). Seriously! EMS people in Iowa are trying to change that. I only
found this out last month during a regional EMS meeting at N.I.C.C. in Peosta, IA. In the urban
areas you will more than likely receive an ambulance every time you call 911; however, in rural
communities where the fire departments and EMS services are volunteer based, you stand the
chance of not receiving an ambulance or fire truck if no one is available in that area. You will
find that many of these small town volunteers take a lot of pride in their service and do their best
to help their community in an emergency situation. I am currently a member of the Centralia
Peosta Fire Department where I live and it is a volunteer service, but I would bet that on every
call you receive at least one ambulance containing a paramedic and EMT as well as at least one
fire truck. EMS is growing ever so slowly and people are gaining more and more interest so I
believe in the near future ambulances will be required to respond to at least all medical
emergencies.
You may ask yourself what costs are all involved when first responders, EMS, fire, and
police show up on your front door. Costs are as follows, but not limited to: vehicles, fuel,
maintenance, equipment, personnel, and treatment. We are lucky in Dubuque to have two
services that can get an ambulance to you. The Dubuque Fire Department and EMS can be
dispatched at any given time to respond to emergencies. When you call 911 in the city of
Dubuque, you will receive a police officer in his squad car, some firemen in their fire trucks, and
some Paramedics in an ambulance (usually in this order). The department has six buildings
(headquarters and ENG. House 2, 3, 4, 5, and 6), five tanker fire trucks, two ladder trucks, one
hazmat vehicle (hazardous materials), half a dozen of command vehicles, and two ambulances
that are in service. I believe they have about 75 employees, which at least get paid a starting
salary of $48,000 plus benefits. All of this is paid for by the government through your tax
dollars.
You would think that if you pay your taxes you shouldnt have to pay for an ambulatory
transfer to the hospital in case of emergency. Well the fact of the matter is that the city will still
bill you for the departments services. I believe the minimum cost of an ambulance ride in
Dubuque is $800. Moving to the private ambulatory service, Paramount Ambulance is a for-
profit company. They do not receive any money or grants from the government to pay for
personnel, vehicles, equipment, and are not exempt from taxes. They bill I think at least $1,000
for in call in the tri-state area, but there bread and butter are doing hospital to hospital
transfers. They do transfers from practically anywhere to almost any hospital care within 150
miles. However, not every patients insurance will cover the bill; it all goes back to medical
necessity. It is comforting to know that in Dubuque, IA, we have a choice in an ambulance
service that has well trained professionals.
You might be wondering how this applies to athletic injuries. Most of this is knowledge
shared from me to you to keep you informed. It also was a way to give you an idea of the costs
involved in an emergency situation. To relate this to athletics, I will share an event that I
personally was a contributing member of. During this winter I was a member of a stand by
crew for Paramount Ambulance at the Five Flags center for a wrestling match hosted by Loras
College athletics. The day went by seemingly slow and safe until an AT was waiving over to our
staging area. I was the only one there at the time so I grabbed by medical bag and started to walk
over to the mat where their seemed to be an injured athlete. About halfway to the mat more
people started to frantically waive me to come faster, so I slightly jogged (an EMS professional
never shows signs of panic).
When I got there I found a wrestler lying supine on the mat with his arm being stabilized
by the head lady of the Athletic Training staff. I looked at his arm and it appeared that he had
popped his elbow out of his joint. I quickly radioed for backup to bring an ambulance and air
splint over. One of the students said we have an air splint, I will go get it. He brought the splint
and we stabilized his arm and walked him to the ambulance outside. The Paramedic in the
ambulance took over from there and established an IV and brought him to the hospital.
An athlete cannot predict when they are going to get injured. They train for success.
When they do get injured they need the best pre-hospital care in order to have great definitive
care and the fastest quality rehabilitation. Yes it may cost you or your insurance a hefty price, but
they are only trying to help out and provide care. With this Affordable Healthcare Act, I am not
sure how it will affect the money outcome with EMS, but one thing is for certain, its always
comforting to have an ambulance in an emergency medical situation.




















Reference Cited

Reber, Craig D. Officials: Iowa EMS in need of life support. Telegraph Herald [Dubuque]
December 15, 2013. Print.