At age 78, I have chronic heart problems, which on an average of
once a year for the last several years (so far) have sent me to the hospital
emergency ward. The procedure is a comforting routine. Taxpayer or
not, anyone can call 911 and get emergency assistance. The great guys—
and I am not being sarcastic, they are terrific—from the Tucson Fire
Department arrive, evaluate the situation, and after a discussion in which
my agreement is always sought, bundle me off in their shiny red
ambulance to St. Mary’s Hospital, less than half a mile from my home.
There I am put in the emergency room and treated with their customary
good care. I offer my thanks and never hear anything else from them
until the next time. I have nothing but praise for the Fire Department
team and the hospital staff. The whole emergency life-support system
gave me a much-needed feeling of comfort and security, enabling me to
concentrate on the demands of my condition.
Like many others, perhaps even most people, I assumed that
these wonderful public emergency facilities were paid for out of the
general revenues, that is, income and property taxes, and the like; a
conspicuous exception to the greed and profiteering that has become the
hallmark of American society in recent decades.
Until this year. This year, the next time for me was this past
April, and the routine was exactly the same. The team came in like
gangbusters and got me to the hospital in their ambulance with the
Tucson Fire Department name proudly painted on its sides. This time,
however, there was a different aftermath, presumably courtesy of
Obamacare: about a month later, I received a statement from my HMO
informing me that I might be billed $300 for the emergency services
resulting from the 911 call. Sure enough, about two weeks later I
received a bill from the Tucson Fire Department for $300!
Since this had never happened before, I wondered if it was some
sort of billing confusion. What did my HMO have to do with the Fire
Department or the emergency services? It was only after I received the
bill for $300 from the Tucson Fire Department that I became alarmed
and started to make enquiries. I called my local AARP. They had no
information about it (conflict of interest? they also retail HMO plans). I
called the Fire Department and was assured that it was not a mistake, but
had started with changes made at the beginning of the year. The man I
spoke with indicated that they had already had several calls about the
charge; I was not alone. I called my HMO and was informed that a
decision had been taken at the beginning of year to start charging for emergency ambulance services, a newly instituted co-pay. He implied
that it was an industry-wide change.
I had already noticed that since the passage of the so-call health
care reform bill with the endorsement and therefore the responsibility—
of the president—there have been fiscally minor increases in co-pays.
For example, my doctor’s co-pay was doubled from $5 to $10. I can still
afford that, but think of all the thousands of extra $5s going into the
coffers of HMOs to further bloat their profits and bonuses. I also seem to
be being billed now more of less regularly for additional charges each
month (the latest is $7.30) for services that were formerly routine. About
the same time, the co-pay on medications went up about 50%, more for
them, less for us.
I thank God that I am still solvent and can manage to pay these
charges without going under—yet, but, as a member of the besieged
middle class, I suspect that there are many millions with more financial
responsibilities than I who will have to make difficult choices as they
face these creeping increases.
To make a long story short, I called the Fire Department once
again, this time for clarification of the rules. Yes, there is now a $300 co-
pay for ambulance service. If I call 911, they will respond without charge
as usual, but if I put my foot in their ambulance, I owe them $300. I had
no choice but to pay. I have since heard from a friend in Florida, also a
retiree, who said that he had had a similar experience this year.
Can you imagine the implications of this? How did my HMO get
its sticky fingers into this pie? I do not know, but the suspicion lies with
the backroom agreements made during the health care debate.
Concessions to the pharmaceutical industry and the health insurance
cartels were showered upon them in order to get the bill passed, however,
flawed it might be, in order for politicians to claim victory. As it turns
out, it is exceedingly flawed indeed and may be at best a Pyrrhic victory.
Back to 911. Emergency services are supposed to be funded out
of the general revenue. Like the Police Department, the services of the
Fire Department are supposed to be available to any citizen (or non-
citizen) in trouble. Will there be co-pays down the road for putting out
fires or police interventions? I can imagine scenes of distraught people
trapped in a room during a home invasion calling 911 and the operator
demanding a hefty co-pay before she sends in the cavalry. As for myself,
I know that I am going to hesitate about calling 911 when something
feels funny in my chest. If I can walk, crawl, or call a cab, I shall
probably eschew the comfort of a $300 600-yard ambulance ride.