Charging fees for 911: a good idea?

MLeigh85 · Mon Apr 05, 2010 3:55 am

I am not good a putting quotes in the post just yet but I just wanted to add one thing. Alot of people abuse the 911 system and often call in the same thing 2 or 3 times a day. Whether an argument with a family member or a habitual runaway that is 15 years old, that is always comes back within 2 hours. Not only does waste an officer's time but it waste ours (communications) as well. We have to notify other agencies, enter them into a database and put alerts on the people.
There are other times where people will call for medical assistance for something as simple as stubbing their toes.

MtGrizzly · Sun Apr 11, 2010 4:02 pm

I was a paramedic for 25 years and owned a private ambulance service. I am now retired.

"Charging" for emergency response is hardly new.

Some volunteer organizations - fire, EMS - have charged for services for a long time. Generally, if a volunteer organization responds, they bill the person receiving service. The person then bills their insurance company. Some insurance companies pay these bills, some do not. Whatever the case, the agency typically takes what insurance pays and doesn't back bill the person for the difference.

Most volunteer EMS agencies that transport patients charge about the same rates as commercial services do. My local volunteer ambulance is extremely aggressive in collecting from patients they transport.

Most agencies/hospitals that operate aeromedical evacuation helicopters operate on a 'subscription' basis. You can pay a nominal fee to 'join' the service and, if you need to be heli-evac'd, you get the service without cost. Don't pay the subscription fee and you will be billed at full rate.

When I worked for St. John's Ambulance Service in NSW, Australia, in the seventies, it was operated statewide on a subscription basis.

Of course, private EMS providers charge for their services, as do most governmental agencies that provide patient transportation. The largest EMS provider in the US is a private company, American Medical Response, and they charge for service, even though most of their services work under government contract and are subsidized.

In Tracy's situation, the move to charge for responses is a blatant attempt to put some of the responsibility for the city's financial mismanagement on the shoulders of the citizenry. My feeling is this arises from the government's refusal to acknowledge that it expanded services, because of increased tax revenues during the real estate boom, beyond that which can reasonably be supported in a non-boom economy. The presentation of the plan is, at best, meant to mislead. I don't know whether that was calculated as a way to decrease 911 services. In the end, it should be realized that fire/EMS agencies represent bureaucratic 'empires' and such 'empires' will do anything to prevent being marginalized or reduced in importance in anyway.

It is extremely difficult to determine whether someone 'deserves' a response, or what level of response they deserve. There is some abuse of the 911 system, but it is not widespread. Nuisance calls do not make up a large percentage of the calls to 911. As a paramedic, you are taught to treat everyone the same, regardless of their ability to pay. I have never know a paramedic who didn't act on that standard. If someone who worked for me hadn't believed this, I would have fired them.

The bottom line is that Tracy Fire, as with most other agencies, will respond to your calls for help. They will now charge you for that response. They will not charge you upfront. A vast majority of responses to requests for medical aid come from indigent patients. Medicare and Medicaid pay virtually nothing for pre-hospital care. So, the real ability of Tracy Fire to collect their fee is highly questionable. I think they would have trouble going to court to get you to pay for a government service.

I don't know anything about the incident of the paramedics leaving the patient at the scene because of snow. The links to the story are dead. I seriously doubt it was a case of, "We don't want to walk in the snow." However, the number of stories about patients and victims of fires being missed by fire and EMS providers seems to be growing. Or, at least, they appear to be growing. It's hard to say, given that the number of agencies providing this service has risen sharply in the last few years and the reporting of such incidents - because they are sensational - has expanded.

MtGrizzly · Sun Apr 11, 2010 4:08 pm


	MLeigh85 wrote: I am not good a putting quotes in the post just yet but I just wanted to add one thing. Alot of people abuse the 911 system and often call in the same thing 2 or 3 times a day. Whether an argument with a family member or a habitual runaway that is 15 years old, that is always comes back within 2 hours. Not only does waste an officer's time but it waste ours (communications) as well. We have to notify other agencies, enter them into a database and put alerts on the people. There are other times where people will call for medical assistance for something as simple as stubbing their toes.

How do you figure doing your job is a 'waste of time'? Isn't answering calls from the public what you are paid to do? Isn't calling something a 'waste of time' a value judgment?

Do you expect that all calls that 'should' be handled by your agency will conform to what you believe is not a 'waste of time'?

Sounds to me like you are just doing your job.

MLeigh85 · Mon Apr 12, 2010 6:27 pm

at mtgrizzly, no i do not waste my time on any calls but i do not handle just one particular entity i do police, fire and medical, 911 and admin. what i mean by wasting time is someone that calls on a saturday night at 11 pm when people are getting shot and stabbed and there may be someone with a true life or death emergency and one person calls in to say they have a court date in two weeks and wants to reschedule that, they call our number because someone always answers if they cant get a hold of someone in courts on a saturday night at 11 pm. now that is wasting my time. i answer admin calls from alm companies and 911 and dispatch. none of what i do is a waste of time but people call with b.s. sometimes. i am very passionate about what i do and very good at what i do. i could put countless examples on here on how people waste time by calling over frivolous matters, i answer the call and do what needs to be done.

bleachededen · Mon Apr 12, 2010 9:04 pm

As long as you are at your station, being paid by the company that employs you, you are not wasting time. If you're being paid simply to connect calls, then that is what you do; I can only assume your job description does not include some clause that states you get to judge which calls or more important than others, and as long as you patch everyone through to the right place, you've done your job and are not wasting any time. I'm sure there are people who call 911 when it's not "a life or death" situation, but that doesn't mean it's a waste of time. If someone were to call you and ask what dress you thought they should wear to the charity gala that evening, I might then concede that that is a waste of your time, but any calls that are coming to you in earnest about matters that your job is meant to deal with cannot be considered a waste of time. If you really believe that they are wasting your time, maybe you need to get a different job. Or maybe you just need to be less judgmental. After all, regardless of who calls, you're still getting paid, and unless you know of someone actually bleeding to death in the streets who really isn't getting the help they need but you can't do anything about it because some kid cut his finger, I see no problem whatsoever.

No one's time is wasted when people legitimately need help, and it doesn't matter how small that help may be, neither you or I am the one to judge the severity of a person's need. All you can do is your job, and as long as you're doing that, your time is never wasted.

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