A showdown is now brewing over the future of the city's ambulance system – full of arguments over dollars, and what makes the most sense.
San Diego firefighters now want the contract for emergency medical transport services.
Since 1997, a private firm named Rural/Metro has been the city's ambulance provider.
San Diego's Fire-Rescue Department chief now wants an in-house operation.
Business-backed taxpayer advocates say that could be more costly-- a claim hotly disputed by firefighters.
About 120,000 calls a year bring Rural/Metro ambulances to the scene of medical emergencies, taking people to the hospital three out of four times.
In most cases, firefighters get there first, or take part in the response.
Rural/Metro's contract runs through next June. What happens next is up to City Hall.
The firefighters union wants to take over the service, and Fire-Rescue boss Javier Mainar agrees.
But legally, that can't happen unless a different bidding process is developed.
If one is, the San Diego County Taxpayers Association has concerns.
"We're just looking at it in terms of what, really, would the budget look like if this service were brought in-house,” says Felipe Monroig, president of Taxpayers Association.
A study by the business-friendly group concludes that taxpayers would shell out an extra $37 million a year in lost franchise fees, startup expenses, and costs for more ambulances and 321 new employees-- not counting untold rate fallout from the Affordable Care Act.
Another major concern, says Monroig: “The transference of liability, where now you have a vendor that takes liability of there’s an accident, if a standard of Medicare care is not meant. That would be brought on by the city-- and any lawsuit, the city would have to pay for as well as pay out any benefit.”
The department's rank-and-file says those private-sector numbers are flawed, and concerns based on wrong-headed premises.
"The difference they're going to argue is, 'We're doing it for less.’ It doesn't matter. The taxpayer doesn't see that they're affected by it,” says Frank De Clercq, president of San Diego City Firefighters Local 145.
“There’s big profit in it, and that's why you're seeing the lobbyists and these timely, so-called reports that these taxpayer groups are putting out. When, in fact, their whole board is comprised of people that have an interest in it because they're all wanting to privatize," he said.
"We're not in it for a profit. Our shareholders are the citizens. We want to provide the highest services."
The issues go before the City Council's Public Safety & Neighborhood Services Committee tomorrow.
They include disputes over response times for both fire rigs and Rural/Metro ambulances-- which are exempted from standards under what critics call "loophole" conditions.