Silver Chips Online

As the ambulance rolls, insurance pays the tolls

Ambulance reimbursement fees are a wise way to raise revenue for emergency response

By Maureen Lei, Print Managing News Editor
October 7, 2010
When a fuse box explodes and sets a home on fire, a senior citizen has a stroke or an office building collapses, a hero must come to the rescue. This hero is the fire department.

Sam Jacobson
Fire departments provide services that make daily life safer and provide care in the case of emergencies. In a society without properly funded and functioning fire departments, chaos will ensue. If fire departments are unable to obtain easily accessible funds, like ambulance reimbursement fees, service will suffer.

According to Neil Greenberger, spokesman for the Montgomery County Council, the Montgomery County Fire and Rescue Service (MCFRS) Fiscal Year (FY) 2011 budget includes an ambulance reimbursement fee. It is a $300 to $800 base charge, depending on the severity of the situation, plus $8.15 per mile traveled by the ambulance.

Ever since the fee was instated this summer, its opponents and supporters have clashed. Some claim that it puts financial and medical burdens on citizens, but others feel it is a reasonable way to help the shrinking MCFRS budget.

According to Patrick Lacefield, spokesman for Montgomery County Executive Ike Leggett (D), neither insurance holders nor citizens without insurance pay the fee. If a county resident with insurance takes an ambulance, the county bills the insurance company, and the resident is not responsible for deductibles, co-pay or any other form of payment. He or she pays nothing. If a county resident without insurance takes an ambulance, the county bills no one. He or she pays nothing.

Lacefield described the reimbursement fee as a means of tapping into an idling resource. Residents pay their insurance companies premiums, and a portion of this money is designed to pay for ambulance services. However, the county has not collected it in the past.

Even though the reimbursement fee will not affect county citizens, it is predicted to bring the MCFRS $14 million this year, and $170 million over the next 10 years, including this year. The FY 2011 budget includes the projected $14 million, said Greenberger. With the MCFRS budget already reduced from $193 million in FY 2010 to $182 million in FY 2011, it makes little sense not to utilize this opportunity - especially since the money does not come from the pockets of county residents.

The $14 million of revenue is needed now more than ever. The budget suffered a six percent decrease from that of FY 2010. This cut would not have been made if there were enough funds to go around in the county. It is an indication that the county cannot fill expenditures the way it has in previous years. To turn down any source of revenue, then, is an imprudent choice to make.

The $14 million in reimbursement fees would ensure that the MCFRS could continue to guarantee world-class care in the case of an emergency. Without reimbursement fees, the MCFRS would struggle to pay for the equipment, facilities and staff necessary to do so.

Even so, some argue against the fees. The Montgomery County Volunteer Fire and Rescue Association (MCVFRA), a distinct entity from the MCFRS, recently had its petition against the fee rejected by the Montgomery County Board of Elections. Eric Bernard, executive director of the MCVFRA, said that similar fees in other local jurisdictions have been shown to deter those in medical emergencies from calling 911.

He failed to acknowledge that statistics regarding 911 calls show mixed results. There are enough instances of rates staying consistent and even rising after fee enactments to invalidate his argument. In some jurisdictions, such as Fairfax County and Prince George’s County, rates increased after enactment. In others, they may have decreased, but there is not a strong enough trend to support Bernard’s conclusion.

Bernard also said that the only county residents without insurance who do not pay the fee are those of low economic status. "[Residents without insurance] don’t pay only if they meet the poverty level and send in tax records and personal bank records," he said. Again, his statement is false. There is no established poverty level to meet, and there is no requirement to submit financial records. Those without insurance simply do not pay.

Opposition to ambulance reimbursement fees is fueled by one thing: misinformation.

The MCVFRA’s arguments against the fees seem to make a good case, but they are completely unfounded. In reality, the fees bring much-needed revenue into a tight budget at no cost to the people they are meant to serve.

http://silverchips.mbhs.edu/story/10347