Ambulance fees would burden the poor
By John T. Bentivoglio
The Oct. 4 editorial “The case for ambulance service fees” dismissed several troubling aspects of such fees and ignored evidence that they could risk lives and have unintended consequences. Your readers deserve a more careful analysis of the facts.
First, studies and surveys demonstrate that medical costs, including ambulance fees, contribute to delays by people in seeking emergency care for heart attacks and other life-threatening medical events. Such fees run counter to three decades of effort by public health officials to lower barriers to calling 911. Anecdotal experience confirms that some patients probably would refuse transport if fees were charged.
Second, in the case of proposed fees in Montgomery County, the threshold for waivers would leave many working poor subject to the fees, and some of those who are eligible, such as immigrants, might be leery of asking for a waiver. So while the “majority” might not feel the impact, fees of $300 to $800 would fall on the poor, uninsured and underinsured individuals, and the elderly. Have we grown so callous that we should ignore these groups when help is needed most?
Finally, The Post dismissed concerns about insurance-rate increases. Does The Post really believe that insurance companies, facing millions in new costs, won’t pass these along in higher premiums? Why haven’t fee proponents offered evidence from insurers or regulators that rates won’t rise? Perhaps The Post has forgotten the important lesson that there is no free lunch.
Ambulance fees are bad public policy, and the Maryland Court of Appeals was right to give Montgomery County residents a say on this important issue via a referendum in the November election.
The writer was the lead attorney in the lawsuit challenging the rejection of the ambulance fee petition.
| October 7, 2010; 8:31 AM ET
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