Monday, October 11, 2010

Resources for Ambulance Fee Issue

From my peer, Ken Hartman (Director, Bethesda/Chevy-Chase Regional Center)


As you know, the County Council approved the ambulance transport reimbursement legislation earlier this year, and included the anticipated revenue from it in the current (FY11) operating budget. Two weeks ago a court ruled that a question may be included in November’s general election ballot to affirm or repeal the law. Should the reimbursement fee be repealed the County will need to immediately account for the loss of revenue in the current fiscal year.

In light of a potential repeal, County Executive Leggett has proposed a savings plan for this current budget year that eliminates or reduces projects and services in order to make up the projected $14 million that would be realized with the implementation of the ambulance reimbursement fee.

Should ambulance reimbursement be repealed, the County Council will have the final approval on specific budget reductions. Below is a link to materials and facts that might be helpful as you talk with neighbors, friends and family about the ambulance reimbursement fee. You’ll find a brochure, a Washington Post editorial, and a flyer listing the pros and cons. Feel free to distribute the material.

Washington Post Editorial

Link to County's on-line information

Facts about the Ambulance Reimbursement Fee

Ambulance Reimbursement will raise $14-$17 million a year in revenue that will be dedicated to maintaining and enhancing Montgomery County’s world-class emergency medical services.

County residents will not pay anything. Ambulance reimbursement will be billed directly to residents’ insurance companies, which have already factored the cost of patient transport into their rate schedules. Ambulance reimbursement will be waived for uninsured residents and will be covered by their tax dollars.

Montgomery County is one of the few jurisdictions in the region that is not already collecting ambulance reimbursement from insurance companies. Fairfax County collects the fee, as well as Frederick, Prince George’s, Carroll, Charles, Arlington, Washington, and Prince William counties. Cities such as Alexandria, Baltimore, and the District of Columbia also collect ambulance reimbursement. (see maps)

There is no evidence that those in need of transport will be dissuaded from calling 911 because their insurance is going to be billed or because they are uninsured. In the jurisdictions that have been collecting ambulance reimbursement, there is no evidence of that happening. Montgomery County will fund a public education campaign to make sure that residents know there are no charges to them for emergency medical services and no changes in service.

There is no evidence that ambulance reimbursement will raise insurance rates. Ambulance bills are in the “hundreds” of dollars, compared to hospital, physician, surgeon, rehab, device, and drug bills, which are typically in the “thousands and tens of thousands.” Ambulance expenditures account for less than 1 percent of insurance expenditures. Since most insurance companies determine rates on a regional basis – and most jurisdictions in the region bill insurance companies for this charge – in most cases County residents may already be paying for ambulance service as a part of their premiums.

The quality of patient care will continue to be the highest priority for Montgomery County’s Fire & Rescue Service. A resident’s ability or non-ability to pay will never be considered when providing service.

When a resident makes that 911 call, the first priority will be to take care of that patient’s immediate medical needs. If deemed necessary, the patient will be transported to the hospital. If not, ambulance reimbursement will not be charged to the insurance company.

{Please become a 'follower' of this blog so you'll get future postings.}


Robert said...

The ambulance fee is an abomination and contrary to good public health practices. There should be absolutely no barriers for anyone calling for an ambulance when they think they need one. Lives saved are worth more than the revenue raised by this fee.

The idea that there will be no cost to county residents is also nonsense. We will pay more in insurance premiums. As costs to insurers go up, they will add to premiums. There is no free lunch.

The County Executive's proposed list of cuts if the fee is not approved by the voters is an obvious use of the "Washington Monument" ploy -- "we will cut highly desired or essential things if we don't get this money. Instead, the County Council can cut unnecessary items, like the Executive's extensive security detail or street sweeping in the fall, just before we spread salt and sand on them with the first snow storm.

Lastly, what's next? ... a fee for other public safety services? ... a charge to call for the fire department when your house is on fire? After all fire insurance would undoubtedly pay. ... or a fee if you call the police?

The county should never charge a fee for an essential public health and safety service. Since the availability of these essential services benefit everyone, they should be paid through taxes.

Anonymous said...

Every place I have ever lived has charged an ambulance service fee. These fees are virtually always covered by insurance, and for those whose insurance does not cover the fee or those who have no insurance, there are always other recourses for these fees. Expecting a county government to pick up these expenses is asking way too much, especially given the state of the budget in light of the economic turn down and less tax revenue coming in to the county.

Anonymous said...

It is an insult to our intelligence to expect us to believe that we will collect an additional $14 million from insurance companies and the companies will not try to recover this money by increasing fees - regionally or otherwise.

To imply that because other jurisdictions are charging ambulance fees and we are already paying for them, that it won't cost us anything to charge an additional $14 million is so cynically dishonest that it is no wonder why constituents don't trust their government.

No one believes that the insurance companies are so altruistic that they will allow their payouts to increase by $14 million and not recover those costs.

So, let's at least have an honest argument and find out from the insurance companies what the increase to the regional premiums will be.

Transparency anyone?

Anonymous said...

What if an undocumented immigrant calls an ambulance? No insurance. Will they have to prove income or county residence in order for the fee to be waived?
Where is the answer to this documented? There are a lot of claims being thrown around.

Anonymous said...

It's not like one insurance company is going to be losing $14 mil - its the aggregate of all the insurance companies that insure people in the area (and out of the area, if an out of county person takes the ambulance). It one insurance company was losing $14 mil, that would be one things. But this will be spread around. Besides, even $14 million is a drop in the bucket to more insurance companies, who deal in much larger numbers every day.
Emergency services aren't cheap. If the government thinks they can distribute costs this way, all for it. I would rather that than see the services cut or have their budgets cut further and risk deteriorating services.

Post a Comment