RIVERSIDE: Monopoly aid


THE PRESS-ENTERPRISE The Press EnterprisePublished: 13 February 2012 05:36 PM

Riverside has no business enforcing a de facto monopoly on ambulance services. City officials should drop the flimsy rationale for the status quo, and ask the pertinent question they have avoided: Would letting additional ambulance companies operate in the city improve service and cut costs to residents?

Twice in the past five months, the Riverside City Council has rejected applications by ambulance companies seeking a piece of the Riverside nonemergency ambulance business. The city denied applications from Mission Ambulance in October and Alpha Ambulance in December. Only one company, American Medical Response or AMR, provides nonemergency ambulance transport in Riverside. The city controls nonemergency ambulance transport, such as from a hospital to a long-term care facility, through a system of franchise permits which are ostensibly available to any qualified ambulance company. Riverside County oversees emergency ambulance services.

But a state agency last month said Riverside overstepped its authority in rejecting the applications from Mission and Alpha. The city denied the permits on the grounds that there was no public need for additional ambulance service. Yet the director of the state Emergency Medical Services Authority said that Riverside cannot use “need and necessity” to limit ambulance services under state law. That agency has no enforcement authority, however.

But Riverside’s approach was flawed in any case. In practice, the “need” metric consisted of city officials checking AMR’s performance record and deeming it acceptable. The city ducked the question of whether allowing additional ambulance companies into the city would be better for residents. Competition can bolster service and trim costs — no small issue when ambulance transport can easily run $1,000 or more a trip.

Yet the city never bothered to compare Riverside’s costs with prices in areas that have competitive service. Councilman Paul Davis argues that Riverside residents pay far more than in surrounding areas because of AMR’s exclusive contract. Surely that issue should be a central focus of the deliberations.

Even stranger, the city’s approach includes consideration of whether allowing additional companies into Riverside would “impair the economic viability of the existing franchisee.” But that provision creates an insurmountable obstacle for other ambulance companies. Letting another provider operate in Riverside is bound to “impair” the current monopoly holder’s finances.

But why should that be a concern at all? There is no public interest in city government protecting a private business from competitors. That mind-set only invites questions about whether other factors influenced the choice — such as the $1.4 million in paramedic training and equipment that AMR provides Riverside each year under a separate contract.

The city does not benefit from generating public suspicion about undue influence or insider dealing. The council’s only concern should be ensuring good, cost-effective ambulance service. Anything else is irrelevant.