Hurt or sick in PBC...take a cab!

Steven Rosenblum, Jupiter, FL  If you live in Palm Beach County Florida and you need to call 911 for ambulance/paramedics, you may be in for additional pain after your visit to the emergency room, because Palm Beach Fire Rescue will be sending you a bill.

On Easter Sunday, April 20, 2014 my back went out.  I was in extreme pain and unable to get up.  I called 911 and Palm Beach Fire Rescue dispatched an ambulance staffed by two paramedics.  They moved me from the futon where I was laying face down to a gurney and then loaded me into their bus (police/fire lingo for an ambulance).  They administered no drugs.  In fact the paramedic advised me not to take the morphine, since the hospital would be able to give me something stronger.

The ride from my home in Jupiter to Jupiter Medical Center would normally take me 6-7 minutes by car. The trip in the ambulance took about 10-15 minutes.  Most of the time in the ambulance was spent with the paramedic getting my information, medical history and vital signs.  He also apologized several times for the rough ride.

Once at the hospital they unloaded me and rolled me into the emergency room.  And that was the extent of my interaction with the paramedics and ambulance of Palm Beach Fire Rescue.

Fast forward to this past Friday, April 17, 2015 when I received in the mail a bill for $626.00 from Palm Beach Fire Rescue for the above mentioned incident.  I was aware that they had billed my insurance and that the claim was not paid, because PBFR is out-of-network for Blue Cross Blue Shield of Florida and I had not met my out-of-network deductible.

Having not received a bill for almost a year, I had mistakenly assumed that if the insurance didn’t pay the County took care of the cost.  After all, taxpayers pay for PBFR budget, including its emergency services.

After receiving the bill I called BCBSFL to ask why the only ambulance that can come if you dial 911 is out-of-network.  It’s not like when you have an emergency you can shop around to see who’s in-network.

I was informed by BCBSFL that Palm Beach Fire Rescue chooses not to be in-network with them.  They also informed me that if PBFR was in-network, BCBSFL would have paid $389 for the service.  I also called the billing office for PBFR.  They told me they don’t reduce their bills.  They would not accept the amount that BCBSFL would have paid.  All they offered was to put me on a payment plan of $25/month.

Here is the problem as I see it.  Taxpayer funded emergency services are there to aide everyone in the area they serve.  Since it is taxpayer funded, it is already paid for.  If you call 911 because your home is on fire they dispatch Palm Beach Fire Rescue fire trucks to put out the fire and you don’t get a bill afterwards.  If you call 911, because someone is breaking into your home, they dispatch Palm Beach Sheriff’s Office deputies and you don’t get a bill afterwards.  However, if you call 911 for a medical emergency they dispatch a Palm Beach Fire Rescue ambulance and you DO get a bill afterwards?! 

Now the ambulances, the paramedics and the supplies are being funded by the same PBFR budget as the fire trucks, firefighters and their supplies.  That budget exceeded $380 million dollars in Fiscal 2014.  So why does a victim get a bill for the ambulance?

Part of the answer can be found in the history of ambulance service in Palm Beach County.  Until the late 1990s private ambulance services responded to emergency medical calls and citizens, or their insurance, paid the fees.  When Palm Beach Fire Rescue took over, that fee system remained.  The other part of the answer is the assumption that insurance will pay for the ambulance service.  For most people if the insurance pays they don’t really care.  But that is exactly the mentality that has the health insurance and health care systems in so much trouble today.

The fact is that Palm Beach Fire Rescue is double-dipping on ambulance service. They’re funded by tax dollars and charging individuals again when they need an ambulance.

This experience has really opened my eyes.  If I have a medical emergency again, I will definitely think twice before calling 911 for an ambulance.  I’ve spoken to others who have had similar experiences and they also say they’ll think twice before calling for a Palm Beach Fire Rescue ambulance.

This policy is a deterrent to people calling for emergency medical assistance when they need it.  It could, and for all we know already has, cost lives.

But beyond this obvious danger is the principle that taxpayer emergency services are there for everyone to use if they need them.  They are already paid for by tax dollars and there is no reason that someone should have to pay for those services again.

I have been in touch with the office of County Commissioner Hal Valeche (R) District 1. His administrative assistant is looking into the situation and I hope to hear back from her about it soon.

Only the Palm Beach County Commission can address and change this policy.  And they will only act if the public lets them know that we find it unacceptable. 

I would urge everyone that reads this to phone and/or email their Palm Beach County Commissioner to let them know you want this situation addressed.