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How the US created an ambulance crisis

And what can be done about it.

Edward Vega
Edward Vega joined the Vox video team as a video producer in 2021. His coverage focused on all things cinema, from the intricacies of film history to the nuts and bolts of filmmaking.

Here’s a pretty obvious statement: In the more rural, spread-out parts of the US, an ambulance will typically take a while to get to you. Makes sense; driving a longer distance takes longer.

Here’s the catch: Other emergency services like police and fire don’t actually have this same problem. It’s relatively unique to ambulances. It turns out that emergency response time is about a little more than distance. Something is different about ambulances that is slowing them down in rural areas of the US.

That difference starts with the ways that ambulance services are funded in most of the country: Instead of being paid for by taxes like police and fire services, ambulances are often paid for by a sort of à la carte model — the more people they take to the hospital, the more they get reimbursed. It’s a model that works well for emergency services in densely populated areas, but less well for everyone else. In this video, we look at how exactly that translates into longer response times, and what can be done to fix it.

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