Public or private?
Aurora’s ambulance service has become the center of one of the most important debates our community has faced in years.
At first glance, the question appears simple: Should Aurora continue operating its own ambulance service or contract with a private provider? But after listening to three hours of presentations, questions and public comment last week, it is becoming increasingly clear that the real question is something else entirely.
How did we get here?
Nobody disputes the quality of care provided by Aurora’s paramedics and EMTs. Residents spoke passionately about stories of professionalism, compassion and lifesaving service. When someone in Aurora dials 911 during a medical emergency, help arrives. That matters.
The problem is financial sustainability.
For years, the city has watched an EMS deficit grow while reserves dwindled. Today, officials face a difficult decision because the status quo is no longer affordable.
What stood out from last week’s discussion, however, was how often both sides pointed to the same underlying problem.
The firefighters union argued that opportunities for revenue-generating transfers were missed, staffing decisions were not properly managed, and leadership failed to maintain accountability and operational efficiency.
A citizen focus group arrived at a similar conclusion through a completely different process. Using national EMS data, the group found that Aurora once operated at an efficient level compared to agencies across the country. Their analysis suggested that many of the cost increases seen since then were tied not to the paramedics providing care, but to management practices, oversight and organizational leadership.
Neither presentation claimed EMS should make money. In fact, both acknowledged the opposite. Emergency medical service is a public service. Like police protection, fire suppression, parks and streets, it requires taxpayer support.
The debate is over how much support is necessary and whether the city can operate the service effectively.
If Aurora’s leaders conclude that privatization offers the most predictable financial path forward, they should explain why. If they believe a public model can be repaired through new leadership, stronger accountability and operational reforms, they should explain that as well.
But the community deserves more than a choice between two organizational charts. Taxpayers deserve the assurance that the mistakes which helped create the current crisis will not be repeated.
Whether the next EMS director works for the city or a private company, the expectations should be the same: measurable performance standards, transparent financial reporting, strong oversight and accountability for results.
The city cannot simply assume a new structure will solve old problems. Aurora’s ambulance service is too important for that.
In the end, the future of EMS in Aurora may depend less on who signs the paychecks and more on who is responsible for the outcomes.
-- Kurt Johnson