Name: How the US created an ambulance crisis
Uploaded: 2025-06-06T02:56:46.000Z
Duration: 6 min 52 s
Description: Thousands of YouTube videos with English-Chinese subtitles! Now you can learn to understand native speakers, expand your vocabulary, and improve your pronunciation...

Adverbs of degree

If you called for an ambulance, how long is too long to wait?

Maybe you're having a heart attack, or you were in a car accident, or some other serious condition. 18 minutes?

The gold standard is eight minute response time.

So from the time you call 911, the ambulance shows up.

But if you live in any of the red areas on this map, you might be waiting longer.

Areas that were outside of a 25 minute drive time.

That's Yvonne Young, one of the authors of this paper, which sought to map the position of every ambulance station in the entire US.

They found that roughly 4.5 million people live in ambulance deserts. 4.5 million people who, if they had a stroke or were suffering cardiac arrest, might not make it to a hospital in time to survive.

It makes sense that in a more spread out area, an ambulance will take longer to get to you.

But there's more to the story than just geography.

The rural ambulance crisis is a product of our own design.

So in addition to Yvonne, I talked to some of the people overseeing that frontline response to ask, how can we fix it?

Just popping in to say this is the first of three videos that we're doing on how emergency help gets to remote locations.

Rural areas often struggle to get the same level of service as more populated regions.

We wanted to explore what those challenges look like and what can be done to make things better.

And we're grateful to T-Mobile, our sponsor, for supporting this video.

T-Mobile has invested billions in getting 5G coverage across the US.

And they're committed to supporting first responders and their families with exclusive savings.

So if you want to learn more about that, check out the link below.

T-Mobile didn't dictate the content of this video, but their support did help make our reporting possible.

If your house is on fire or you are scared for your safety, you might call 911.

And for the most part, you'd get a response that wouldn't cost you any money out of pocket.

Most places, the fire department and the police department are considered essential services.

The government has to provide those for its population and it funds those largely through taxes.

EMS in the majority is not considered an essential service.

So your town has no obligation to provide an ambulance service.

Without the same government funding, payment must come in another form.

And that's reimbursement by insurers or payment from individual patients.

EMS is really reimbursed like they're a taxi service.

We only get reimbursed if we do the transport.

That is transported from the scene and taken to a hospital because that's where insurance and personal information can be established through paperwork.

If an ambulance responds to a call and that person doesn't want to get taken to the hospital.

There's personnel on that ambulance being paid.

There's a service that's being provided, but there's no reimbursement for it.

And this is the tricky thing about ambulance services.

All of the costs of running it, like gas, medicine, personnel, all that has to be paid for and ready to go at all times in case a call comes in.

But regardless if one call comes in or a hundred calls come in, those costs don't change, which means the best case scenario for keeping the services funded is for them to make as many trips as possible.

Otherwise they're just sitting there burning money.

Here in the city, we could be to a call in under five minutes, spend five, 10 minutes on scene, be at the hospital in five minutes and back in service in 25 minutes.

In some of the other counties that we're servicing, it could be a 35 minute ride just to the hospital.

That's an hour, hour plus that your unit's out of its area.

Cities also generally have more calls because they have more people and more incidents.

In sparsely populated, remote, rural locations, they're only doing 30 runs a year.

That low volume of calls also makes it hard to pay emergency workers who work around the clock, which is related to another thing commonly true of rural emergency response.

I mean, if people can't make a living off of it, then we're reduced to volunteers.

Volunteers are an essential part of EMS response in rural areas.

The overhead costs of running an ambulance are high.

So rural communities often rely on unpaid non-professionals to save on those personnel funds.

We have set up this system where your CPA, your plumber, might also be your EMT when you call 911.

It's just hard to recruit people working two and three jobs.

And a lot of the members that are still holding down the fort and responding to a lot of the calls are members that have been there from the beginning.

All that, the lower volume, less reimbursement, and shrinking volunteer pool, that's what adds up to slower response times.

There are areas of the state where you do not want to, you know, have an accident because there's no one, no one will be coming, at least not in a timely manner.

The sticky situation we find ourselves in with EMS is ultimately about resources and the issues of distributing them.

The study that we did in North Dakota, we not only looked at ambulance deserts, but we looked at if we could place them wherever we wanted, what would be the optimal set of locations?

And we were able to show you could serve the whole state with fewer number of ambulances and cover the whole state.

The problem really is is that these ambulances are organized by community goodwill.

You can't tell these communities, oh, sorry, you've got it in the wrong spot.

Part of the solution might be that we need to start thinking about EMS designation as an essential service.

Some places have started ambulance tax districts where local taxes do pay for EMS.

The community I live in just started an ambulance tax district.

They're paying to make sure that there's 24-7 coverage.

Robert Steems has started operating in some ambulance tax districts.

Significant reduction in response times and significant reduction in mutual aid where they have to rely on other communities to back them up.

Ultimately though, experts think the problem will require large-scale change.

We need to get the reimbursement rates up so that we're actually getting paid for the level of service that we're providing.

Until they change the reimbursement of those services, we will continue to be in crisis.

If you're ever in that situation where you need to dial 911, you don't want to have to worry about the system being in crisis.

The service that's being provided is just as critical and crucial as police and fire.

So it's time to be recognized for that and give us avenues of recruiting and training and funding that's going to allow us to address that EMS crisis.