Man refuses to pay EMS bill

[Dustdevil]

Yeah, I know that refusing to pay an EMS bill is the norm, not the exception, so I fail to see how this is news. But the article is just so hilarious on so many levels that it's an über entertaining read. Check it out!

I went to paramedic refresher with the loser medics in this county, and I have to say they are the most horrible bunch of medics I have ever had the displeasure of associating with.

[Comments in-line]

http://www.ems1.com/legislation-funding/articles/806586-Calif-man-refuses-to-pay-911-bill/

Calif. man refuses to pay 911 bill

San Bernardino residents can pay an annual paramedic subscription of $24 or $200 per paramedic response

By Andrew Edwards

San Bernardino County Sun

SAN BERNARDINO, Calif. — To Edward Poffek, paying $200 for paramedics when he already pays taxes is just ridiculous.

Agreed! Especially since they don't even transport! He called for an ambulance, not a house full of monkeys.

A 30-year resident of San Bernardino, Poffek never had to call 9-1-1 for medical service until Sept. 16 of last year.

The first time he ever heard of the charge was when he got the bill in November.

"I refuse to pay," he said. "I'm not going to pay it. They can take me to court. They can file a lien."

Again, most people don't pay, so I'm not sure how this is news.

"The Police Department doesn't charge if I call 9-1-1. It's a public service," Poffek said later.

Charging for emergency medical services has become an increasingly populary way for local governments to shore up their budgets.

Ding! Ding! Ding! It's called robbing Peter to pay Paul. Very sound fiscal practice. And exactly why California is bankrupt.

Loma Linda's city council joined San Bernardino and Montclair by approving a similar fee in February, resulting in a wave of public outcry. In response, Loma Linda is taking up the issue again and will discuss possible changes to the program during its meeting tonight.

But unlike Loma Linda, fire officials in San Bernardino and Montclair said the charges were instituted, not in response to any specific budget troubles, but to account for the increased expense of advanced paramedic services.

But wait... didn't the IAFC tell you that this was going to MAKE you money so you could save your overpaid firemonkeys? If it's costing you so much, why not fire the idiot who talked you into it and contract it out to someone with better financial management (and medical) skills?

San Bernardino residents can pay an annual paramedic subscription of $24 or $200 per paramedic response. The billing system has been in place for at least 10 years, and the council reduced the response charge from $250 in 2006, said Bernard Horak, the Fire Department's emergency medical services coordinator.

The fee can be waived for low-income residents, Horak said.

Fire departments typically receive more calls for medical attention than actual fires, but the billing structure in San Bernardino and some other cities appears to be based on the premise that advanced paramedic services go above and beyond fire departments' traditional duties.

No shit, Sherlock! Way above! So why are they doing it?

San Bernardino added paramedic services in 1977, but that decision was not matched with a commensurate increase in funding, Horak said.

And it has taken you thirty-three years to figure this out? FAIL!

The department has since grown from two paramedic squads to nearly 70 paramedics aboard a dozen engines, a hook-and-ladder and a single paramedic squad.

And maybe TWO out of seventy who actually want to be paramedics.

Paramedics, unlike less-trained emergency medical technicians, are able to insert breathing tubes into patients and deliver intravenous medication.

I wouldn't go as far as to say they are "able". Authorised might be a better choice of terms. Regardless, we have yet to see a study that suggests that makes any difference.

Horak said San Bernardino paramedics have recently taken on training to detect heart attacks with what's called 12 lead EKG technology and to deliver medication directly into the bone marrow if a patient's lungs are collapsed.

Whoopeeee!!! Welcome to the twentieth-century, SBD! Good luck getting a doctor on the other end of that biophone to interprete it for you.

"We have a drill now that will allow you to get right into the bone," Horak said.

And this is a good thing?

In Montclair, Fire Chief Troy Ament said his department took on advanced paramedic work in 2001. The subscription fee program was created at that time to pay for the new work, which was previously handled by a contractor.

LOL@ "advanced paramedic work". There's no such thing in SoCal. And they admit they took over the work and are failing miserably at managing it. So why are they still doing it?

San Bernardino publicizes its paramedic subscriptions by occasionally putting notices in water and trash bills, but the charge has surprised Poffek and others.

"Anytime somebody receives a service it can be a difficult realization," Horak said.

The "difficult realisation" is on your end, Horak. It's the realisation that you simply bit off more than you can chew with this. Give it up!

Horak said fire officials to again publicize the charges during the fiscal year that begins July 1. Ament similarly said Montclair officials are working on a new marketing plan for their paramedic subscriptions.

Publicise it til the cows come home. I hope they publicise that citizens simply don't have to pay this extortion and you go even further into the red. And anytime government has to "market" something, they're doing something wrong. Stop it!

Edited April 14, 2010 by Dustdevil

[JPINFV]

"Horak said San Bernardino paramedics have recently taken on training to detect heart attacks with what's called 12 lead EKG technology and to deliver medication directly into the bone marrow if a patient's lungs are collapsed."

[Dustdevil]

As if his medics are capable of diagnosing collapsed lungs, lol.

[Kiwiology]

...and I have to say they are the most horrible bunch of medics I have ever had the displeasure of associating with.

You obviously haven't worked with me yet ....

Seriously, OMG ROFLAMO hahahahahahah what a bunch of hillarious retards God makes a bunch of chimps at the zoo masturbating each other seem less amusing! :D :D

[Richard B the EMT]

Even before the merger into the FDNY, NYC EMS billed for services, dispite being a "Public Service", tax supported agency.

BLS and ALS have different charge scales, if O2 used (charge), ALS skills actually utilized (charge), ALS meds (charge), night differential (charge). Mix well, bill the patient, the patient's family, or the patient's Health Maintenance Organization (Blue Cross/Blue shield, Medicaid, or Medicare).

Even the volunteer ambulance service providers are now billing for services rendered (have to wonder if mine would still be around if we had gone that route).

[Chief1C]

You have to bill for services.. How would you pay for anything? In PA, if EMS gets taxes, you can't bill. With a tax and subscription combined, with our population, we'd not last a single year. The subscription wouldn't even cover our insurance. I just forked out over $1700 just for a minor equipment upgrade. Probably about 70% of our calls, are for people who don't subscribe. Billing them, pays the bills, per se. Billing the insurance of our subscribers, a requirement by law, pays the bills. The firemen get a tax, a very low tax, it's all people can afford. There's less than 6K people in the entire county. If EMS got a tax, not to be confused with EMS-Emergency Management Services Tax, we'd get the short stick, and end up with everyone shut down and one ambulance for the whole county.

[Dustdevil]

The problem here is that they are not charging for ambulance service. They're charging for firemonkey first responders, which I'm sure the caller did not request.

This isn't the first article we've seen here where people were contesting charges for first responders who never even laid a hand on the patient.

Edited April 14, 2010 by Dustdevil

[WolfmanHarris]

I ran a hypoglycemic call a few weeks back. As we were hanging around waiting for the pt. to finish eating and chatting with the family, the sister mentions that she was glad they didn't send the Fire Department. She didn't them standing around in her house, when she knew as well as we did that was her brother needed was D50 or glucagon and they didn't have it.

I'm strongly in favour of the right resources at the right time.

Until a recent change to our dispatch protocols that only co-respond FD for VSA, MVC's and medical call where there is a report of alerted level of consciousness, we had FD roll on all kinds of "chest pain" calls and slapping on an NRB and waiting. And since our response time is pretty darned good, we were usually there within a minute (if we hadn't beaten them). Since then we've got the call volume for the various local FD's by more than 40%. One of their unions has started lobbying council to change it. I don't see it happening though since the dispatch change was based on a retrospective review of what calls FD had been too and whether in retrospect their presence ended up being beneficial.

Two other major services in the province have made a similar change. Apparently Ottawa is moving to an entirely no FD medical response plan.

[Jeepluv77]

In 2007 I was at work and pregnant and started mild bleeding. I wanted to drive myself the less than 1 mile, through exactly 3 stop lights, to the hospital to be checked. My boss, however, decided to take my keys and call and ambulance with threats of firing me if I didn't go. So I went in the ambulance. En route I got asked a few questions and was given o2 through a cannula. A month later I got a bill for $635. Needless to say, I was astounded. Especially since this is a service that is supported by taxes and it is a fire-based service. The EMT and Medic both had the worst attitudes ever. I have since found out that is because to work for that fire department they are required to work one ambulance shift a week. Very few, if any, actually want to be on the ambulance. And if you want to be on the ambulance, you have to work fire twice a week. Which exludes most that are actually there for the medical aspect. I ran my fields there two semesters ago and worked with a medic that had no clue what a combivent was. When I explained it was albuterol mixed with atrovent she was still clueless. Her response when I showed her the ipratropium bromide as I was setting it up? "Oh, so that's what that is?" Nice. Hope I never actually need a medic there.

[HERBIE1]

As if his medics are capable of diagnosing collapsed lungs, lol.

I think I need to look over my protocols. I had no idea that "collapsed lungs" was an indication for IO injections.