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By your same argument, if a state is running the emergency services, what guarantee is there e.g. a heart attack in Los Angeles doesn't end up in Redding? It w

By your same argument, if a state is running the emergency services, what guarantee is there e.g. a heart attack in Los Angeles doesn't end up in Redding? It would be possible to have emergency services organized nationally. I wonder if cities that overlap two or more states share emergency services. Seems like that would be ideal so that you'd always end up in the closest hospital.

AnthonyMouse 7y ago
> By your same argument, if a state is running the emergency services, what guarantee is there e.g. a heart attack in Los Angeles doesn't end up in Redding? Well for one thing, because it's more than 500 miles away. > I wonder if cities that overlap two or more states share emergency services. Seems like that would be ideal so that you'd always end up in the closest hospital. Of course. It's the same as people who visit another state can still use the roads in that state. It's easier to cover a non-majority percentage of usage from out of state residents in exchange for implied reciprocity than to do a bunch of two-way accounting that in practice will generally just net to zero anyway. The services are organized and funded locally because the local people are the ones with the strongest interest in them. Most of the people who use emergency services in Los Angeles will be people from Los Angeles, so they're the ones with the greatest interest in whether they're implemented competently and efficiently. The problem with nationalizing things like this is that they have no real economies of scale, so all you're doing is adding unnecessary bureaucracy and creating wasteful arbitrage opportunities. Because then it's in the interest of the majority of states who pay less in taxes than they receive in benefits to inflate costs on purpose because it brings federal money into their state. California and New York -- and Texas -- have been getting screwed by this for years across a wide variety of federal programs that don't actually need to be federal programs.

AnthonyMouse 7y ago

> By your same argument, if a state is running the emergency services, what guarantee is there e.g. a heart attack in Los Angeles doesn't end up in Redding? Well for one thing, because it's more than 500 miles away. > I wonder if cities that overlap two or more states share emergency services. Seems like that would be ideal so that you'd always end up in the closest hospital. Of course. It's the same as people who visit another state can still use the roads in that state. It's easier to cover a non-majority percentage of usage from out of state residents in exchange for implied reciprocity than to do a bunch of two-way accounting that in practice will generally just net to zero anyway. The services are organized and funded locally because the local people are the ones with the strongest interest in them. Most of the people who use emergency services in Los Angeles will be people from Los Angeles, so they're the ones with the greatest interest in whether they're implemented competently and efficiently. The problem with nationalizing things like this is that they have no real economies of scale, so all you're doing is adding unnecessary bureaucracy and creating wasteful arbitrage opportunities. Because then it's in the interest of the majority of states who pay less in taxes than they receive in benefits to inflate costs on purpose because it brings federal money into their state. California and New York -- and Texas -- have been getting screwed by this for years across a wide variety of federal programs that don't actually need to be federal programs.