NYC EMTs Handle Record Emergencies, Still Earn Less Than Queens Delivery Workers

New York’s EMS professionals keep the city alive, yet their earnings trail behind those of food delivery workers, raising questions about urban priorities and the sustainability of vital public services.

With disarming frankness, Oren Barzilay, president of Local 2507, the union for New York City’s emergency medical services (EMS), proclaims that his members are “literally working for minimum wage.” This is not rhetorical excess. In 2024, the city’s approximately 4,000 EMTs and paramedics, the keystones of the city’s response to medical crises, earn just $18.94 an hour—less than many food delivery workers, babysitters and even the dog walkers of Park Slope. The paradox is sharp: a city that prides itself on first-class services is, in the realm of life-and-death intervention, offering compensation that barely covers a MetroCard and a slice.

The union’s #StandWithEMS campaign, launched in early October, aims to spotlight the burgeoning gap between the risks borne by front-line medical workers and the remuneration they receive from City Hall. The context is stark. The FDNY’s EMS division is, by the numbers, the busiest emergency medical response agency worldwide. In 2024, its teams fielded over 1.6 million calls—an increase of more than 15% since the pandemic’s onset. But while emergencies have grown, wages have not kept pace.

EMS attrition has reached what the union describes as a crisis. Barzilay reports that, within five years, some 70% of EMTs have left the job, lured by better pay in other professions—including as firefighters within the same department. On one recent Friday, a striking 175 EMTs resigned en masse to join the FDNY’s fire service, where starting pay for similar training is commensurate but job pathways and overtime prospects are more lucrative. “If you take away all the deductions after taxes,” Barzilay claims, “we’re left with $12 and change.”

It is not just payroll that suffers; public safety does too. According to the Mayor’s Management Report, New Yorkers now wait an average of nearly two minutes longer for an ambulance than they did four years ago. Calls to 911 may go answered, but the ambulance is slower to arrive—sometimes by half an hour or more. Barzilay cites real cases, recounted at City Council hearings, of New Yorkers who perished while waiting for an EMS crew delayed by understaffing.

The consequences ripple outward. Stretched thin, many EMTs and paramedics now sleep in their cars or at their stations, unable to afford rents anywhere near the precincts where they serve. The work’s demands—“four months of training for EMTs, nine for paramedics”—are far from trivial, and their responsibilities can mean the difference between resuscitation and tragedy. In an irony only a large bureaucracy can muster, these lifesavers are sometimes less able to sustain their own lives than the patients they revive.

Such facts portend poorly for the long-term sustainability of vital city services. A city as large and wealthy as New York should not be, and need not be, a place where the people running into burning buildings, or resuscitating cardiac arrest victims in fifth-floor walk-ups, are treated as expendable. This raises more than institutional embarrassment; it portends systemic risk. Eroding morale and persistent vacancies undermine resilience in the event of mass-casualty incidents, never mind the daily pulse of assaults, overdoses, and ailments that characterise urban life.

The crux of the matter is not simply one of fairness or even humanitarian concern; it is an economic calculation. Worsening EMS response times mean rising insurance costs, preventable deaths, and longer-term pressure on hospital emergency rooms. Beyond that, persistent pay disparities have the potential to sharpen the city’s divides, threatening the social contract New York has, for decades, tried valiantly to uphold.

A national imbalance, a city’s choice

New York is not alone in relegating EMS pay to the bottom rung of municipal staffing charts. Across the country, EMTs routinely earn less than police officers, firefighters, and even municipal sanitation workers, despite their frontline role in public health emergencies. Yet the city’s position—one of the nation’s wealthiest metropolitan areas, and one repeatedly battered by natural and man-made crises—makes its laggard status notable, if not perverse.

Other cities have experimented with addressing this gap, with uneven results. In Seattle and Boston, recent wage increases have helped slow attrition, but have also strained municipal budgets. Nationally, the pandemic drew attention, if only briefly, to the indispensable roles played by EMTs and paramedics. Most of that pandemic-era “hero pay” proved both finite and paltry.

For New York, the solution may demand both creativity and realism. The municipal wage structure, shaped by years of governance, union negotiations, and fiscal acrobatics, is not quick to change. Any meaningful increase in pay for EMS professionals—say, to something approaching a living wage in America’s most expensive city—will require political capital and budgetary trade-offs. Some will argue (with cause) that every new dollar for first responders might mean one less for pre-kindergarten, affordable housing, or libraries. But refusing to reward critical, hazardous work bodes poorly for the city’s broader promise of safety and resilience.

There are glimmers of hope, however tepid. Some City Council members have signaled willingness to examine the discrepancy. Yet legislative momentum in Albany and City Hall is sclerotic at the best of times, and other priorities—most notably, the city’s ballooning migrant services budget and sluggish property tax receipts—crowd the agenda. It is a miscalculation to view public safety and fiscal health as zero-sum; the two are tightly intertwined.

One wonders whether the dissonance between rhetoric and reality will persist indefinitely. New York has, over and over, relied on a surprisingly thin cadre of essential workers to deliver outsized results. But hoping they will continue to do so, while offering less than the going wage for bicycle couriers, is a calculation unlikely to add up over time.

A data-driven city must face its numbers: 1.6 million emergencies, 70% attrition, two-minute delays—and a mounting cost in trust and lives lost. We reckon a world-class metropolis should treat its frontline medics accordingly. Anything less verges on municipal self-sabotage. ■