The U.S. health care system is being overwhelmed by the coronavirus pandemic in several states, and emergency medical services are struggling nearly everywhere.

“[T]he 911 emergency medical system throughout the United States is at a breaking point,” the American Ambulance Association recently stated this in a letter to the Department of Health and Human Services (HHS). “Without additional relief, it seems likely to break, even as we enter the third surge of the virus in the midwest and the west.”

Dr. Ed Racht, chief medical officer at Global Medical Response, recently told Yahoo Finance Live (video above) that the pandemic “has become the perfect storm for emergency medical services. The public relies on EMS. There are very few places in the United States where you can’t dial 9-1-1 and have someone who’s trained and very capable that comes to your problem in under 10 minutes. So we’ve relied on that to manage emergencies, to manage uncertainties.”

And despite EMS services obtaining funding from HHS, many are still in financial trouble.

“This perfect storm of a highly contagious infectious disease as we’re learning about it while we’re managing it,” Racht said, “with the increased costs of personal protective equipment, frankly early on, the challenges of making sure we had appropriate [PPE], the training and education of our front-line caregivers, the operational changes, the either decrease in ambulance volume in some communities which impacted revenue, or the dramatic increase — all of those variables create significant challenges for sustainability for EMS systems to continue to operate.”

‘A fascinating paradox’

Emergency medical services make money by being reimbursed after transporting a patient to the hospital.

The pandemic has thrown a wrench in that business model. Hospitals across the country are becoming overwhelmed by the number of patients being admitted with symptoms of COVID-19, the disease caused by coronavirus, and some are running out of available beds in intensive care units (ICUs).

“During COVID, the health care system — very appropriately, by the way — really worked to try and minimize the number of patients who were transported to overcrowded hospitals that had saturated ICUs,” Racht said. “What happens with an increased number of no transports is that revenues decline substantially.”

He described the situation as “a fascinating paradox,” because EMS operators are doing their best to keep patients out of the hospital if possible, even though it means another blow to their business.

“The patient gets managed, but the ambulance does not get reimbursed for that,” he said. “The equivalent would be to imagine going to a physician’s office and the physician really only gets reimbursed if the patient’s admitted to the hospital. So the incentives are to move the patient to the hospital.”

That’s why the American Ambulance Association recently asked HHS for $2.6 billion in emergency funding. Without more financial relief, the group warned, there could be longer wait times for 911 calls and even ambulance companies going out of business.

“The EMS professional is probably one of the best professionals on the planet,” Racht said. “They want to get out and help. They want to make a difference. And now we’re going into almost a year of a very challenging environment, so we’re worried. And EMS infrequently is as worried as we are today about being able to sustain that as the pandemic continues.”

Adriana Belmonte is a reporter and editor covering politics and health care policy for Yahoo Finance. You can follow her on Twitter @adrianambells.

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