Your Local Fire Department Now Doubles as Health Care Provider

by Mike Hall, Sep 8, 2009

In 2008, fire departments around the country responded to 15.8 million medicals calls, a 213 percent increase over the 5 million medical runs record in 1980. The combining of cities’ fire and emergency medical services accounts for some of the increase.

But as the logs of a Washington, D.C., fire company show, the lack of health insurance by too many people—especially low-income families—has turned some local fire departments into mobile emergency rooms.

According to a recent article in The New York Times:

Among the hidden costs of the health care crisis is the burden that fire departments across the country are facing as firefighters, much like emergency room doctors, are increasingly serving as primary care providers.

About 80 percent of the calls handled by Engine Company 10 are medical emergencies because the firehouse serves one of the city’s poorest areas, where few residents have health insurance, doctors’ checkups are rare, and medical problems are left to fester until someone dials 911.

Says Fire Fighters (IAFF) President Harold Schaitbeger:

The EMS transport and emergency care systems are being used for health issues that are more appropriate for a family doctor—and it’s not free. It’s paid for by the insured in the form of higher premiums and by taxpayers as taxes are raised to cover the extra cost.

Health care reform legislation that includes a public option would allow regular and preventive care to keep what may begin as a treatable and controllable health condition from turning into a 911 call. But without meaningful reform, he says,

people will continue to rely on first responders for their primary care. And the system will remain sick.

In one 24-hour period this summer, D.C.’s Engine Company No. 10 responded to more than two dozen emergency calls—two fires and the rest were medical emergencies. It is the same throughout the District. The Times reports the D.C. fire department responded to more medical emergency calls per capita than any other in the nation—and most come from poor neighborhoods.

But firefighters say the trend to rely on first responders for care has moved beyond poorer neighborhoods. Says Schaitberger:

Increasingly, first responders are responding to medical calls made by people who are out of work. As the number of unemployed has risen, so have 9-1-1 calls for medical care. People who once had good jobs and good health care are substituting primary care and family doctors with 911.

He also warns that such calls tie up a community’s resources and cost communities more because so many calls for emergency medical care aren’t true medical emergencies.  Also, the increasing reliance on first responders and on 911 also comes at a time when firefighters and paramedics all across the country are being laid off, as the nation’s economic woes place a strain on public budgets. The recession is shrinking our resources and reducing manpower while the demand for emergency medical care is skyrocketing.

Until Congress passes meaningful health care refrom, firefighters like Engine Company No. 10’s J.R. Muyleart will be some people’s primary health care option. He tells the Times:

I joined the force to battle blazes, not to be an emergency room doctor. If it’s a serious medical call, a fire, we sprint, regardless. It just seems like so many people use us as their primary care providers.

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