There are sometimes different rules for different services. Around here the ambulance company is a privately held, for-profit corporation regulated by city and county governments. They bill, are qualified for Medicare, Medicaid and insurance carriers, and they’re pretty reasonable. But the local fire departments, who are usually first on-scene with paramedics, are all tax-district or city supported. They don’t charge a dime for any of their services.
Something… tweaking… in brain…
Isn’t there some basic process whereby rescue agencies send an “invoice” that encourages people to at least make a token contribution towards the reimbursement of rescue costs? (But in reality it’s not mandatory).
Maybe I’m foggily remembering (or mis-remembering) something from that other thread I mentioned.
No. It varies greatly as has been pointed out. Even far from large cities, if you are in a Tax Zone then taxes pay for the gear and training for a volly corps. In our town, the Fire Dept. gets tax money yearly. We get almost nothing. Therefore, we do bill. We do not send an “invoice” hoping to get a token contribution. We do fund drives. The bills sent are for services rendered, not for a new coffee pot down at the station.
However, we do not push the billing and threaten folks who can not pay.
Just an idea but if they dont pay up couldn’t you take them back to where you rescued them from and re twist their ankle or whatever?
It makes me wild,you offer a perfectly viable solution to the problem and people look at you as though you were some kind of mental patient!
Sunrazor- Actually, in most of Colorado, the fire department doesn’t have paramedics, just EMTs or first responders. Also, any supplies they use are restocked by the transporting ambulance service, who then bills for them.
As far as the actual story goes, it seems like that’s something they do anyway, and I can’t imagine it’s worth the bad PR to send a bill, especially when they’re a volunteer fire department.
So you received medical care, but don’t want to pay for it and you’d rather drive up everybody else’s bill? Nice. :rolleyes:
St. Urho
Paramedic
[QUOTE=St. Urho
So you received medical care, but don’t want to pay for it and you’d rather drive up everybody else’s bill? Nice. :rolleyes:
St. Urho
Paramedic[/QUOTE]
I think his point was that they charged him an outrageous amount for a one mile trip, that really wasn’t necessary. He was bullied into making the trip by the medics and the cops and then they hit him with a $1k bill? That’s why he refused to pay.
If the local agencies would charge cost plus a reasonable markup, then most people would gladly pay for quality service.
The problem with almost all medical services is that there is no free market competition to keep prices reasonable.
My local ambulance service went from a mostly government-subsidized entity to a “for-profit” entity several years ago. Ambulance rates went from a nominal fee to $1000+ whenever an EMS transports a patient. No discount is given if more than one patient is transported in the same ambulance. Additional fees are charged if they use their light/sirens. :rolleyes: One of the reasons cited for the change was that some people were using the EMS service as a “free taxi” to the hospital whenever they had a hangnail.
The fact remains that whether the hiker was being stupid or not, someone has to pay for the highly trained EMT’s that are on call 24/7 to help our butts out of whatever crisis we can get into. I would prefer a general populace tax rate to include these services rather than a user-based fee. It’s very distasteful to think that some cube-clone is going to decide if I was being careless, grossly negligent, or just plain stupid. Also, having to assess a degree of negligence is virtually impossible with the number of lawyers willing to fight any case that lands on their desk.
I would be very surprised to find that he had nothing done for him, and still received a $1000+ bill. Where I work, that’d be an advanced life support ambulance trip, probably with c-spine, oxygen, an IV, and pain medication.
The mileage charges make up a very small part of the bill. The service I work for bills about $12/mile and that’s pretty close to average for this area. Most of the bill consists of what’s actually done for you- EMT or paramedic care, procedures, medications, etc.
The rates for most services around here are actually regulated by local government- we have contracts to provide 911 response and they set our charges- base rates, mileage, everything. Also, keep in mind that you’re paying the costs of having a 24/7 911 ambulance available. In addition, the average ambulance service collects about 51% of what they actually bill, so you’re subsidizing the transport of people who don’t pay their bills.
In terms of being bullied, it’s hard to say. However, if he/she were in an accident that totalled a car, and had a broken rib, I’d definitely advise them to go to the hospital by ambulance. In general, you have the right to refuse care. That said, there are certain situations where you can’t refuse care (and I’m not saying any of these were the case): if you have signs of a head injury, if you’re not alert and oriented, if you’re intoxicated, or if you’ve threatened suicide.
As far as the crew being scammers- I get paid the same whether I do 0 transports in 12 hours or if I do 12 in 12 hours.
I’m not understanding what’s so horrible about charging a person for services rendered. I’m all for having people pay all or at least a portion of the bill racked up for their rescue. I’m up here in Oregon and over the winter we had more than one occurrence of hikers traversing Mt. Hood which is known to be dangerous in the winter and needed rescued. The amount of money spent on finding and rescuing these people is insane. Why shouldn’t they pay some? They took the obvious risk and put themselves in a dangerous situation. They should be expected to pay for any rescue efforts put out because they wanted a thrill.
I got billed about $150 bucks for an ambulance ride to the ER. I paid out of pocket, but I didn’t have health insurance at the time.
A friend was med-flighted to a trauma center after a car wreck and billed more that $3K. His health insurance paid.
Both these things happened more than 10 years ago, so it’s not new. I guess a rescue doesn’t count as necessary medical treatment, so it wouldn’t surprise me if insurance didn’t pay it.
Our county is debating doing the same thing for “obviously stupid” acts that require rescues. The most common thing seems to be towing boaters to shore who run out of gas out in the middle of the lakes. So far they haven’t been able to come up with an acceptable definition to distinguish between real “accidents” and “stupid avoidable mistakes”. They may end up billing for them all.
Just a couple of years ago the city I work in proposed charging everyone who needed an police cruiser/fire truck/ambulance come to their aid. The bill was soundly defeated, given most residences were of the mind that they already paid for those services - through city taxes. I’m selfishly glad to know that if some idiot runs a red light and hits me while I’m in the city, I won’t be billed for having the misfortune of needing assistance.
Like with the OP’s scenario I can only see charging people for any of these things if there was deliberate recklessness involved. Given how many emergencies happen without willful wrong intent on the person’s part, I can’t imagine charging them for a situation outside their control. If this hiker wasn’t doing something stupid to land himself in the situation, I’m going to have to side with him on the matter.
Where I live it’s a $ 5,000 hit to have the bird land. To have it take off and cancel before it touches down is free ( incredibly ).
That happens more than one might think.
Nobody’s disagreeing with this. The guy in the OP, however, was just out for a day-hike and happened to sprain his ankle. If Colorado wants to be asinine and charge the guy $500 to go get him, that’s fine, but what that says to prospective tourists is to stay the hell away from Colorado.
One opinion and one comment:
The opinion: Hiking or skiing or recreation of any kind in the backcountry has inherent risks. When you go into the mountains, you take those risks and, IMHO, should be responsible for any outcome. Even if it is on a maintain trail and even if you are a visitor to the state and even if you were not acting recklessly.
The comment: Until the citizens of this state are willing to pay more in taxes to fund this sort of service, there have to be charges to compensate the costs. You cannot have great state sponsored services, even if it promotes tourism, without charging adequate taxes.
However, there might be a good slogan for the Colorado advertisements if the state was able to do away with rescue costs: Come to Colorado, get lost or broken in our mountains and we will find and fix you free of charge. 