Councilman Proposes Payment Before Ambulance Service

[Steve Owen]

Ambulance services are not covered by, nor are they subject to, EMTALA. That only applies to hospitals receiving federal money.

[Richard B the EMT]

I was always taught that, to the patient/family/bystanders, it is an Emergency, until we get there, and if the case requires it, downgrade or upgrade. That covers both the BLS and ALS areas.

I also have heard teachings that when the EMTs or Paramedics arrive, the Emergency is over. Help is there.

Yeah, an over-simplification, but that doesn't mean they ain't true.

[Asclepius]

If they can't afford a cab, I seriously doubt they can afford an ambulance ride.

In my experience, many times they can afford the cab and/or they may even have an operating vehicle in their driveway, but they know they're not going to have to pay the ambulance bill, so they call us and like idiots, we keep taking them.

I,too, worry about the potential can of worms this could unleash...but we've got to stop GIVING away our services to non-emergencies...so, who has other suggestions?

[BushyFromOz]

this reminds me of a story.......

My first arrest was in a small rural hospital where the LMO's are GP's who work in private practice but are called into the hospital when needed. I remember standing over this guy ding compressions and next to the resus bed was an EFTPOS machine for paying the bill.

I guess this pt wasn't going to be paying up before he left.

My pet peeve with non emerg patients at the moment are those who call you at 3am for the tummy ache they had since yesterday, they have a government funded health care card and know they wont get a bill, so you begrudgingly take them in with their partner following behind in their perfectly usable care.

My solution

* Aggressive public education that ambulance do not guarantee you will be seen quicker by a Dr

* Everyone will get a bill of some type, even with a health care card your gonna have to pay something, perhaps just a little more than a cab fare would cost?

*Aggressive recuperation of unpaid bills

*A set of defined protocol that enable us to refuse transport to ridiculous ailments - eg. sore ankle, runny nose, i think i got bitten by a spider 2 days ago and "Im farting today because i drank milk and i don't normally have milk, i think I'm having allergic reaction and i want to get checked out" (<<< did this at 3am this morning, and he wont get a bill either)

Sounds like I'm a heartless little whino but the reality is that in some form there will need to be some way to cut expenditure in health care as the cost of it is rapidly becoming equal to GDP (by 2050 here they say)

Edited April 28, 2010 by BushyFromOz

[Kiwiology]

I thought you guys over in Oz could decline transport just like we can? If I get a patient with a runny nose I sure as hell ain't taking them to the hospital

[46Young]

When I worked in Charleston SC they had a "no need for EMS" protocol where the crew could refuse txp. The thing is, no one wanted the potential liability, so no one used it.

Anyway, it's the best when we're called for BS and the family follows the cabulance to the hospital in their car. In the time they called us, we responded, evaluated and transported, they could've been to the hospital two or three times over by car.

[stcommodore]

We already have card readers for drivers licences...

We all know people call cause they dont have a car, dont want to walk 5 blocks, have welfare so there is no bill, need I go on?

[BushyFromOz]

I thought you guys over in Oz could decline transport just like we can? If I get a patient with a runny nose I sure as hell ain't taking them to the hospital

Yeah, i wish. There is nothing explicitly saying that we cant refuse transport, but ill bet ya 50 bucks and a carton of beer that the service wont side with you if there is a complaint

[stcommodore]

"agressive public education" doesn't work. The goverment has spent how much on the census and still had issues? System abusers don't read the newspaper, and most don't read so I don't have a solution besides "you call we haul."

[Richard B the EMT]

Yeah, i wish. There is nothing explicitly saying that we cant refuse transport, but ill bet ya 50 bucks and a carton of beer that the service wont side with you if there is a complaint

Enjoy your Fosters. I don't think any agency would, no matter the agency or the personnel.

Sir? Sir! You have to finish writing the check before we can move you to the hospital. Please finish writing the check before you faint again! Sir?