La Crosse city officials have once again proposed getting into the ambulance business — this time with just one ambulance that would work in concert with Tri-State Ambulance.

In addition, the city promises to train 12 firefighters to be paramedics — to work the ambulances and to have one paramedic on every first responder call.
City officials say this won’t cost the taxpayers anything. Should we believe them? We can’t say because we don’t have enough information.

And that means we should be very cautious about this plan — and we should insist on full financial and medical information about the plan.

Let’s consider finances first. City officials say they can train 12 firefighters to be paramedics, purchase two ambulances, even though only one will be in service. It will take a year to get set up. The city says training, setup and four years of ambulance service will cost $1.2 million. The city says it can get $1.2 million in fees from patients during that four-year period, enough to pay for the program.

Is that right?

Tri-State official Matt Zavadsky said it costs his company $650,000 a year to keep one ambulance running for one year.

One difference is that city firefighters are already on the payroll, so the city would only have to include the costs of their salary upgrades in the total.

Still, would that be enough? Keep in mind that La Crosse already is a high-tax city, and it has many other things to spend money on, not the least of which is the Bliss Road reconstruction. Can we afford to have the city enter into an ambulance service when a private business already is doing that without a taxpayer subsidy?

Tri-State is a subsidiary of Gundersen Lutheran, which is the city’s largest employer and taxpayer. Does it make sense for the city to potentially be taking revenue away from its largest taxpayer?

Let’s also consider the medical implications. Franciscan Skemp Healthcare CEO Dr. Robert Nesse said at a public meeting Wednesday that he doesn’t have the information he needs to decide whether this is a good idea.

“It’s hard for me to judge what’s needed unless we agree about what data is available,” he said. “There isn’t enough information out there right now.”

He said the two most important pieces of information are:

- What is the ambulance response time now in La Crosse? Nesse said a six-minute response time would be good. Eleven or 12 minutes would not be as good, particularly for a cardiac case.

- What is the right number of paramedics for a metro area the size of La Crosse’s? Like doctors, paramedics need to do a certain number of procedures on a regular basis to keep their skills up. What is that number? And how many paramedics is the optimum number for La Crosse?

“What is the value of having additional paramedics as the service volume increases?” Nesse asked. “What is the right number for a city this size, and what is the right number as the ambulance service increases?”

The proposal also calls for the creation of multi-jurisdictional governing board, made up of local elected officials and representatives from the medical clinics to oversee the emergency medical service.

Nesse suggested that the governing board be set up first. Then it should spend its time getting the information needed for a decision.

Whether the decision is made by local elected officials or by referendum as some people suggested Wednesday, objective information is essential to that process.

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