I had a vision of Emergency Care in the Future. Then I awoke in a cold sweat, it was a nightmare.

The year is 2020.

EMS in the US is now strictly privatized. There is no governmental intervention in patient care whatsoever. All medical care was briefly socialized in the early 2010s but failed when over 75% of the population was obese or ill from chronic disease. A federally mandated national diet was enforced and followed, closing most of the fast food chains but the load was far too great for underfunded hospitals and clinics to bear and the system imploded. The private sector responded by reopening the hospitals and clinics to paying customers only.

After massive budget cuts, the Fire Service was unable to keep highly trained, highly paid Paramedics and EMTs on staff. Fire Companies were closed leaving only a framework in the event of an emergency.

When a medical complaint is called in, private ambulances submit instant online bids to the caller and the caller chooses the company to respond, being charged immediately, regardless of complaint or outcome.

Physicians have taken over patient care via hand held patient care devices which instruct a patient to speak their chief complaint into a microphone which allows the ambulance technician access to only the tools needed for that complaint based on protocols. Then the patient boards the ambulance, the technician applies the treatments indicated, and the patient is placed in a medically induced hypothermic coma.

The ambulance technician is not legally allowed to make verbal contact with the patient for the fear of violating the patient’s privacy. The ambulance was GPS guided to the call and the driver is never even informed of the service address, again for fear of loss of privacy.

Once at the hospital, the patient is taken into a sound proof room and thawed, then tended to by a staff of nurses and medical students. Only students are allowed to work in the Emergency Rooms, all licensed physicians are in private practice.

When a patient’s condition is stabilized they are immediately moved upstairs, into surgery or returned home with instructions to call their private doctor.

The ambulance will be randomly assigned to the next bid.

Nightmare indeed.

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