The Commissioner further indicated that denial of County Emergency's application would lower the cost of ALS transfers for most Riverview patients. Additionally, the Commissioner expressed concern that the public welfare is harmed by the disturbing lack of cooperation between Polk Ambulance and County Emergency. The law in this area places great emphasis on protecting the public from competition between ambulance services. 144.802 to manifest a legislative intention to protect the public welfare against deleterious competition in the ambulance services field. The provision embodies a legislative determination that the ambulance service business is one in which the public welfare is not promoted by free enterprise.
Ambulance service is essential to a community.
It is also a service for which demand is inelastic and expenses largely fixed. Where the demand is insufficient to support additional services, either quality is sacrificed or rates and public subsidies increased, but in either event, the taxpayer-consumer suffers. In North Memorial Medical Ctr. In affirming the Commissioner's denial, we stated that in the absence of specific evidence to the contrary, the Commissioner was entitled to presume there would be a deleterious effect on the public health through a reduction in services or an increase in price. The cases indicate that any competition between ambulance services is harmful to the public.