Minimum Wage and EMS

Minimum Wage and EMS

Sep 2, 2014

Last night, one of the major EMS news outlets (I cannot find which one this morning) posted a question on Facebook asking “What effect will raising minimum wage have on EMS?”  Since we are days away from a planned strike of fast food workers, I felt like this was as good a time as any to take a look at the topic.  While part of me hopes that some news outlet other than The Onion will post the headline “Fast Food Workers Strike, Americans Forced to Eat Healthy” my opinions on this topic are not quite so tongue in cheek.

If you follow me on Twitter, or are friends with me on Facebook you will learn pretty quickly that I am not a fan of our President and more specifically his policies.  I think the affordable care act has been a painful rollout and the promises made to appease those who opposed it, “if you like your plan you can keep your plan” specifically have been violated and scapegoated on the system itself rather than those who have set the now stringent regulations associated with the act.  Now, there is a considerable push from many to raise minimum wage as high as $15, a wage that many EMTs in the field currently do not make.  If this happens, the response by many EMS departments and companies might be surprising to some.

Raising minimum wage is effectively a “war” on big business.  People want a bigger slice of the pie that currently goes to the upper echelon of companies or their stakeholders and shareholders.  This same structure exists in EMS but in many ways, we are handcuffed when it comes to how much money that we can make by the very people who are talking about raising the money that companies are expected to pay their workers.  Ambulance reimbursement is a constant hot button topic at lobbying events and with EMS advocacy groups and in leadership forums.  We, as an industry, are just getting by.  If you want proof of that, look no further than Rural Metro ambulance after they declared bankruptcy in 2013 and are now getting ready to shut down their failing Indiana division.

Or, if you are an American Medical Response employee, take a look at the restructuring that occurred a couple of years ago as they company consolidated to make themselves more profitable.  While reducing redundancies and cutting less profitable endeavors  is a sound strategy to increase profits it is a sign of the times when it comes to EMS.  Our call volume increases annually by 6%.  We see 6% more patients.  While “dry run” non-transport rates still remain in the 20% range for a number of services, we are still transporting 6% more people each year than the previous year.  Despite this increase in business that we see nationally, companies still declare bankruptcy.  They still are reducing staff.  Pay raises are still being kept at a minimum.

While it is easy to be critical of the for profit companies like Rural Metro and AMR, take a look at what is happening to some municipal departments as well.  Memphis firefighters are currently battling for their pensions.  Other cities are looking to cut cost wherever they can resulting in potential layoffs and minimal raises, if their people get anything at all.  Increasing pay rates means taking away money from research and development opportunities, and it will mean that we will have to work with lower quality equipment.  Many think that increasing minimum wage just means adjusting the sizes of the slices of pie, well its not that easy.  McDonald’s can increase the price of a Big Mac by $0.25, and Apple can make an iPod a little be more expensive but ambulance services are not afforded the same luxury.  We can charge as much as we want, but we are only going to collect so much and regardless of how hard we go after those who cannot pay their outstanding balances, we are not going to collect as much as we think we are.  Not to mention, such practices can be considered morally and ethically wrong by many people.

The goal for everyone, no matter how much they make, should be to live within their means.  We all want nicer things.  We all want the ability to wear better clothes, have toys that are more fun, have a bigger TV, more DVDs, a better cell phone but that is not always possible.  We have to live within our means whether we make $10, $15, or $20.  Those who fail to be able to responsibly do that would see more benefit from financial coaching than just being given more money.  Increasing minimum wage will not solve the problems of this country.  Paying someone $5 an hour more will not magically make them more responsible.  The same problems will persist.  We will just experience them with higher price tags on items.

Let’s say that this minimum wage increase happens.  Let’s say that all of the protests that are supposed to occur on Thursday really work.  What makes people think that EMS services with incrementally increase wages as minimum wage goes up?  What makes people think that EMTs and in some places paramedics will not become minimum wage level jobs?  Money is just not as fluid in our industry as it is in others.  And let’s not lose sight of what could possibly happen to those of us who have our money invested in 401K’s.  The performance of those retirement plans is directly influenced by the profitability of the companies the money is invested in, not the profits of your specific company.

If you ask me, I feel that focusing on minimum wage increases should not be this country’s goal.  Increasing minimum wage gives workers a greater ability to make those jobs into careers.  Instead, why not attempt to reduce the cost of gasoline, for example?  Or how about making education more affordable?  Why has the tuition of the college that I graduated from thirteen years ago nearly doubled?  As I am around the corner from paying off the student loans that got me through school, I had a tough talk with my dad the other night about how I would not have been able to attend my first choice school if I tried to go at today’s rate.  And like i said, thirteen years later, I am just finishing up paying off my student loans.  They were the reason that I was able to get a four year college education.  Let’s make education more affordable so that minimum wage employment is not the end point for so many people.

So while the country continues their debate about the impact of a minimum wage increase on society, think long and hard about what effect it will have on your career as an EMS professional.  While workers at McDonald’s might want a bigger slice of their company’s profits, we need to first try and make sure that the companies we work for start getting a bigger slice of the health care money that is out there.  Once we recoup our costs and have more money to distribute within our own industry, then we can fight for better wages.

For us, this is more than just a single battle to increase wages.  We need to think long and hard about what we ask for as an industry and the direction that we push our industry in.  At this point, increasing minimum wage might benefit some, but we could potentially shoot ourselves in the foot and end up with layoffs and more consolidations as our companies search for other ways to recoup their costs and make their companies more profitable.