Stossel: Government Bans Ambulance Competition

you’re going to tell me that I’m not fit to
work in your town? Phillip Truesdell and his daughter Hannah
Howe run Legacy non-emergency ambulance service in Ohio they take patients places for treatment, move people from hospital to hospital take people to doctor’s appointments. I started a business with one truck, and in
a year I went to six trucks in the state of Ohio. But when they tried to expand to Kentucky,
just a few minutes away across that river… they were told, “you may not pick up patients here” I can take them, and I drop them off and I
can’t go back and get them. People waiting hours for medical transportation. Kentucky’s government says a “public health
crisis exists” citing a report that found “… a shortage of ambulance providers.” When six-year-old Kyler Truesdell fell of
his motorcycle, his mother says The doctor at the local hospital in Maysville told her that
he should be transported to Cincinnati children’s to check for internal injuries. we’d be about a 2 hour
wait before they could get there. Kyler happens to be Hannah’s cousin, but
Kyler still had to wait two hours for an ambulance. We would’ve done it for free, but it would’ve
been illegal so we couldn’t do it. It’s illegal because of CON laws. in Kentucky and 3 other states, you have to
get something called a Certificate of Need to run an ambulance service. Certificates are awarded only to businesses
that the state’s bureaucrats deem necessary. So you applied for one? We did. After 11 months of waiting, they discovered
that their application was being protested by existing ambulance providers. we go to court, and these three ambulance
services show up They hammered her. Treated her like she was a criminal. What do you mean hammered her? They just, “Do you know what you’re going
to do to this company?… …Do you know what you’re going to do to this
town?” It wasn’t nothing to do with us being physically
able to do it. Just came through like the big dog not trying
to let anybody else on the porch. later they learned Four ambulance companies applied for permission. How many got it? None. That didn’t seem right to Phillip Anybody that draws breath ought to be allowed
to work. Who gives the big man the right to say, “You
can’t work here?” The government. The law. Kentucky ought to change that law. He and his daughter were lucky to find the
Pacific Legal Foundation, a law firm that fights for people’s right to earn a living. 46 States operate without certificate of need
laws Lawyer Anastasia Boden filed the suit with
“The goal … [of restoring] the Constitution’s promise of … economic freedom” “This prevents a proliferation of unnecessary ambulance services.” Traditionally we allow the consumers to decide
what’s necessary. The existing operators are never going to
say that more businesses are necessary because they don’t like the competition. None of those ambulance providers would talk to us But one did send us a statement that says, “…saturating a community with more EMS agencies than it can … support … … [leads] all agencies to become watered down.” “We can’t have too much competition because
businesses will start cutting corners.” And that’s just absurd. We now recognize that competition leads to
efficient outcomes. not in states with CON laws, where patients
…wait. Those are precious minutes to the consumers
who would benefit from ambulances. Not just ambulances, 35 states have con laws
for things like medical imaging companies, hospitals, even moving companies. Once you get these laws on the books, it’s
very hard to get them off because the monopolies like their monopoly. This all started back in the 70s with the
federal government in an attempt to keep prices down and to expand service. But what they found 10 years later was that
certificate of need laws were resulting in exactly the opposite. The Feds actually learned a lesson from their
mistake and said, “Whoops, this is bad. Let’s get rid of these.” But by that time, the damage was done, the
laws were on the books, and now it’s too hard to get them off. So you sue. We sue. They’ve taken 14 cases of government overreach
to the supreme court. They won 12. it is an abuse of government power to restrict
somebody’s right to earn a living just as a handout to the other businesses. It’s not a handout. It’s protecting a vital service. It’s protecting a vital service for the current
operators only. Your local hospital could close! In Virginia, when politicians tried to repeal
their state’s hospital CON law, the established hospitals “… poured more
than $200,000 into [ads] …” like this. the general assembly is voting on legislation
that will financially ruin your local hospital We don’t see that in other States without
CON laws. We see hospitals alive and well Call your legislator now. But in Virginia, the ad campaign worked. The state still has con laws. They like these laws, they keep the competition
out, and they’re going to fight to keep these laws on the books. People think of hospitals and medical issues
as different from regular competition. It’s just more important. If it’s more important than it’s exactly the
place where we need more competition because competition has been the driving force of
innovation, lower prices and better services. Everywhere! Competition works! CON laws are a bad deal
for both consumers and entrepreneurs. No one should have to ask permission to compete. Who gives them the right to say that you can’t
start a business?


  1. These aren't ambulances. These are taxis charging for medical services. I've got no pity for these pork barrel swine.

  2. 2:36 describes the crux of many Socialist arguments. So often they argue that "We do not need a hundred types of deodorant" or "50 brands of shoes each with 50 styles" (And yes I am paraphrasing Bernie Sanders here). Well, the basis of a free market is that if there is a need, or what is also called a demand, people will buy the product, and subsequently people will make the product. If there is no need, or no demand, then people will stop buying it, and subsequently people will stop making it. Capitalism, while certainly not perfect, often has a way of sorting itself out as to what is needed, and what is not.

  3. This is completely disgusting! And we, somehow ALLOW this is OUR America! Time to restore OUR RIGHTS! Revolting!
    Patients rights matter! State run monopolies are UNCONSTITUTIONAL.

  4. How the F do you water down amber lamps services? All kidding aside, WTF does that even mean? The only thing gov is good at is screwing up.

  5. Ron and Rand have been screaming about this for decades …literally! Unfortunately, a small number of citizens in office, can't win against the establishment politicians in office.

  6. In most cases, it would be cheaper, faster, and pose less of a health risk to take an UBER to the hospital and pay the driver for cleanup of any blood.

  7. There's a benefit to CON laws: many of these services have very high fixed costs, so multiple services are combined and served. Think of a hospital: the hospital needs to be able to afford to stay open, so it needs to sell MRI, X-ray, and other services. If another service opens selling only MRI, and MRI is in high demand, the hospital could go out of business.and that would put people in danger . CON laws do have disadvantages but they sometimes protect communities long term well being.

  8. I’m very familiar with how KY works. I’ve worked in the highway construction industry in eastern Ky and if you want to succeed you have to provide kickbacks to the right politicians.

  9. Ambulance and tow truck companies are the most crooked, criminal businesses there are. Getting rich taking advantage of folks during their worst time. Unless Im bleeding out, if I need an ambulance I'm calling Uber. Probably be here faster and won't change me $4500 for a 2 mile trip. That type of abuse goes beyond capitalism, like selling $20 bottles of water to hurricane victims, it should be illegal.

  10. We need to re-define the word "monopoly" at the FEC to include, any business in any industry that government limits the number of entities competing in. Also, we should have legislation that includes, "Any company lobbying for legislation that would limit the number of participants in any market, shall be charged with violating antitrust laws regarding monopolistic behavior"

  11. Here's the thing, because of competition, oversaturation of transport services, you should NEVER trust any medical test results from a Lab or Hospital that uses a Courier Company. These labs and hospitals will hire the cheapest courier that they can find even if that company doesn't have the proper equipment to transport (Frozen, Refrigerated, or Ambient) samples. Your test results depend on how they are transported, any variation, rise or drop in temperature will ruin the end result.

  12. This is one of the million reasons healthcare costs are astronomical in the US. Regulate every aspect of the market so competition disappears and everyone left can raise their prices through the roof.

  13. "I don't understand why health care is so expensive but I can get a computer a million times more powerful than a computer 10 yesterday ago that's 10 times cheaper." Seriously this is what Bill Maher said a few weeks ago.

  14. 5:24 "Who gives them the right to say that you can't start a business?" Without knowing Mr. Truesdell, I'm just going to assume he's the average american and say: you give them that right, you do. Every regulation, every tax, every tariff and every import quota on the books that restricts another persons freedom, but which happens to not effect you directly and which you advocate for, is how these laws come about. It just so happens that this one effects you directly and now there's an outrage. I recall a documentary where impoverished Venezuelans who voted for Chavez were not happy with the outcome but did not connect the dots an still thought he was a great man. My sympathy is very limited.

  15. Given that emergency services tend to take the best part of an hour to get to the scene of an emergency, competition is a good thing. Whenever the government monopolizes something, it goes down the drain!

  16. cronyism the antithesis of capitalism. The opposite of freedom. It's what stifles the free market and makes everything more expensive and crappier.

  17. "Certificates of Needs" that's mthe most German sounding regulation I've heard in the US for a long time, because literally half of everything one wants to buy or do in Germany requires a certificate of needs. xD

  18. The emergency room in rural America have the same problem. I know one emergency where the waited 5 hours for an ambulance out. Sad but true.

  19. The intention of Libertarians is correct, but the blame is misplaced. The tragic logical flaw in the Libertarian philosophy is that they see "the government" as the problem, when in reality it's the private for profit companies (lobbyist) that influence the politicians (government) to create laws that favor said private for profit companies!

  20. Dallas has a problem with 3 helicopters showing up to accident scenes when an ambulance could do the job. They drag people into the choppers without them knowing the bill will be $200,000.

  21. Government politicians/lawyers quid pro quo and crony capitalism to ban liberties/freedoms or create the need for government permits/permission where none is truly needed.

  22. This is what goes on in Kern county, CA. Hall ambulance successfully blocked all other ambulance companies from operating in Kern County. People have died because Hall ambulance can't provide the care they promised to all the communities they promised to serve. Good O'l Boy GREED. These are good people owned by greedy corporations. That's a pity and there's nothing we can do about it.

  23. Ambulances should be completely privatized and deregulated. People can pay like with Uber and if you can't afford it then tough luck. THE FREE MARKET WILL SOLVE IT

  24. If you cut corners you are not competing your are shutting your door before you even opened them. Competition does in fact make people work harder and better for the customer to gain public trust and relationship. As is of there is no competition and you cant go elsewhere the current business are running a monopoly and will charge high and quality of service will not matter because the customer cant go elsewhere

  25. The government doesn't care about anybody but themselves. They don't have to think about where the money is coming from, they prefer guaranteed outcomes that they can strictly control and control people thereby. The premise is just authoritarian. And it should be communicated that it Is fundamentally an authoritarian premise.

  26. If I wanna open a hospital to offer cheap, cutting edge and high quality health care I’d be arrested the day I open up without a “certificate of need”. Nobody seems to understand this when they complain about healthcare. There’s no reason why a competitor should decide whether or not they want competition and have government back that decision with the force of government

  27. yeah, you don't want over-regulation. If you needed more examples, look at taxi licencing in Italy or France.
    On the other hand you don't want free for all competition in ambulance services. Except if you are fine with having REO Meatwagon and Trauma Team as your ambulance services 😉 (

    So what it's unregulated? OK, what would increase revenue of private ambulance companies? More sick, injured people. Do you want that incentive unchecked?

    You might also consider preventing creation of "skin hunters" business. When a ambulance company aligns in any way with undertakers…

    Probably we need balance.

  28. People (Ignorant leftists mostly, but some ignorant conservatives as well) say our high healthcare costs are a sign of a failed free market. This ignores the fact that there is no free market! CON laws restrict competition. In a free market, there is free competition. High healthcare costs is a sign of our failed government intervention. Not a sign of a failed market.

  29. So strange to see a law aptly named. It's not "Freedom for Health Choice Laws" or something absurd. The name fits: "CON Laws" — you're conned.

  30. The whole area around Rockford, IL, appears to be serviced by ONE company. It's fucking ludicrous. They charge an arm and a leg for their services. Funny, you're better off dying than being transported to a hospital.

  31. I generally agree with much of what Stossel reports on, but in this case I don't. I work for a county hospital, that receives no public funding in a CoN State. We are rated very high nationally, and they service we provide is a model for many healthcare systems, many much larger than ours. Because we are a county 403b, it's our duty to treat patients regardless of their ability to pay. This means that we provide many services at a loss. If CoN went away, our community could become flooded with pop up imaging centers and outpatient surgery centers, which are big money makers. These type of places, who are open on a 9 to 5 basis, and would only be available to those with good insurance coverage, would be taking away money generating services from our hospital who can't refuse anyone services. We are open 24/7/365. We serve the underserved, usually at a loss. If CoN were to go away, it would be very difficult to provide as many high quality services as we do, especially to members of our community that can't afford to receive them.

  32. Virginia is a growing radical leftist state with a governor who allows for late term infanticide, up to birth, and reportedly immediately afterwards (?)

  33. the Virginia con law cost me an extra 2 hours of waiting for an ambulance to go to VCU medical center to get my fingers reattached after a table saw accident. unfortunately, I had waited too long to get to the hospital from the local one within the time window of being able to reattach them so thanks a lot cronies. appreciate it…….to add insult to injury I had the VA as my sole health insurance provider, so after almost two years of a circus and a few letters to my congressional representative that was taken care of well. If there is a way for anything to be done the most inefficient way at the most costly amount the government is the best place to look.

  34. "Do you know what it would do to this company?"

    "Well, since your company can't get there for two hours, and I have a possibly critically injured patient in my ambulance on the way to the hospital, quite frankly I don't give a fuck what it does to your company."

  35. There is a shortage.
    Capitalists respond with a solution.
    Government:nah, we got it.
    Shortage persists.
    The government is there to help and knows what is in your best interest. Only when it is responsive, and not under bureaucracy.

  36. they should jail the politicians that support crap like this to teach the other corrupt pricks a lesson. I blame them more than the company's that pay them to do it

  37. No one has a "right to earn a living", but everyone has the right to participate in voluntary transactions without government interference

  38. " I have some apples, would you like to buy them? Yes, thank you. That's as complicated as it should be to start a business in this country." – Ron Swanson

  39. This is what I call corruption- Restricting competition- Let them compete. Worried about quality? Have certification process and do annual/quarterly inspections problem solved-

  40. Amazingly how anti business my county is in Washington State. They allow for independent Ambulance companies. I see them all over the place. Like buzzing bees collecting pollen. Its amazing to see.

  41. There's always the assumption that a company is doing well because they are executing better, on their better ideas. Underhanded manipulation is how a lot of companies exist and do well. Government is the main problem to competition and preventing better ideas from entering the market. Government has a place. Its there for our benefit. There are lots of people in government that do their best and look out for their fellow citizens. Its the Corrupt few, that make life unbearable. The same way you don't complain about all police but for the few that bring shame to their fellow officers. It only takes a handful of people to do real damage to any community. Making sure incompetent, lazy, stupid and corruptible people are not allowed to work in government, should be a number 1 priority.

  42. Thank God for John Stossel. His book Myth, Lies, and Downright Stupidity turned me into libertarianism in my junior year of high school. Before then, I was a hardcore leftist.

  43. I love that you contracted Certificate Of Need into CON. That's exactly what it is. It's also more failed central economic planning. That's why the USSR collapsed.

  44. I don't want the free market getting the lowest common denominator or tech app enabled 1099 service workers to be in my ambulance. I want a well trained, well paid person we, licensed and paid by a state agency that is well funded by us to be a public service for us. Like firefighters, police, etc. Because we all agree that we need these services and therefor that we need to pay for them.

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