Why EMS is not safe from outsourcing

Moving billing jobs overseas lowers labor costs in competitive EMS reimbursement market and displaces workers

By Arthur Hsieh

Outsourcing work done by Americans to overseas companies has been a strain on the U.S. economy for more than a decade. While EMS providers might feel comfortable that the provision of our services are provided by local workforces, it’s merely an illusion. As this article points out, large EMS agencies will do what they can to reduce the cost of providing service and maximize net revenue - in another words, make a profit.

There is nothing wrong with this concept – rather, it’s one of the main principles that capitalism is founded upon. It is the engine that drives the U.S. economy, provides a very high standard of living, and permits us to pursue the goal of liberty and happiness.

Offshoring has been a stumbling block in this process. While it’s true that labor costs can be much cheaper in other countries, there are other costs to contend with, and more importantly, unintended consequences as well. The concept that U.S. workers can be retrained to do something else that provides equal or greater personal income hasn’t quite worked out that way. Not everyone can become a member of the high tech or biotech industries, nor will those industries absorb all of the displaced workforce.

In addition, displaced workers are colliding head on with a reducing demand for human labor resulting from the increasing efficiency of the American workplace. So while the availability of retraining funding is nice (and needed), it’s no guarantee that people will land on their feet.

Finally, shrinking reimbursement for EMS services stands at the crux of the issue. While a $52.8 million profit sounds quite good, that represents a 1.65 percent margin over costs. According to AMR’s website, they employ more than 18,000 people transporting more than 3 million patients. Do some math, and you can quickly see why there are serious flaws in this model.

I’m not an advocate for socialism. Yet there has to be a way to create solid economic conditions that allow companies to maintain healthy profits and healthy employment levels. In our industry of helping people in their time of need, it seems ironic that we’re having a hard time helping ourselves.

About the author

EMS1 Editorial Advisor Art Hsieh, MA, NREMT-P currently teaches at the Public Safety Training Center, Santa Rosa Junior College in the Emergency Care Program. Since 1982, Art has worked as a line medic and chief officer in the private, third service and fire-based EMS. He has directed both primary and EMS continuing education programs. Art is a textbook author, has presented at conferences nationwide, and continues to provide patient care at an EMS service in Northern California. Contact Art at Art.Hsieh@ems1.com.

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