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Posted at 9:44 PM ET, 10/11/2010

A critical need for ambulance fees

By editors

By Richard Bowers

John T. Bentivoglio’s Oct. 6 letter criticizing The Post’s editorial in favor of Montgomery County’s proposed ambulance fee reminded me of the old saying: You are entitled to your own opinions but not your own facts.

The fact is that there is no evidence from the many jurisdictions with ambulance fees that people are more reluctant to call 911 when they have a medical emergency, just as there is no evidence of any resulting insurance premium increases. I know, because the Montgomery County Fire and Rescue Service asked. The reason there are no increases on premiums is that these are premiums already being paid — reimbursements that other jurisdictions are using to improve service and save lives.

Mr. Bentivoglio claims a burden would fall on the county’s poor because of ambulance fees. That’s false, too.

No Montgomery County resident, whether insured or uninsured, rich or poor, would pay one dime, receive a bill or be responsible for co-pays and deductibles. Non-county residents without insurance — who do not pay county taxes — would receive a bill, along with a hardship-waiver application with a generous eligibility threshold set at incomes up to 300 percent of the federal poverty line.

The fact is that ambulance reimbursement means a safer Montgomery for everyone, because the Fire and Rescue Service would have the resources to meet critical needs — at no additional cost to county residents. Let’s give our firefighters and paramedics what they need to keep us safe. The Post got it exactly right.

The writer is chief of the Montgomery County Fire and Rescue Service.

By editors  | October 11, 2010; 9:44 PM ET
Categories:  HotTopic, Maryland, Montgomery County  
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Speaking of facts, what the Chief and the County Executive never seem to mention is that as county taxpayers we already pay $0.097 per hundred dollars of real property assessment and $0.242 per hundred dollars of personal property assessment every year!
So call it what it is----a tax by a County government that has trouble living within its means!

Posted by: aihinrockville | October 12, 2010 8:12 AM | Report abuse

I can't speak for Montgomery County, but here in Manatee County, Florida, if you have no (or not very good) health insurance, calling EMS can cost you up to $1000 out of pocket, and if they decide to use the non-profit Bay Flite helicopter system to transport you to the nearest shock trauma unit, on the other side of Tampa Bay, you can expect a $5000 - $10,000 bill for an injury as minor as a broken arm (not exaggerating) before you even get to the hospital.

I'm sure Montgomery County liberal Democrats will not ruin something as vital as emergency medical services, but what happens if you get Republicans in office, as we have in Florida?

They go lic lic lic, lic lic lic, and shlurp shlurp shlurp, every time they can find a way to get a dollar out of a working person.

And if you can't pay, those accounts go to collection agencies and ruin your credit.

Remember, you may not have the lic lic Republicans running things now, but if you ever do, you will regret every fee you allowed to creep into your system, because the Republicans see those fees as a way to lic lic lic money from you while -- I always love this bit of hypocrisy -- "not raising taxes."

Posted by: roblimo | October 12, 2010 11:16 AM | Report abuse

What the chief, and particularly the county executive also neglect to ever mention is that the fire service currently brings in nearly 200 million in revenue, mostly through the Fire Tax paid by every property owner in Montgomery County. In FY10, that tax, combined with other revenue sources (code enforcement, permits, etc) brought in $192,319,280. Total expenses for FY10 were projected at $191,235,140. The problem however is the money earmarked as a "Fire Tax" doesn't even go to the Fire Department, it goes right in to the general fund where the County Executive spends it as he wishes.

Those are facts. Feel free to examine the budget if you like, it is readily available on the county website.

Posted by: MOCOite | October 12, 2010 12:26 PM | Report abuse

The "no evidence" argument that people are reluctant to call 911 defies logic. A person can be reluctant to call an ambulance when experiencing chest pain at a given time. Some time later in the day, the pain is so intense that the person, or someone else in the household, finally calls, but it is too late, and the person dies. Reluctance is not measured only in the total number of calls in a jurisdiction. If the delay in calling is not measured, then I suppose it counts as "no evidence."

Posted by: suslibrarian | October 13, 2010 12:27 AM | Report abuse

Chief Bowers states that is it a fact that there is no evidence. Fee supporters need to cite studies that show no evidence. He writes that he knows because MCFRS has asked. How did other jurisdictions answer on the reluctance question? Have they conducted studies? Where are they published so that voters on the referendum can read them? On the other hand, what about Journal of the American Medical Association study, "Health care insurance, financial concerns in accessing care, and delays to hospital presentation in acute myocardial infarction"? There is a link (Here is a link to this study, right after the phrase, "is likely to kill somebody".) at The Conclusion in the abstract: "Lack of health insurance and financial concerns about accessing care among those with health insurance were each associated with delays in seeing emergency care fo AMI." One can also enter 20388895 in the search box in PubMed ( to bring up the abstract.

Posted by: suslibrarian | October 13, 2010 2:09 AM | Report abuse

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