26 February 2018

Why are ambulance bills so high?

| David Tuckwell
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A costly conundrum: Are ambulance bills too high?

Imagine the following scenario: your neighbour calls a plumber to your house thinking that a pipe is leaking. You tell your neighbour, ‘I don’t have a leaking pipe’, but they call the plumber anyway. Shortly after, the plumber arrives from around the block. The plumber confirms what you told you neighbour—you don’t have a leak. Then drives off. The following day you get a bill in the mail for $650 from the plumber. Sure, you never called a plumber, and explicitly asked for him not to be called. Sure the plumber did nothing and confirmed that you didn’t need one in the first place. But you still have to pay $650. How would you react?

While this scenario with the plumber is made up—this is happening every week with ambulances in the ACT. Under ACT law, whenever there is an ambulance call out, regardless of whether you want one, and regardless of what they do, Canberrans have to pay a minimum of $650.

I know this, because it recently happened to me. When I sought to appeal the fee, I received the following from an emergency services spokesperson:

“What work the ambulance actually did, if any; unfortunately, due to privacy, we do not have records of the medical conditions that occurred. These records are held at the Ambulance Services Office.

Who called the ambulance and whether the patient consented (or explicitly said no); In relation to emergency ambulance attendance and charges, clause 201 (2) of the Emergencies Act 2004 provides that “A fee determined by a service provided to a person by an emergency service is payable by the person even if the person did not ask for, or consent to, the provision of the service.”

There is a lot to say about this.

As the scenario with the plumber illustrates, there may be no other line of work in the ACT where Canberrans have to stomach a bill regardless of the services rendered and regardless of whether they asked for any services. We might want to ask, ‘why do we make a special case that ambulances can charge like this?’ If this is an essential service, as medical services usually are, why isn’t the ACT government subsidising it?

The second issue is, why does it cost so much? On my back of the envelope calculation, $650 is roughly Australia’s weekly median take-home pay after tax. Even if we agree that ambulances should cost something – is this figure fair?

The third issue is the lack of any appeals process. There is only one circumstance under which you can have the ambulance bill waived: extreme financial hardship, which is difficult to prove and embarrassing for the person who has to prove it. Centrelink recipients can also get their fees lowered, but only in some circumstances.

Like everyone, I respect and appreciate the role that ambulances play in Canberra. And like everyone I am happy to pay for life-saving emergency transportation and services. But the question is why is the fee so high, and why is the process so rigid?

Have you ever had to foot an ambulance bill in the ACT before? Should the ACT be like Queensland and Tasmania and make ambulances free for local residents?

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I’ll only call an ambulance if I need treatment on site (snake bite, car accident, etc), and I’ve seen the cost discourage others from using it as well.

When I first moved here we had an incident where a housemate of mine had severe chest pains and was finding it difficult to breathe. None of us were from the ACT so when we found out how much ambulances cost here my housemate was adamant for us /not/ to call one. Instead we ended up called a friend to take her to the hospital. She was low income and waiting to receive a health care card.

More recently another friend of mine fell of his bike, resulting in a concussion and a fractured shoulder. He decided to called an uber over an ambulance.

I’d be interested in chatting with and possibly interviewing anyone (with or without insurance) about their experiences with the ACT ambulance service for a student journalism project.

Capital Retro10:55 pm 03 Mar 18

If a road ambulance costs $1,000 to pick up and transport a patient from Tuggeranong to TCH, what does it cost for the Toll helicopter to do it from Perisher to TCH?

Do private healthcare funds cover the costs of an emergency helicopter?

I guess we will soon have drones doing it.

The answer to this problem is pretty simple.
If you did not call the ambulance, and you do not need an ambulance when one turns up, you tell the paramedics “thanks guys, but I’m ok and do not need you” Then you do not provide your personal information. Even the ACT government cant send you a bill if they don’t know who you are.

If an ambulance turns up, even if you didn’t call it, but still use the assistance offered by the paramedics, then you will have to pay as you made the decision to use their services.

Grahame Cheers5:07 pm 01 Mar 18

What happens when it’s a prank call?
How does the Ambulance Call Centre handle this?
Do we still have to pay if an Ambulance turns up at the front door?

Capital Retro9:17 am 28 Feb 18

A few years ago the ambulance billing system failed and and unknown amount of revenue was lost. It could have been millions of dollars. I chased up my account and paid it (that’s actually how the section found out their system had failed). I know several people who received ambulance services about the same time and they were never billed (one person twice!) and they have never paid.

I demanded an enquiry but, well, you know, this is the ACT and nothing happened. I wish the Auditor General would put the cleaners through the administration there.

Southerly_views1:01 am 28 Feb 18

The ACT Government double-dips by discretely applying multiple charges for ambulance services which increase every year. They do this via four different avenues; fees and levies added to rates, vehicle registration and on your private health insurance. On top of these levies you will be invoiced additional charges for ambulance attendance with treatment only ($649) or treatment and transport ($936) – unless you are a pensioner and eligible to receive services free of charge. ACT school children are also transported free when attending school.

Your rates bill includes the ever increasing emergency services levy of $294 this year (of which ambulance is a component). Each and very car registration that you pay includes a road rescue fee of $25.90 which does provide free treatment and transport if you are involved in a road accident. Private health insurance providers are charged a levy on every membership of $2.61 per week (135.72 yearly) for singles and $5.22 for families (271.44 yearly). Most insurers cover only emergency attendance and/or transport, often limiting the number of transports to two or three a year.

Based on these fees and charges an average family living in a Canberra home, with two cars and a health insurance premium will pay around $616 to government whether they use an ambulance or not. A family with no health insurance and one car will pay about $319 in fees and levies upfront with an extra $936 payable if they use an ambulance (other than for a car accident or school)

Compare the ACT to South Australia where SA Ambulance sells its own 100% cover to residents for all treatment and transport by ambulance within SA for a premium of $161 pa for families. Add an additional $30pa for Australia wide coverage.

ACT Government triple dipping? – you do the math!

Grahame Cheers4:56 pm 01 Mar 18

True. They are double dipping. Typically normal for this government.

A quick Google search shows that ambulance cover costs $40-60/year. In the “priority list of things to pay for in life”, this seems like a worthwhile annual investment for exactly the reasons provided in this article. I appreciate that many ppl can’t afford/justify private health insurance, in which ambo cover is included but the ambo only policy is worth seriously considering.

K-c24, while your comment is correct and there is the option of cheap ambulance cover, it doesn’t address the issues raised by David. It is extraordinary that a person can be billed for a service they never requested and for which they can obtain no information from the service provider.

You’ll find that that cover is only for ’emergency ambulance transport’. If, as it seems is the case in this article, the incident isn’t classified as an emergency, your ambulance policy is unlikely to cover you. I’ve been in a situation where I knew I was really unwell and needed to go to hospital but I wasn’t sure if it would be classified as an emergency if I called an ambulance. Ultimately I did call and it was classed as an emergency but I imagine there are many people who face that same dilemma and end up making the wrong decision – whether the effect is financial or much worse.

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