‘An Arm And A Leg’: What A Fleet Of Firetrucks Can Teach About Public Health

Ryan Gamlin spent a decade on the business side of health care — working with insurance companies. That was before he went to medical school. Now, he’s an anesthesiologist in Los Angeles and on the front lines fighting COVID-19.

It’s an experience he described as “scary, in a way that I never expected to be scared, going to work.”

He was frightened one day last summer, too, when a California wildfire came within feet of the hospital where he was working. But then, a fleet of firetrucks showed up to protect the hospital.

“City, county, park service, forest service, new trucks, old trucks, unmarked trucks,” Gamlin tweeted.

These days, with medical equipment from masks to ventilators in short supply, he’s been thinking back to that experience.

“I realized the fundamental difference between public safety and health care. Public safety is built on latent capacity,” he said. “We pay for people and equipment to stand idle, overprepared for emergencies.”

For Episode 3, we spoke with Gamlin about his experiences on both the business and medical side of health care.

“We’ve left no latent capacity in health care,” he said.  “Everyone was working at their maximum,” even before COVID-19, he wrote in a Twitter thread.

“And some part of the tragedy that’s now unfolding in this country is because of that. Because we let health care become a business. And because businesses don’t keep a hundred extra fire trucks around, their crews trained and ready, just in case.”

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