columnists | emergency services
Public or Private
New York City’s History of
Private Emergency Services
Sadly, no shortage of people to remember. Photo: Mayor of Norfolk, Virginia
O N September 11th, 2001, 343 Hunter Ambulance. He had been an workers, told the press, ‘They’ll do this
journal of international peace operations | volume 5 | number 2 | september-october 2009
firemen and 21 police officers emergency worker for 19 years and was over my dead body,’ and at the time,
died at the World Trade survived by his wife and two children, one Mayor Giuliani rejected the proposal.
Center. In the weeks and months that of whom was studying to be a paramedic.
followed, New York City and the world at Yamel Merino was a 24-year-old single But six years later, the city’s non-profit
large celebrated the heroism of these men. mother who worked for Metrocare hospitals – which had long been part of
Ambulance in the Bronx. She left behind the New York’s 911 emergency call
Three New York firefighters were an eight-year-old son. system – were given permission to
pictured raising an American flag at contract with commercial firms. Prior to
Ground Zero in an image that referenced The EMS death rate was low because this, ambulances had been staffed by the
the 1945 flag-raising on Iwo Jima. Crowds their job required them to attend to hospitals’ own employees. The first
loitered outside city firehouses, applaud- medical emergencies on the ground, but contract went to Metrocare and over the
ing the firemen as they returned ex- Schwartz and Merino were not alone at next four years, this Brooklyn-based
hausted from laboring at the site. A the World Trade Center that morning. company captured around 10 percent of
firefighter figurine named Billy Blazes Hunter Ambulance lost two emergency the city’s emergency medical services.
briefly became the nation’s hottest-selling vehicles. Metrocare lost seven. A
toy. subsequent investigation would reveal that The union warned that this new arrange-
14 minutes after the first tower was hit ment would create powerful incentives for
This is a powerful narrative, one that we and three minutes before the second, 19 private ambulances to divert insured
all recognize. However, it leaves out the municipal and 17 private units (both patients to their sponsors’ hospitals. But
paramedics who also died at the World voluntary and commercial) were already at within days of its announcement, the
Trade Center that day. There were eight or on their way to the World Trade charitable hospitals were complaining that
of them: three were volunteers who just Center. Two hours later, 55 municipal and some of the city’s EMS workers were
happened to be nearby, three were 42 private units had been deployed. There directing patients away from their facilities
employees of non-profit hospitals and is no evidence that the private sector was and two city ambulance workers were
two worked for commercial ambulance lacking a public service ethos that day. later suspended.
The contracting out of emergency medical Over the months that followed, as
It is these last two who challenge the services has been a source of controversy Metrocare signed more contracts, New
simple equation that only direct public in New York since the idea was first York found itself in the midst of an
employment can deliver a public service floated by private ambulance companies ambulance war, with private emergency
ethos. Mark Schwartz was a 50-year-old in 1994. The president of Local 2507, the workers being subjected to death threats,
supervisor and assistant vice president of union representing the city’s EMS
The author is Executive Director of The Serco Institute.
columnists | emergency services
tire-slashing and radio-jamming. Local