Wednesday, October 8, 2008

Give Fees a Chance - Washington Post Editorial

Cash-strapped Montgomery County should approve an ambulance charge.
Wednesday, October 8, 2008; A18

EVEN AFFLUENT Montgomery County is feeling the strain of an uncertain economy. With a $4.3 billion budget in fiscal 2009, the county is facing a quarter-billion-dollar shortfall in fiscal 2010, so local leaders are looking for ways to save. They may start by eliminating free ambulance rides. Isiah Leggett (D), the county executive, has proposed an ambulance transport fee that would generate an estimated $14.8 million for fire and rescue services. Critics counter that the fee would deter residents from calling 911. But most neighboring counties have ambulance fees, and there's no evidence that residents are reluctant to request ambulances as a result. The fee would make only a small dent in the deficit, but every dent counts.

Mr. Leggett's office says county residents -- even the uninsured -- wouldn't pay a penny of the fee. Insurance companies would cover most of the cost, and the county would make up the rest. It gets a little more complicated for nonresidents who request an ambulance . Nonresidents who have insurance will only have to make up the difference between what their insurance pays and the cost to the county. Nonresidents who don't have insurance will have to pay for the entire ride unless they secure a waiver. The fees run from $300 to $800. There's no data on how many ambulance riders don't have insurance.

An ambulance fee is an easy sell in some counties. In Montgomery, it has met resounding opposition. As of last week, the County Council had received 1,000 calls opposing the fee and only about 50 in favor. Montgomery's well-organized volunteer firefighters ferociously oppose the measure. They contend the fee would harm their ability to raise funds. The county shouldn't take for granted the thousands of hours of service that firefighters donate. But if fundraising efforts bring in less as a result of the fee, Mr. Leggett has promised to make up the difference.

Phil Andrews (D-Gaithersburg-Rockville), chairman of the council's Public Safety Committee, opposes the measure and worries that the fee could motivate insurers to raise their rates. Mr. Leggett's office counters that insurers in the Washington area already factor ambulance costs into their budgets. Since insurance companies determine their rates regionally, the executive's office argues, Montgomery residents already are paying for the ambulance rides. Insurance companies have yet to weigh in on the proposal.

The council is scheduled to vote on the fee this month. There's no question that the county's underfunded fire and rescue services need cash. Before the county levies yet another tax on overburdened residents, it should give the ambulance fee a chance. It works for other counties, and there's no reason to believe it wouldn't be successful in Montgomery.

1 comment:

Woodside Park Bob said...

While the Post may think ambulance fees are a good idea, I think this is an amazingly poor way to raise revenue. If it costs even one life because people are reluctant to incur a high charge -- and ambulance fees are expensive -- then the revenue gained isn't worth it. In addition, fees will undoubtedly reduce contributions to the volunteer fire departments and rescue squads. We don't charge for other essential emergency services such as police and fire. We don't even charge for non-emergency services such as schools and libraries. Just because some people's health insurance will cover the charges doesn't mean we should charge -- it will only increase insurance premiums. Ambulance charges are extremely poor public policy and should be rejected.