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Old 08-07-2012, 04:49 PM   #51 (permalink)
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in that case, i think at the very least 911 responses should be strictly public. it sounds very opportunist to me to bill someone for an emergency. i think the people who are surprised is because they thought the taxes include all emergency services. i mean a hospital bill is a no brainer but a separate ambulance bill is definitely not as well known. on a related note, what happens when a homeless guy needs an ambulance ride? does he get refused because it will be impossible to bill him later?
Just like the responsibility of knowing the laws falls on the citizens, I would bet that is the reasoning. If you don't know what you are getting into, you could always just not call.
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Old 08-07-2012, 04:56 PM   #52 (permalink)
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they're both emergency services, when push comes to shove you may not have a choice. i just don't know why it's free to call for a fire truck and a cop car (as far as i know)but as soon as you tell the operator on 911 you need an ambulance, you get slammed with a bill that not everybody knows about. it seems kind of scammy.
Fire and police are paid for with county taxes generally speaking. That typically is paid out by homeowners who pay property taxes as well as a few other sources of revenue, phone taxes are one example. Fire and 911 are not free.
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Old 08-07-2012, 05:41 PM   #53 (permalink)
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Fire and police are paid for with county taxes generally speaking. That typically is paid out by homeowners who pay property taxes as well as a few other sources of revenue, phone taxes are one example. Fire and 911 are not free.
i know i should have clarified, free in the sense that there's no bill afterwards. i know they are funded by tax money. i still think it's low to bill someone in an emergency for something that feels necessary at the moment, or at least when the person is in a state of mind that can easily be convinced to think it is necessary. i guess you better find make sure your insurance covers ambulances. i still find it misleading to call 1 emergency number for services paid for separately.

still, what happens when a homeless guy needs one?
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Old 08-07-2012, 07:39 PM   #54 (permalink)
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i know i should have clarified, free in the sense that there's no bill afterwards. i know they are funded by tax money. i still think it's low to bill someone in an emergency for something that feels necessary at the moment, or at least when the person is in a state of mind that can easily be convinced to think it is necessary. i guess you better find make sure your insurance covers ambulances. i still find it misleading to call 1 emergency number for services paid for separately.

still, what happens when a homeless guy needs one?
Yep, I agree completely. As far as the homeless guy I guess it depends. I've been plenty of places that wouldn't bother with them until the flies got started, then they'd just call the coroner.
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Old 08-07-2012, 08:01 PM   #55 (permalink)
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Heinous, the reason I don't know more about billing and costs is because it is not frequently an issue for the EMTs in the seats. You call for EMS, we show up. Do you need/want a ride to the hospital? Ok, how about we get you on this stretcher.

Sometimes it's an issue when someone is alert and acting appropriately and they have the option of refusing transport. "I don't have insurance...how much is this going to cost me?" "I don't know. I do know it is expensive, and that might play into your decision. However, you have X, Y, and Z going on, and while I can't force you go to go the hospital, I REALLY think you should because...." is generally how it goes.

As far as homeless people: Ask ANY EMT how many homeless people he's dealt with. You show up, pick them up, and bring them in. You evaluate their complaint like any other patient. You treat them as you should any other patient. Homeless people aren't the only people who don't pay. I have been to many houses multiple times where I know the patient is "self pay," which means uninsured (and which often means "won't pay.")

It is, in my opinion, ethical and required than in 911 service you provide services without consideration of how the patient will pay. I don't check for a health card before running an EKG or stopping a seizure, and I don't know of any system where that is the norm. If you're homeless, you still get morphine, a splint, and a transport to the ER for your obviously broken leg. This isn't hypothetical...I do it every day.

It doesn't stop at EMS, either. Look up EMTALA, which in the US requires any ER or appropriately staffed health center to provide life saving/stabilizing interventions and provide a physician evaluation to anyone who presents to them without consideration of whether they can or will pay.

As far as it being "low" to bill for EMS: why stop there? Should the ER adopt a "No-bill" policy? That should probably extend to the ICU and surgery too, because they're both dealing with unstable patients still in the middle of an emergency. I could go on but I think you get the point.
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