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As Long as We Remember...

December 27, 2002

How much for a mild heart attack?

Mike Kuster

Most readers received a letter recently explaining Frederick County's latest and greatest waste of taxpayer money. Beginning next year, Frederick County residents will be charged for ambulance services.

Of course, the geniuses behind this plan believed they could reduce taxes on residents by making ambulance services a fee for service. This may sound reasonable until you begin to think.

There are several flaws in the logic of the designers of this plan.

Problem Number One - Insurance Billing:

The plan is to bill individual's insurance companies for transportation. Has anyone heard of the high cost of medicine? It is in paper work. Each and every insurance company has its own set of codes, its own set of forms, and its own set of requirements for the submission of insurance claims.

Some people have more than one insurance company. So, the county will have to submit any remaining claim to the next insurance company using that company's codes, forms, and requirements. And so on.

Billing insurance companies for transportation will require at least two full-time positions. Cost: ~ $60,000.

Problem Number Two - Billing Individuals:

We call these "self-pay bills" at my office. If an individual:

1) does not have insurance,

2) their insurance does not cover transportation,

3) or the county gives up on trying to get money from their insurance company,

Frederick County will send a bill to the individual for payment.


This results in little more than staff frustration. Prepare for no responses, dollar bill payment plans, arguments over payments, etc.

If they don't pay, will Frederick County send the accounts to a collection agency?

Is Frederick County willing to ruin a citizen's credit over a ride to the hospital?

By the way, note staff mentioned above. Will Frederick County have to add staff to the payments window at Winchester Hall? Won't the county need people to bill the citizens?


Problem Number Three - "No one will be turned away for inability to pay" Clause.

How does Frederick County know my ability or inability to pay? The only judgment the county can make is the value of your home. Some people have valuable property and little income.

Who will make this judgment? Are we hiring people to screen individuals? Will we have to show the EMT two pay stubs as we are wheeled aboard?

Please pay up or Frederick County will forget your bill?

What the hell are these people wasting our time for?

Problem Number Four - Double Taxation on a Needed Service

Has Frederick County reduced the budgeted amount going to Rescue Services next year?

No! Well, when will we see our tax savings?

Oh, my tax dollars will go toward a service for which I will then be charged hundreds of dollars per use.

Hell NO!

Problem Number Five - Subscription Plan

I've subscribed to a lot of things, but I really don't want a subscription to an ambulance ride. Does it come weekly or monthly? Frankly, I hope to never be in one.


If someone does not have insurance, they probably cannot afford insurance. Therefore, they probably cannot afford to pay their ambulance bill. They probably cannot afford a subscription of $50 per year either.

We're back to the whole question of "when do I have to pay?"

The county is venturing where it does not belong. Insurance billing is a tricky business with new laws on the horizon. The county is not prepared to finance this endeavor.

Unfortunately, this is going ahead full steam ahead. The new Board of County Commissioners should reconsider this billing system before new federal laws go into effect and put the county into bankruptcy due to lawsuits and un-funded mandates for anyone billing for medical services (including transportation).

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