Stossel: Government Bans Ambulance Competition

35 states have laws that let established businesses block new businesses. This hurts consumers.


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Want to start a business? Imagine having to get your competitors' permission first.

John Stossel points out that in 35 states, laws block new businesses from operating unless they get their competitors' permission. One such law prevents Phillip Truesdell from operating ambulances in Kentucky.

"You're going to tell me that I'm not fit to work in your town?" he asks.

He and his daughter Hannah Howe run Legacy Medical Transport, an ambulance service, in Ohio.

When they tried to expand into Kentucky, which is just a few minutes away from them, they learned it would be illegal.

It's illegal due to Certificate of Need laws, also called "CON" laws. In Kentucky and three other states, you have to get a Certificate of Need to run an ambulance service.

Truesdell doesn't think this is right.

He tells Stossel, "Anybody that draws breath ought to be allowed to work. Who gives the big man the right to say, 'You can't work here?'"

"The government. The law," Stossel responds.

Then "Kentucky ought to change that law," says Truesdell.

To do that, he and his daughter are working with the Pacific Legal Foundation, which filed a lawsuit with the goal of getting CON laws declared unconstitutional.

Kentucky authorities and established companies resist. One ambulance provider told us, "When saturating a community with more [Emergency Medical Services] than it can financially support, all agencies become watered down."

Truesdell's attorney, Anastasia Boden, calls that "absurd." She tells Stossel, "It is an abuse of government power to restrict somebody's right to earn a living. [It's] just as a handout to the other businesses."

"It's not a handout. It's protecting a vital service," Stossel pushes back.

"It's protecting a vital service for the current operators only," she responds.

Boden says we need competition, "because competition has been the driving force of innovation, lower prices, and better services."

Stossel agrees: "Competition works! CON laws are a bad deal for both consumers and entrepreneurs. No one should have to ask permission to compete."

The views expressed in this video are solely those of John Stossel; his independent production company, Stossel Productions; and the people he interviews. The claims and opinions set forth in the video and accompanying text are not necessarily those of Reason.

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  1. Call a limousine, it’s cheaper.

  2. In my home town back in Michigan, the local ambulance monopoly was held by a funeral parlor. Some people thought it a conflict of interest.

    It was so bad that, when my dad had a bad heart attack, the local ambulance had to stop at the border of its territory, and transfer him to the next territory's ambulance, when he was being transported to a hospital outside their legal reach. (The local hospital wasn't up to handling cardiac emergencies, we were out in the sticks.) Because it wasn't legal for them to operate outside their territory.

    Well, I suppose he would have died anyway, it was a pretty bad heart attack.

  3. It won't last. Ambulance charges are currently so excessive, and often not entirely covered, that the public won't stand for it much longer. They have especially increased during the past five years.

    There will be UberAmbulance or GrubhubAmbulance within two years. Mark my words.

    1. Didn't you hear --- CA is banning Uber.

  4. "Let Them Compete" ?

    But Stossel supports coercive monopoly governments.
    How come they are let off ?

    1. When did he support coercive governments? He's described himself as libertarian for years.

  5. Consumers hurt themselves by supporting coercive govt. That NEVER turns out well, on net.
    Fighting coercive govt. on specific issues is a lost cause. STRIKE AT THE ROOT OF THE PROBLEM!
    The LP doesn't do that. I joined in '73 and quit in '80 after wasting 5 years fighting for freedom in an organization that hopelessly accepts and supports coercive govt. I stopped doing that, e.g., I don't vote.

  6. Imagine Mc Donald's opening a burger join in Nowheresville Ohio in 1956, and after being the only game in town for three years, manages to hornswoggle the town poohbahs into enacting a new ordinance banning ALL new burger joints (Anna's Burgers started in 1947, so they are cool to keep going...) from opening in town, forever. Not knowing this, along comes Burger King in 1962, buys a hunk of dirt and applies for the permit to build the building.. and they learn the happy fact that unless MickeyD approves, they can't. That's Good Ol' Boy Protectionism at its worst.
    In this case, the Ohio ambulance service is wanting to operate in an additional state. Perhaps an undue restriction on Interstate Commerce should be brought. States cannot restrain trade between the several states.

    1. Didn't you hear -- The liberals re-wrote the commerce clause in their liberal courts during the FDR administration. It no longer means state-to-state trade conflicts "amongst the states" but now only means the federal government gets to regulate anything they want "within any/all states". As if the federal government banning flavored vape wasn't the perfect example.

      And if that's not good enough -- there's always the ability to "tax" (never-mind it's context); The "tax" clause is the "anything goes" clause as long any wild excuse can associate it with money.

      And if theirs no money to be found -- there's always the "preamble" (The introductory statement; which isn't even a part of the Constitution). It's for the "General Welfare" (And that entails absolutely ANYTHING at ALL).

      1. Better fix that before the lefty trolls have a hay day.... "promote the General Welfare" since "General Welfare" of the federal government is also in there (nope; don't want the federal government to go bankrupt) at this point it might be a blessing.

  7. There is another similar but reversed "Good Ol Boy Protectionism racket that is rapidly growing. It is the one where someone develops a product that has a useful application, manages to get decent market saturation ofer time, THEN manages to get government on board, such that government now MANDATES the universal use of that product, and/or restricts the design/specifications to ONLY be supplied by the established players in an industry. Examples that spring instantly to mind are child restraint systems for car travel.... used to be a simple device that could be fastened into the seatbelt in a car, put the child inside, and, so the story goes, no matter WHAT happens to everyone else in the car, the kid survives unharmed..... yeah, right. Used to be the consumer was free to select their own preferred features and size factors for THEIR child. About every two years that one is now no longer LEGAL for their kid, they have to go buy a NEW one... which, guess what now.. is about twice the price of the one they used to use, and not much different. Of COURSE all this engineering, certification, standards testing and the list of features/options makes them VERY costly. They also weigh in at about four times what they used to. Get caught in a car with a child NOT in one of those, you'd thihk you had just raced through town at 120 miles an hour and got caught, then "blew" a number that is one tenth of your speed..... though you had hit nor harmed no one. "CHILD ENDANGERMENT'" Lock him up.. and it is the car seat manufacturers have forced this upon us.
    Same with having no option but buying a car with some fifteen air bags, back up cameras (NONE of them are decent)

    Or how about THIS one: septic systems. Used to be a homeowner could get a leaflet from the county, count the number of bedrooms in the house, look at the county geologic map for their soil type and perc rate, run a couple quick calcs and decide how many feet of leach field he needed. Then, get a shovel, rent a backhoe, and put it in. And they WORKED. For decades. No more. NOW one MUST hire a professional "designer" who charges $10-20K JUST for the design and blueprints..... now, Mr. Homeowner, don'tchya go thinkin you can save some coin by using the method outlined above. Oh no, You, BECAUSE you are a homeowner, are too stupid/careless, ignorant, lazy to do it yourself and do it right. Now you MUST hire the "pros" Total cost, $50K plus, and they almost always fail around here within five years. One friend of mine bought a place, failing gravity system, refinanace and spent $35K on a new system. Before, they could not flush a toilet when the dish or clothes washer was going, and certainly could not use both at the same time. Thirty five thousand later, they STILL could not flush the toilet when either of the washers were running. Five years later he duped ANOTHER $30K and finally got a system that worked. And I've watched the mandated contractors cut corners, cheat on the system byt charge per the design..... doesn't matter, the "pros" are doing it so it MUST be good. All this because some of the "leaders" in that industry managed to convince government that they are the "ONLY ONES" fit to do these. Hah, I've designed and built my own, the latest one is still doing fine after 25 years..... but since ALL the money does not go to government, folks are fooled into thinking it MUST be better for us..... (right, but only when THEY say so

  8. Sell your soul to the [WE] foundation -- Because you don't own you - [WE] own you and [WE] will decide what's best for you.

  9. This article described the entire Canadian economy where monopolistic trade practices assisted by the government will imprison upstarts.
    Worse Canada does this in the Food industry.
    Try and start a Chicken Ranch - you will be prosecuted
    Try and start a Dairy - you will be prosecuted
    Try and start an egg business/hatchery - you will be prosecuted
    Canada has done this to PROTECT obscene profiteering in the food industry.
    IN Asia such profiteering would see Canadas food Millionaires and Billionaires serving 20 years for profiteering on necessities of life - being food. It is much cheaper to shop for groceries in Japan (and the Asian nations) than in Canada - how did that happen??? It is even cheaper to shop at Costco in Japan.

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  12. The problem with the notion of competition is that ambulance services have no incentive to be better (or cheaper). In an emergancy first to arrive gets the patient (I guess that is one good thing, but why waste the gas rushing to the hospital?).
    In many states they have private air-ambulances. One couple air lifted after a particularly bad crash - two helicopters, same hospital, the first was public - cost of trip $3500. The second was private, cost of trip $33000. I guess the patient forgot to ask before they loaded him up.
    At my college down their were 3 ambulance services, north side, south side and college run (student volenteers <= that's the one you wanted). You could have an accident outside the south side firehouse, but if it wasn't their 'turn' you had to wait until the northside came to pick you up.
    Nope, don't mess with emergency services.

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