Puerto Rico’s Missing Ambulances

Back in September 2014, I wrote about how the failure of Puerto Rico’s government to pay its bills led to the closure of the island’s last air-ambulance service. The commonwealth authorities eventually forged a temporary fix to keep the vital service running.

But now, barely five months later, local news source El Vocero reports that we’re running short of all ambulances — aerial and otherwise. Money, or the lack of it, is again the issue, but there’s more to it than that.

Onerous government regulations are forcing private ambulance companies to shut down in Puerto Rico.
Onerous government regulations are forcing private ambulance companies to shut down in Puerto Rico. (Wikimedia)

Public service contracts in Puerto Rico require ambulance companies to replace their vehicles every ten years. On the face of it, that’s not such a bad idea: the job, and the state of our road network, take a heavy toll on the vehicles. In the course of each replacement, on-board equipment is also updated.

The problem is that each new ambulance can cost over US$100,000 per unit: a cost that could be avoided by installing new equipment without buying an entirely new vehicle.

Ambulances Under Attack

The economic downturn of the last 7 years has hit private medical providers as hard as any other business. Roberto Roque, of the Central Eastern Association of Private Ambulances, made the situation clear when he said that the insurance companies were “strangling” the sector. Many companies have already closed, leaving the island with “almost no ambulances.”

The insurance industry is also regulated by the local government, meaning that private ambulance services face a two-pronged attack from the state, limiting their ability to stay afloat.

Public Service Commission President Omar Negron has announced hearings to examine the regulatory environment, and listen to private service providers’ concerns. But the hearings aren’t expected to produce their findings until May. In the meantime, those private companies providing a life-saving service hang by a thread.

This fresh crisis once again highlights the perennial paradox of government regulation: measures taken “in the public interest” end up doing more harm than good. Puerto Rico provides multiple examples of this.

The only regulations needed for ambulance services are those enforcing primary health and safety rules: making sure that equipment is clean and functional, for example. Restricting when ambulances can and can’t be used prevents companies from broadening the scope of their services and even from providing life-saving care.

But deregulating the marketplace, even a little, will allow ambulance companies, insurance providers, hospitals, and individual patients to determine what is best for them.

Overregulation only ends up hurting the very people it’s meant to protect. And let’s put it another way: if you fell ill or had an accident, wouldn’t you rather an ambulance from 2004, albeit with modern equipment, came to take you to hospital, rather than no ambulance at all?

Edited by Laurie Blair.

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