Here’s a chart from Vox about the changing trends in fire department calls, showing the number and type of fire calls over time:
One common objection when a bike lane, traffic circle, median, or road diet is proposed is that emergency vehicles won’t be able to get through the now-narrowed street. I’d never thought much about the slim marginal value of the vast majority of fire calls before, but here’s one of the conclusions from the article, taken from a “libertarian economist”:
Typically, they’ll get there a minute or two before an ambulance does, and in some cases they start treatment,” Tabarrok says. “In my view, it’s mostly redundant. Other people will say that getting there earlier can save a life, but most of the time it has no bearing whatsoever.”
He points to a study conducted in Toronto that found having firefighters on the scene improved health outcomes in about one to two percent of all medical calls — essentially, instances of cardiac arrest in which they happened to arrive first. The study also found that, on average, firefighters respond to a call no more quickly than paramedics and had much less medical training.
The reason firefighters’ numbers continue to grow, he says, has more to do with their strong unions than their usefulness. This ends up being expensive for taxpayers: in Boston, the fire department consumed 7.5 percent of the city’s total budget. And even if we do want to use firefighters as extra paramedics, there are cheaper, more efficient ways of doing so. “Why are we sending these huge trucks careening through traffic just to give someone oxygen?” Tabarrok asks. “I say, ‘send the guy on a motorcycle.'”
Food for thought next time you’re in a meeting about public safety! (There’s another good story on topic in the Boston Globe.)
Is it the credentials as an economist or the professed libertarianism of Prof. Tabarrok you question?
Excellent question.
Full disclosure: As a political candidate I was endorsed by the Mpls Firefighters’ Local. I learned quite a bit about fire / medical services as a result. Apparently we have survivability rates in Mpls that vastly exceed even close-in suburbs due to having a professional fire department that can arrive anywhere within 2-3 minutes. Another thing is that the need for fire protection doesn’t decrease as fires decrease. At least that’s not a trade-off I’m willing to take, that since fires are x% less likely than they were in 1980, that I’ll accept a y% greater chance of a structure being lost due to slower response rates.
One thing that I did push was the need for trucks that fit the urban environment, rather than the other way around. And, from what I heard, they were completely open to it (after all, a higher number of smaller units helps their rolls as well). Apparently there was a chief a decade or two ago who wanted to buy gigantic fire apparatus like what we see in many suburbs. Yes, there’s a need for large ladders that can reach heights in a city such as ours. But for the most part, they all agreed it was better to have a smaller, more nimble set of crews that could assemble at a fire to respond in a more tailored way.
I really think this is a great point.
I called police to help out a couple of passed out drunks across the street a few weeks ago. We got a fire truck, a police car, and an ambulance. One drunk was taken away (no cuffs) in the police car, the other in the ambulance. The firefighters mostly stood around ready to offer support.
I completely understand that they can be faster to arrive and provide medical care, but was the truck only there in case a real fire call occurred while they were out?
Matt’s point about several smaller vehicles acting in concerts is a good idea. Would the first layer be more ambulance-type vehicles to respond to these kinds of calls?
On a separate note, why is a fire fighter’s medical care and a police car ride tax-payer provided while the ambulance ride and paramedic care are not? Is it because we don’t believe in universal health care but we believe in universal police and fire protection? Firefighters are now first responders for emergencies with medical care.
I work in health insurance, so I think I can comment on it. It is pretty arbitrary what services are provided, and also has a lot to do with “it’s always been done this way”. Health insurance for workers started in World War II as a loophole around wage controls (coincidentally right at the time medicine started to get more sophisticated and extensive). Rather than change that the government decided to supplement it with Medicare for the old and Medicaid for the poor. With most people insured (85% before ACA) there’s been no major rioting in the streets for change, just fear of wait times, “death panels”, and restrictions on doctors.
Also, the services the fire department provides (CPR, evaluating a patient on the scene, etc.) we’ve decided aren’t billable medical procedures. Transportation is a billable service, but ambulance providers usually can only bill a flat rate + mileage, they can’t itemize every band-aid used and add that on. As a side note ambulance services are often a major headache for all concerned (providers, insurance, patients) because they need to pay at in-network benefits even though they are often out-of-network, so it can take several tries to get the bills processed correctly.
There has been some attempt to bill people for police services, notably for fixed term jail sentences, but trying to bill people for being hauled away in handcuffs probably isn’t going to be that productive. And some places charge for fire protection, there was that notable case in Tennessee where firemen let a house burn down that hadn’t paid.
I think we are starting to believe in “Universal Health Care”. ACA is an attempt at that without disrupting the established systems too much. It should be noted too that “Universal Care” varies in practice. In the UK both insurance and providers are government. In France the insurance is government and providers are private. In the Netherlands both insurance and providers are private. We seem to be trying to go to the Dutch model, where private insurance is mandatory and heavily regulated.
Living on Hennepin I see on a regular basis that the large red fire trucks get through the traffic better than an ambulance. They are more noticeable and seem to command more attention. I hate seeing cars just sit at Franklin and Hennepin while an ambulance is trying to get through, and it happens all the time.