EMS Is On Life Support

By Arthur Schwartz

In January 2017, I woke up one morning and knew something was wrong. I felt like a spear was going through my left shoulder, I was sweating and nauseous. Instantly, I knew it was a heart attack. My wife quickly drove me the one block to what is now Northwell Hospital. They took an EKG and a blood test and said, “You are going to Beth Israel.” I was put on a gurney, pushed over to the 11th Street ambulance dock, and loaded into an ambulance. One EMT asked me if I was the labor lawyer they read about in the Chief Newspaper. I said yes, and asked if I was having a heart attack. (No one had said the words to me at Northwell.) “Yes,“ the smiling EMT said, “we’ll get you to B.I. fast.

Ten minutes later they rolled me through some doors, into an elevator and to the cath lab where the door was locked. Back into the elevator, down to emergency where my EMTs started yelling, “What the F… How can your cath lab be locked?!“ The nurse sent us back, the door was opened, I was transferred to an operating table, and sedated. The next thing I knew, the pain was gone and I felt normal.

Part of what saved me was that Beth Israel was close. (That’s why I worked hard to keep it open for the next seven years). But my EMTs were key. They not only saved my life, but got me there so quickly that I had no heart damage!

Our city’s Emergency Medical Corps is in a crisis. There are over 3,500 FDNY medical technicians and paramedics. The average EMT makes about $56,000 a year ─ and that’s with lots of overtime. After taxes that’s $3,500 a month. We all know that living on $3,500/month, including rent, for one person is tough. And if an EMT has kids? Forget it.

The result, according to Michael Greco, president of Local 2507 AFSCME ─ which represents the rank and file city EMS workers ─ is that over the next year more than 900 will leave to seek higher pay and better benefits as firefighters. Although EMTs and paramedics are part of the Fire Department, firefighters start at $56,000 per year. EMTs top out at around $60,000 per year after five years and most leave after four. According to the NY Times some EMS workers have ended up in homeless shelters or sleeping in their cars.

What has happened with the hemorrhaging of EMS workers? The average ambulance response time for life threatening emergencies was 11 minutes and 21 seconds in 2025, up from 8 minutes and 58 seconds in 2018. This year, according to the Times, that number is on track to exceed 12 minutes.

And you know why the city “can’t” address the problem? Because the city engages in what is known as “pattern bargaining.” No one union can get more than another, even when there is a critical need. After 47 years of being a union lawyer, and being part of the negotiation process, I can tell you this: the city’s public employee unions, principally District Council 37 (an amalgam of 52 unions including Local 2507) is the weakest, almost powerless union in the city. And the city always bargains with DC 37 first and that sets a pattern for the unions in DC 37 as well as all the other non-uniformed unions. Case in point ─ DC 37 hasn’t bargained a contract with a raise for city workers in four years! That means EMS employees haven’t had a raise since 2022.

Can the problem be solved?

It’s an interesting question. In June, the City Council gave a $10,000 one-time bonus to school paraprofessionals, who make even less than EMS employees. Our mayor, usually radical-of-thought, took the position that since the bonus wasn’t part of the bargaining process, it violated Taylor Law, the state’s public employee labor law. He didn’t veto the bill, but once it was enacted because it was not vetoed in 30 days, he filed suit to declare the $10,000 bonus illegal.

When the City Council passed that bonus bill (called a “Respect Check”) observers wondered why it went to paras and not EMS employees. Paras work a shorter week and a shorter year. They can get summers off or earn money in summer school. Paras earn slightly more per hour than newly hired emergency medical specialist trainees and newly certified EMTs. Why weren’t EMTs given a similar “unlawful raise?”

The irony is that the FDNY EMS charges for ambulance service. Typically, EMS brings in hundreds of millions of dollars. As of July 1, the minimum charge for an ambulance trip to the hospital was $1,793, up from $900 in 2021. For Fiscal Year 2025 the Mayor’s Management Report states that there were 1,101,801 medical emergencies resulting in ambulance transports. During that period, the Comptroller’s Office shows that EMS accrued over $500 million for NYC. The current EMS budget including salaries, equipment and supplies is $417 million.

Mayor Mamdani has shown some smarts in addressing some of the city’s other glaring needs, like affordable housing, childcare, and low reading scores in our schools. But this one is life and death.

I know EMS saved my life. When my mother died last year, she was still breathing when I called EMS. It will always irk me whether she might be here if they had arrived five minutes faster. But weak unions and simplistic assertions that state law “doesn’t allow it“ are B.S. The mayor and the City Council need to address this crisis ─ and if the laws “don’t allow it“ ─ change the damn laws!