Will there be a huge debate regarding Houston’s ambulance fees? It’s hard to tell.
I tend to agree with CM Bradford who likens charging an ambulance fee to charging to put out a fire, since the ambulance ride is a part of the Houston Fire Department’s duties. Still, ambulance fees have been around for a while–I still remember getting the bill back in 1990 from my hometown EMS for transporting my ill (and dying) father 10 miles to the next town’s hospital. So, it seems to me the fees will be inevitable.
First, city officials have discovered that dropping a mileage charge that, on average, brought in slightly more than $40 per ride ended up costing the city more than it gained by boosting the base price by nearly $600.
That’s explained by some Medicare math. Medicare, Medicaid and private insurance agree to reimburse the city for both the ride and the mileage on behalf of insured patients. By dropping the mileage fee, the city forfeited that part of the reimbursement – $2.7 million a year. Raising the base price, though, did not raise revenue, because insurers cap what they will pay for an ambulance ride. As a result, the city actually has been collecting less money per ride since it changed the fees.
A decision that looked good in 2010, suddenly looked bad. So, now, they want to return to how it was, but probably with the same increased base fee, right? The debate stands to blame insurers, the indigent, the “ambulance abusers” who are poor to begin with, and everyone else in between.
Now, as far as the indigent are concerned:
Low-income Houston residents are exempted from the costs of an ambulance ride if they fill out a form stating that they cannot afford it and provide proof that they qualify for other forms of government assistance to the poor.
So, can it be balanced out by lowering the base fee and tacking on the mileage fee? I ask this question from a fairness point of view for all those deemed required to pay. At the very least, can we have a discussion about the actual cost of providing ambulance services, how much is expected to be collected from insurance, and determine a fee to pay the difference with a bit of padding, instead of giving the image of making a profit off of sick people? That’s what insurance companies and doctors are for.
The current base price, along with the mileage fee could serve as a deterrent for the poor who may really need an ambulance. And public safety in regards to medical issues should be on the minds of City Council members, much like cops on the streets and fire department response times, when this is being considered.
The bottom line: When there is a class debate based on medical needs (and an ambulance is as much a medical need as treating a sudden serious illness), then the end-result is not going to make anyone happy. I’d rather they chalk it up as a needed public safety expense, much like cops and fire, and move on to other things.