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Ambulance Update

From The Berkshire Eagle:

With necessity being the mother of invention, the regionalization of emergency responder agencies has begun in the Northern Berkshires.

Heading into the third month of the merger of Village Ambulance in Williamstown with the North Adams Ambulance Service, officials say the task of melding procedures and communications continues apace.

Village Ambulance is about the only non-profit which merits direct contributions from Williams, mainly because its services are so commonly used by students. So, I don’t mind some College involvement. I also don’t know enough about the local politics to understand the reasons behind the merger and the winners/losers associated therewith.

I always worry, however, that the local power brokers —- Williamstown town manager Jason Hoch ’95, North Adams mayor Thomas Bernard ’92 — are very smart and that they recognize two fundamental truths: Williams College has endless money and the people who run Williams are (over) eager to use (too much of) that money to improve their own lives. So, what should Hoch/Bernard do? Get the College to contribute much more to the ambulance service, especially for aspects (like coverage outside of Williamstown) that it did not contribute much to before. And what do we see?

The cost of the rebranding, as well as others costs incurred by the merger, is being covered by a contribution from Williams College and Williamstown of up to $200,000. Meanwhile, the service responded to 892 calls In January. The average for North Adams Ambulance has been about 500 in a month. At the time of the merger, Village Ambulance was averaging around 333 per month.In January, the first month of the merger, the newly combined ambulance service responded to 892 calls.

$200,000 is way too much! And I bet this is in addition to the money that Williams usually contributes.

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#1 Comment By anonymous On March 23, 2018 @ 11:00 am

This is tricky. Apparently most insurance plans no longer cover ambulance rides. This has let to an ambulance funding crisis in many places. I know for a fact that this is why Village Ambulance tanked. Since Williams does not staff the infirmary after hours it has a problem handling the alcohol situations during non business hours. Given its rural location and lack of nearby hospital (North Adams hospital is closed and has only a skeleton ER at this point), Williams has a lot to lose if an alcohol emergency goes haywire. Therefore Williams has a huge financial incentive to keep the local ambulance afloat. 200k seems like a pittance to protect the brand. Some schools bill parents for ambulance rides. Perhaps Williams is or should be doing that.

#2 Comment By ZSD On March 23, 2018 @ 12:04 pm


Agreed! With non-life-threatening rides averaging $800-$1000 and life-threatening at $2000 plus, $200,000 just isn’t much money to have this necessary service.

In some rural areas where the local facilities just are not rated for the type of situations that might arise, life-flights by helicopter are not uncommon.

#3 Comment By abl On March 23, 2018 @ 1:52 pm

anonymous –

I think the insurance situation is a little more complicated than that. Most insurance companies do cover ambulance rides (especially in cases of medical necessity). The issue is that few ambulance services are “in network.” In fact, there are many cities and regions of the country in which no ambulance services are “in network” for the major insurance providers. The reason for this is that insurance companies and ambulance services have been unable to reach negotiated agreements on fair service rates.

Unfortunately, the result of this is often that patients get screwed: instead of being billed $250 or whatever the copay is for an ambulance transport, patients routinely are also “balance billed” for the difference between what the insurance company pays the ambulance service and what the ambulance service bills. This often can be a pretty substantial amount. For example, if the ambulance service provides a $1,500 ride but the insurance company only pays $300 for that ride, the customer will be “balance billed” the remaining $1,200 difference (despite receiving essential medical services supposedly covered by her health insurance).

Moreover, if you think that this problem is caused by the insurers being too cheap–and that is likely part of the problem–then the ambulance services also get screwed: patients often do not or cannot pay the difference, leading ambulance services to receive less than the full amount for their services provided. So, in the above example, if the patient only pays $400 to the company, the ambulance service ends up taking a $500 loss on the ride (+ whatever additional administrative costs are required to bill the patient + the insurer rather than just the insurer).

I don’t know enough about the services in question to know what’s going on here — but it’s likely that this increasingly common practice is contributing to the Williams-area ambulance issues.

#4 Comment By ZSD On March 23, 2018 @ 7:51 pm

Further from The Atlantic:

Now a third wave in education and training has arrived, argue economists, educators, and workforce-development officials. The level of preparation that worked in the first two waves—adding more time to education early in life—does not seem sufficient in the 21st-century economy. Instead the third wave is likely to be marked by continual training throughout a person’s lifetime—to keep current in a career, to learn how to complement rising levels of automation, and to gain skills for new work.


#5 Comment By ZSD On March 23, 2018 @ 7:59 pm

OOOPS … Lost my place!

Above comment is now under Diversity Circus. The above and this correction may be struck from the record as time permits for David.

#6 Comment By frank uible On March 23, 2018 @ 10:06 pm

An economist might say, albeit probably naively (economists tend to be naive when it comes to politics), the primary motive for the merger was to produce economies of scale benefiting, directly or indirectly, most denizens of the region.