"The Brotherhood Myth: How EMS Became Public Safety's Forgotten Stepchild"

In 2001, Indiana proudly built and still maintains its million-dollar Law Enforcement and Fire Fighter Memorial, at the time of this being wrote, twenty EMS-only providers who died in the line of duty remain uncommemorated. Their crime? Not having "FIRE" next to their EMS credentials. This isn't just about a memorial - it's about a systemic pattern of exclusion that threatens public safety and devalues essential healthcare providers.

The "brotherhood" of first responders makes for great social media memes and t-shirt slogans. But for EMS providers, it's like getting a holiday card instead of an invitation to dinner. Real brotherhood means having each other's backs. After ten years of advocacy work in Indiana, I've lost count of how many times I've had to fight against legislation proposed by our "brothers" in red and blue - legislation that claims to support EMS but excludes most of the industry's paramedics and EMTs.

Want to see this disparity in black and white? Look no further than Indiana's past approved budgets. You won't have to look far; you can start with 2024-2025. Despite countless testimonies about our crumbling EMS infrastructure and its impact on healthcare outcomes, EMS appears only three times in the budget. The crown jewel? The "Emergency Medical Services Fund" - a whopping $3,920 annually. That's about four thousandths of a cent per EMS provider. Meanwhile, IDHS parades around the state, proudly announcing massive spending for fire-based academies, as if we don't have a critical shortage of available ambulances and a struggling trauma system.

The numbers tell a damning story. Indiana's Public Safety Fund commands 7.9% of the state's $51.6 billion budget - over $4 billion for Public Safety. Yet EMS funding, including competitive grants, amounts to approximately 0.02% of that public safety funding. Law enforcement takes the lion's share, fire follows close behind, and EMS? We're not even in the race.

But here's where it gets interesting - especially for taxpayers. When fire departments run ambulance services, the cost per trip averages over $2,800, sometimes soaring past $3,800. In fourteen years of running ambulance services, including rural 911 programs, my average cost per run was closer to $600. When questioned about this dramatic difference, our "brothers" resort to baseless claims about quality - claims they can't back up with clinical data.

The truth? Fire departments are struggling to justify their budgets in an era of declining fire calls. The US Fire Administration's own data shows another 6% decrease in fire-based calls from 2019-2020. The NFPA reports a staggering 45% decrease in fire-related calls from 1980-2021. Here's an ironic twist - fire departments respond to twice as many false alarms (8%) as actual fires (3.9%). Yet fire-specific funding keeps growing, while EMS providers watch their infrastructure crumble.

Let's talk impact. In 2021, fire-related deaths totaled 3,800, with the expenses of property damage reaching $15.9 billion. Significant numbers, until you compare them to just one of EMS's many challenges - overdose deaths claimed 106,000 lives that same year, with system costs impacting our communities approaching $696 billion. If we're allocating resources based on saving lives, protecting our communities and our financial investments, how do we justify this disparity?

To my colleagues in fire service and law enforcement: This isn't about diminishing your importance. It's about acknowledging that all first responders deserve equal support, recognition, and resources. If you take offense to this discussion, I challenge you to examine why. All first responders matter, and we should advocate for ALL of them, not just those wearing certain colors or patches.

The star of life isn't an asterisk - it's a symbol of dedication that deserves equal respect, equal funding, and equal recognition. Until we address these disparities, the "brotherhood" will remain what it is today - a myth that looks good on a t-shirt but fails to deliver when it matters most.

Written by: Nathaniel Metz, a salty paramedic and community advocate.

These are my oppinons and my oppinons alone.