What if you called an ambulance and no one came?

While Maine isn’t there yet, it is definitely too close to it for comfort. Calls for emergency services are rising amid a long-term staffing crisis, while funding fails to keep up with costs.

The situation is burning out the hard-working first responders left on the job. It’s forcing departments to call in help from hours away, and patients to wait for transportation and care. The system, particularly in rural areas, is on the road to collapse, and it requires the immediate attention of lawmakers, the Mills administration and local officials.

The cracks in the system have been evident for a while. The Press Herald in 2019 published a two-part series showing how the underfunded and understaffed emergency medical response system was failing. It was “barely staying alive,” one official said.

The pandemic has only made things worse. Calls continue to rise, and people continue to leave the industry, whose workforce is down 22 percent since 2013. Where departments are making it work, they are doing so only because their workers are being overworked.

That’s not good for care or the first responders, nor is it sustainable. And because the EMS workforce in Maine is growing older, and there are few people coming up through the ranks to replace them, it will only get worse if Maine can’t find ways to get more people interested in the field.

The first target should be the field’s low pay, which is minimum wage in many cases, and not much higher in others – too low for such a demanding, important job.

The problem is, Medicare and Medicaid pay for the lion’s share of calls, and reimbursement rates remain low, and sometimes the programs don’t reimburse for services at all.

The federal government is working on updating reimbursement, but changes are years away. Maine will have to find another way.

A bill being drafted by Rep. Rachel Talbot Ross of Portland would make emergency response an essential service, perhaps unlocking more federal funds.

Talbot Ross also wants to create a statewide working group to assess what the system needs and to make long-term plans.

Lawmakers should get right on this. As Talbot Ross told the Press Herald, “We need to acknowledge we are in the midst of a crisis and cannot wait any longer to act.”

Meanwhile, communities, particularly those in rural areas, should start to talk about how they can work together to maintain coverage while lowering costs, if they haven’t already. Where those discussions have taken place, they’ve been fruitful.

If you call an ambulance, you expect it to come, regardless of where you live – and you’d be right to do so.

But following through on that promise is becoming harder and harder for Maine communities. If nothing is done, then, soon, the arrival of emergency medical workers won’t be a sure thing anymore.