ABSTRACT
There has been great concern among policymakers since the expansion of Medicaid under the Affordable Care Act about the rising cost of health insurance premiums. The concept of the community paramedic grows out of the traditional career skills of emergency medical technicians. Paramedicine has its origins as far back as the Civil War in the United States, with the city of Cincinnati being the first to incorporate a civilian ambulance in 1865. More than 4.5 million people from some 200 occupations are employed in the delivery of healthcare in the United States. Outsourcing is driven by factors related to labor substitution. Emphasis on involving the patients in their own healthcare decisions is considered an important quality measure. The rise of COVID-19 indicates that other methodologies should be taken into consideration in light of hospitals being overloaded with COVID-19 patients in the ICU. Paramedicine touches a number of government agencies and departments as well as private industry and non-profit organizations.
