By Chris Moran
The Houston Chronicle
Houston City Council on Wednesday approved a $13-per-mile charge for a ride in a city ambulance.
Because few people will pay the fee — almost all of the 131,000 annual trips are paid by insurers or become charity rides — Mayor Annise Parker’s administration framed the charge as a bookkeeping measure. Insurers agree to reimburse the city for mileage, but only if the city charges for it. Not charging the mileage fee costs the city $2.7 million in insurance reimbursements annually, according to a city report.
The measure adds an average of $71 to the cost of a $1,000 ambulance ride. The measure passed by a 12-4 vote, with council members C.O. Bradford, Helena Brown, Andrew Burks and Jerry Davis voting against.
Burks went so far as to say, “We have people who will sit at home and die at home” for fear of a bankrupting bill if they summon an ambulance.
In response, Parker said there are people who hesitate to call for help for financial reasons, but, “We have a significant number of people in this city who use and abuse the ambulance system.” After the meeting, she added, “We have a problem with people calling 911 when they really don’t need an ambulance.”
$295 million owed
The mileage fee does not address the larger financial challenge facing the city’s ambulance service. The city does not receive a dime for about 45 percent of all ambulance rides because the patients are indigent and uninsured. City finance officials reported to council this week that the city is owed $295 million for unpaid ambulance rides but is unlikely to recover even 1 percent of it.
Some of the free riders are what Parker called “frequent fliers” who call for ambulances for rides to scheduled medical appointments or other non-emergencies. The city has identified hundreds of such people and attempts to serve them with cab rides, telenurses and other methods to avoid costly emergency medical transport. By city ordinance, Houston Fire Department ambulances cannot turn away patients for inability to pay.
Seen as burdensome
Supporters of the mileage fee argued that without it, Houstonians are paying twice for ambulance services — once in federal taxes that support Medicare and Medicaid and in private insurance premiums, and again in property and sales taxes to cover the $2.7 million a year the city could be collecting from insurers.
Bradford opposed the mileage fee as another burdensome charge on Houstonians. “What are citizens getting for their property taxes and sales taxes?” Bradford asked. “You shouldn’t fee or charge Houston residents, in my view, for delivery of core services.”
In the past two years, the city has increased water rates by about 30 percent, started a voter-approved monthly drainage fee and raised more than 150 fees for city services. In late 2010, council raised the base price of an ambulance ride from $415 to $1,000 and eliminated what had been a $7.50-per-mile fee.
“There are only two ways to pay for things, either through taxes or a fee for the actual services provided, and we have decided to hold the line on taxes,” Parker said. “The only other solution is a significant cut in the services provided by the city and we have, so far, not chosen to do that.”
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