Uber Ambulance. Good or bad? Should cities build, buy or lease it?

I’ve written a lot about Uber. I was early to start its post mortem, I didn’t want to wait til its body got cold. Also, I wanted to tap the buzzer and say ‘first!’ .
You can catch up with these gems:
Uber Interment
The confidence game. Uber comes undone
The end of Uber. Movable object meets unstoppable force
Uber v. the anti-corporate open source insurgency
Uber. Beginning the postmortem

Uber is more than just a partisan this or that, it has taken me several posts to scratch its surface. I have written about 10 on Amazon and it’s still very incomplete.
I had a preview of a paper (under peer-review) that does forensics on how ambulance use rates changed when Uber began operating in US cities, and looks at data from 2013 to 2015.
During that period, the authors found that ambulance use rates declined by an average of 7% after Uber (specifically UberX) began operating in a city. They argue that this can be explained, at least in part, by low-risk patients substituting ambulances for Uber. If this is the case, ridesharing services are cutting healthcare costs for low-risk patients by reducing the need for expensive ambulances. More significantly, Uber and other ridesharing platforms would be freeing up ambulances for those who need them most: reducing their waiting times and potentially saving lives. Following this logic, some U.S. hospitals have considered formally partnering with ridesharing platforms for low-risk patients.
Although the study doesn’t compare cities that got Uber to cities that didn’t, the prospect of declining ambulance use being explained by regional trends is unlikely, their entry into major US cities is reasonably randomly distributed across the country, with no obvious pattern by region, city area, or population.

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A more pressing objection to the study’s conclusions is that the Uber could reduce ambulance use via an entirely different mechanism – a reduction in DUIs and assaults.

“…the rate of vehicular accidents falls quite dramatically when Uber enters a city, with traffic fatalities declining by 16.6 per cent over a year. This can be explained by both a reduction in the number of people driving under the influence, as well as the fact that the people most likely to use Uber (i.e. millennials) are terrible drivers and anything that keeps them off the road is a good thing.
Second, [evidence suggests] declines in arrests for both assaults and disorderly conduct. This may be because Uber reduces passenger wait times, lowering the risk of someone being attacked while waiting for a cab.” – Sam Dumitriu
However, ambulances dispatched to respond to assaults and DUI incidents are unlikely to make up the vast majority of ambulance use in America. It is unlikely that reductions in assaults and DUIs explain away most of the reduction in ambulance use once Uber enters a city.
Either way, ridesharing services are potentially saving lives; this study is a valuable indication that Uber might be doing so in a completely different way. With this information cities must decide to either build their own Uber fleet of ambulances, buy it from taxi companies locally that have constructed a tech platform, dispatching system and proper pricing algorithm, or cities should lease it, from Uber…or Lyft

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