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Why are ambulance bills so high?

David Tuckwell 27 February 2018 76

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? 

What’s Your opinion?

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76 Responses to
Why are ambulance bills so high?
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JacintaS 2:06 pm 05 Mar 18

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 Retro 10:55 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.

11:28 am 03 Mar 18

Amy Wiggins What does Rob think of this?

7:54 am 03 Mar 18

It’s never free. States have other levies to cover the cost. Some pts free ride is taxpayer funded.

10:38 am 02 Mar 18

Steve Berka, don't call an ambulance in Canberra.

8:30 am 02 Mar 18

God no. It leads to massive misuse of an emergency service with gp and non emergency calls. Worst thing ever introduced!

6:47 am 02 Mar 18

This link is for those in Qld with regards to ambulance cover

12:56 am 02 Mar 18

You do realise that ambulance coverage for all in Qld originated from a levy on electricity bills? But everyone should be covered. There should be an emergency services levy that covers all emergency services, that everyone should pay.

knuckles 10:12 pm 01 Mar 18

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.

7:59 pm 01 Mar 18

In WA we pay an emergency services levy in our council rates which goes to DFES for the fire brigades, SES, sea search and rescue., not ambulance. Our ambulance service is a private service (St John's) contracted to the State Government. It cost over $795 for an ambulance for my daughter to take her 5km. Private health insurance only covers emergency ambulance not non emergency or patient transport. You need to take out extra ambulance cover for that. If your on the old age pension and over 65 Yr it's free.

7:15 pm 01 Mar 18

Every Queensland vehicle registration contains an emergency services levy which provides cost free ambulance treatment and transport. There is a reciprocal agreement for some inter-state visitors depending on their state of origin.

6:35 pm 01 Mar 18

In Victoria if you call an ambulance for someone and they didn't ask for one or were unaware that one was called on their behalf, that poor person still gets charged $500 call out fee. Totally unfair.

Grahame Cheers 5:07 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?

3:48 pm 01 Mar 18

In NSW fees to cover cost of vehicles, equipment, insurances, wages if not only paramedics but ALL staff employed. NSW does not charge for drugs or other treatments.Some states offer free transport but a fee is attached to rates or rego

NSW still has lowest fees

But private insurance = free

Pension or any benefit = free

3:25 pm 01 Mar 18

Well, it costs a absolute motza to run an ambulance service.

And if you want to pay the ambulance officers what you think they costs.

Now, while they’re funded for general ops, other things get added and factored in. And equipment doesn’t come cheap.

That whizz band electrically powered stretcher you want them to use? Minimum $25k per unit. Wanna retrofit an ambulance to take one? Try another $25-30k per vehicle.

Heart Monitor/Defibrillator machine....

Yknow...the thing that goes beep, pong and even zzzap to get you back? Won’t see much change out of $16k each.

Plus ongoing costs of generally running around and consumable medical supplies. Ongoing training of staff. Uniforms. Workers compensation, heaven forbid - buying a new ambulance.

So, yeah he cost is high but to mitigate that, you can purchase stand alone Ambulance Cover, either for individuals or family. Like the old ambulance insurance schemes (which don’t exist anymore)

It’s also standard with full health insurance.

Also, just because it’s ‘free’ in Queensland doesn’t mean it’s free to you - when you’re visiting Queensland. ‘Free’ only applies to Queensland residents and trust me the government has found other ways to make them pay.

Same for NSW. ACT residents if in NSW using a NSW ambulance will cop the bill, unsubsidised as you’re an interstate visitor.

Keep in mind though that if you’re on a pension or health care card, most state ambulance services offer discounts to those people, usually 100% discount once you present your card. That’s fine. But the cost of that transport is passed on to the rest of us in our ambulance fees. Also, false calls, fake calls or calls no longer required etc all add up to costs on the system.

My best advise is to obtain insurance. Or, if you can avoid that trip to hospital and go see a gp that’s good too. Or if not emergency, private transport or taxi or Uber transport are options but only only if appropriate.

I’ve had cause to call on ACT Ambulance when I or family have needed to and they’ve been great. And billing-take it to our health insurer and problem solved 😁

11:08 am 01 Mar 18

Ambulance cover insurance is about $50/year for singles and 100 for families. Likely less then what you spend on your phone or coffee per month.

Also, calling an ambulance should be during a medical emergency or unexpected medical crisis. This hopefully will never or at best rarely occur in ones lifetime

8:59 am 01 Mar 18

The cost of an ambulance trip comes from a formula that the services use, which is the total funding divided by the number of case attended to in one year gives you a cost per trip. That's why cost of ambulance trips go up each year and vary from case to case as service can bill the patient for all resources sent to a incident. And before you ask I'm a paramedic that used to be a manager.

6:31 am 01 Mar 18

All the overtime they pay the understaffed workers.

6:27 pm 28 Feb 18

Um, it is covered when you have ambulance cover...... Small outlay for when you need one....only about $100 for a family.

2:36 pm 28 Feb 18

The speeding tickets

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