Ambulance Debt Should Disappear

ByBob Hertz

If you call 911 and the fire department comes, you will generally pay nothing. In virtually all incorporated cities, the fire department is a public service. It is financed by  local government—usually with property taxes.  

However–  if you call 911 for an ambulance, you could be charged over $1,000, even for a short ride.  Ambulances are normally not a free public service. In many states the typical balance bill can be over $1,000.

It helps to have health insurance,  but you must be careful about deductibles and exclusions. A medical emergency can easily put you straight into debt. (Air ambulances are even more dangerous financially – though the recent Surprise Billing law gives some relief here.)

People  sometimes beg not to be put in ambulances, even in situations where they clearly need them. Consider the New York resident who got her leg caught between a subway train and the platform. She  pleaded “Don’t call an ambulance – I have terrible health insurance.”

Things Could be Worse

What if we privatized the fire department like we do ambulances?

We would then see a “fire fighting insurance industry” emerge. Your insurance company would dispatch its own fire trucks if your house caught fire, or it would reimburse you for whoever did put out your fire.

 

Your insurer would receive a bill from any fire fighting company that  showed up. These bills would be very high, in part because fire companies have trouble getting poor people to pay them.

There would probably be a giant deductible – so that having a fire would still be extremely costly, and even insured people would be reluctant to call for help.

Some people would try to put out fires in their homes themselves, even when these fires become unmanageable.   

A  privatized fire fighting system would eventually seem ludicrous. Saner voices would quickly demand that we return to a public fire department. Ambulance debt should disappear.

Of course  there would be protests against creating another public service. The typical conservative arguments against left-leaning health care plans would also be lodged against a public fire department….

. “So you trust the government to put out your fires? You know that in England they have a

public fire service and sometimes they do a bad job.”

  • “People deserve a choice about how to finance extinguishing fires.”
  • “Many people say they are satisfied with their private fire insurance. You want to take it

away from them.”

  • “You are going to eliminate the jobs of every person who works in the private firefighting

              insurance industry.”

  •   “Tax increases are immoral and hurt the economy. All public programs put us on a 

               slippery slope to collectivism.”

I reject all the above. Ambulances should be funded with tax dollars, plus perhaps a $50-$100 fee to prevent over-use.

Based on 3 to 4  million ambulance rides a year, nationwide, this should require under $6 billion a year in new spending –  which frankly is a rounding error in federal health budgets.

187 Comments

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