This is an archived article that was published on sltrib.com in 2016, and information in the article may be outdated. It is provided only for personal research purposes and may not be reprinted.

One reason it is so difficult to solve the problems surrounding the provision of health care in the United States is that we keep trying to transplant our free-market model of buying things to medical services, and the system keeps rejecting that foreign body.

People in the market for doctors, hospitals and related services simply do not — and never will — have the power of knowledge and choice that they have when they are buying groceries, cars or just about anything else.

This is particularly true when a patient needs emergency services and, even if he or she is conscious and lucid, has neither the time nor the knowledge to shop around and to make an informed decision on how to balance cost and quality.

So it is particularly troublesome to read in Sunday's Salt Lake Tribune that the growing number of air ambulance services in Utah are finding ways to take flight, and send bills, without the kind of oversight that should be taken for granted.

Those operating the upstart helicopter services claim that the relative dearth of state oversight is the right way to provide what they say is needed competition for the two operations that previously cornered the market on air ambulance services in Utah — the University of Utah's AirMed and Intermountain Healthcare's Life Flight.

Pressure from the newcomers has been so successful that they have effectively created their own regulatory body, one that has far less ability, in terms of authority and resources, to oversee the operations than did the now-defunct arm of the Utah Department of Health.

There is a rich, and troubling, irony that the operators of the new for-profit air ambulance services have been allowed to shop for their own regulatory structure while their customers have no ability to choose their own EMS provider.

The situation raises serious concerns over the safety and quality of the airborne operations. Meanwhile, some of the patients who have been airlifted by the new ambulances have been stuck with bills upwards of $80,000, some 10 times the going rate covered by health insurance carriers.

If this were a case of someone willingly walking into a new car showroom and foolishly buying an $80,000 car that they couldn't afford, that would be too bad. But when the person stuck with such a bill was placed in the situation by a system that offers the customer no choice, the need for some real government oversight becomes clear.

Federal law precludes state regulation of air services, but not of health-care providers. Utah officials were wrong to capitulate to legal and political threats from the for-profit air ambulance operators. A new regimen of regulation for these services is necessary. Stat.