I think the point Kevin is trying to make, and correct me if I am off course here Kevin, is that charging for 911 service is not a good way to distribute medical costs, but it is a good way to expose the neo-conservative ideology for exactly what it is. The idea is so blatantly discriminatory and self-serving that it strips away the niceties of the right-wing agenda. No war heroes running for president, no Sarah Palin’s beauty queen face, just the facts: they’ve got the money, and all those outside the razor wire can go screw off, pardon my French. It is the ideology that says the individual is all, the community, nothing.

I think that what is proposed here is that the charging a stiff fee for 911 is outrageous enough that it will speak to those who may have previously been politically complacent. It will raise consciousness and hopefully make some eventual change at election time. It will be enough to stimulate interest in politics, and also in a sense of community, where this may have previously atrophied.

As for people abusing services that are free, well I think there is some truth in this. Many programs provide for a modest deterrent fee for this reason. I think for example, and I may be dated on this, but the fee for ambulance service in BC is $25. But this is billed long after the fact, and those without funds are provided for.

My guess is that when people devalue and abuse these types of service, there is more going on than just money. I think that those that feel they have more of a say in the way things are run, that their voices are heard, that they have a real choice at election time, and that generally feel a part of the community are less likely to abuse or cheat the system. They are more likely to feel they have a stake in things. Those that feel they are forever on the outside looking in, that have no voice, no representation in places of power, and that see things going in directions they don’t like but can’t change; well, they are the ones more likely to devalue, abuse, or rip off the system.

Thank you, etudiant, that put the idea in a different light and although I don't agree that this charge should happen, I now understand the reasoning behind supporting this idea in order to expose greater lies. If that is the case that is being made here, I understand it better now. Thanks.

Hello. I like your username.

Eyebrowse wrote:I gather you don't get free medical care over there unless you have an insurance policy whereas over here the NHS is funded by the govt and everyone get's free medical care if they need it.

Even with insurance here there are still deductibles (an amount the insured must pay prior to the insurance corporation paying so much as a penny) and other forms of legal theft associated with insurance. But yes, it's a lot better than having no insurance.

This isn't to say that the standard of care would be the same as a wealthy person would receive paying for his own care. If I had a few million and I was sick I would definitely pay for private care as I'd get my operation done very quickly (the waiting list would be practically nil) and the after care would be of a far better quality. Basically going private and waiting on the NHS for an op could be the difference between life and death so you can't fault wealthy people for taking advantage of private health care.

Let me ask you about this. I've heard it mentioned by those on the conservative side here in the USA how in those places with universal coverage there is a waiting time for all operations. I don't believe they know what they're talking about. But perhaps they do... I asked this question to an acquaintance who lives in Austria, and from your introduction of the UKs system it seems to me they're similar - including both public and private options - and I'd like to see how different your answer is to it. OK if you had a kidney stone (terribly, terribly, painful) and did not have the money for a private insurance plan, do you believe you'd have to wait days, weeks, months, years, or no appreciable time at all before you were treated?

What is wrong though is to expect your average worker to have to compete on that level. By saying it's your responsibilty to provide yourself with the same care as a wealthy man and If you can't it's your fault is a pretty poor argument. The wealthy man should remember that his wealth didn't just happen on his own blood and sweat, all those workers created it as much as he did but the way capitalism goes just one or two individuals benefit personally on a grand scale from the wealth created with the cooperation of others. To hear capitalists talk you would think they created the very moon and the stars and the rest of us should thank them for allowing us to breathe the same air as them without charge.

Well said! I just finished reading a book by Charles Dickens called Hard Times and the crowning scene of the book, in my estimation, is when one Mr. Bounderby, a captain of industry, becomes undone (unwittingly) by... his mother.

Detected as the Bully of humility, who had built his windy reputation upon lies, and in his boastfulness had put the honest truth as far away from him as if he had advanced the mean claim (there is no meaner) to tack himself on to a pedigree, he cut a most ridiculous figure.

I agree with what you say about charging for 911 though in principle as over here I do think we get too much for free and it takes a lot of the will and motivation out of people to take personal responsibility for themsleves. I mean for example you can live in Britain and do nothing and get a free place to live, free dental care, free eye care, free medical care, free travel, exemption from rates and taxes and all for just doing nothing. Which really must be a real smack in the teeth for folk who do work hard and because they work they don't get any of the above benefits but they really and truly are paying for others to get this stuff that they don't get on a free basis. Although they can get tax credit payments if they earn less than a set amount per year.

Interesting. This seems like a good subject to discuss further.

I was interested in your system of welfare and how you only get eight months of welfare and then you don't get any more. Is this right ?

I don't know. I know that the unemployment benefits time span just got expanded - but from what to what I can't say. I was involved in a layoff last year, and thought I might have an oppurtunity to check out exactly how much of a safety net we have. Thankfully, mostly through connections, I got a new job in short enough of a time that I didn;t even apply for unemployment. But here there is another factor at play - the deviousness of companies who do not want to use you any longer but also don't want to be hit up with paying any unemployment benefits. Their solution? They don't actually have layoffs. Rather, they turn their full-time employees with benefits into part-time employees with no benefits. Then, if you ever decline to show up when they call you in they have grounds to contest paying unemployment benefits. And really, trying to interview for a job while making oneself available to the old company whenever it sees fit to call you in can be something of a tightrope challenge.

Personally I think a similar system would be good for Britain as there are lots of jobs people just won't do and it's the benefits they get that are keeping them from being hungry enough to do those unwanted jobs.

do the wages for these unfilled jobs rise - to the point where someone will do them?

but along comes "Fireman Sam" who isn't a real proper fireman, just a knobend who works for the fire service and is more of a politician than a fireman.

I have never before heard anyone described as being a knobend! Is this a common expression in Scotland?

The main reason I think your argument for charging for your 911 service is sound is that over here people abuse the 999 calls to emergency services.

There is a famous case here of a woman who called 911 because McDonalds was out of Chicken McNuggets.

If people are abusing the 911 dispatch, by prank calling or complaining about chicken mcnuggets, sure, charge them a fee of a sum of money (depending on what they did.) But for a regular emergency, that is outrageous! If someone gets robbed for everything they have and call 911 to get help, how are they supposed to pay the fee? I can't imagine America stooping to anything lower than that if they tried.

As a dispatcher who works for 911, I only do police and fire calls, medical calls are done by the agency next to us, I would like my opinion put in. I think 911 should be free to people that have an actual emergency. Explanation to that being, if a car is blocking your driveway and you call 911 you are tying up that person on a phone call that is deemed a non-emergency and people should be fined not charged. What I am by tying up is basically just wasting that operator's time when they can be on the next 911 call coming that may be someone's mother having a heart attack.
People do call 911 alot, and to me misuse and abuse it. They call to find out someone's bail who recently got locked up or for phone numbers.
If you look at your phone bill, house line or cell phone, you will see you are charged probably about a dollar and some change for 911 services.
Now I know alot of emergency centers have been in the news alot lately for negligence and I agree with you bleach, the emts should have just walked to the door regardless of the weather thats horrible, but if the 911 center was doing its job correctly after all the calls those people put in for help a spervisor should have taken over and then in turn contacted them personally on the air or notified a supervisor of the emts.

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.

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.

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.

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.

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.