Charging fees for 911: a good idea?

[Kevin]

I found this topic on nova's blog.

The town of Tracy, Cal. will soon start charging people for medical emergency calls to 911. The town is trying to make up for a $9 million budget deficit, in part, by charging residents $300 per call, and nonresidents $400 per call. The fee can be avoided by paying an annual surcharge.
Full story here: http://www.npr.org/templates/story/stor ... t=1&f=1003

The argument has been made, with widely varying degrees of forthrightness, that the rich deserve better health care as a result of their having more money than do others. It's goes something like this: it would be irresponsible for someone barely scraping by to spend thousands of dollars on a yacht or vacatoion home. The same expenditure however would not only be reasonable, but actually good for the economy (and thus the middle class) should it be made by someone who can actually pay for the items in question.

-should money be a determining factor in whether or not a city/state/federal entity attempts to save/assist them?

[wilde]

I think that sounds absolutely atrocious. It's one thing if the fee were, say $5, but $300? If it were an actual emergency, they'd already have enough bills to deal with. So if someone has a heart attack and has to pay a fine for having a heart attack?

Pretty ridiculous. At least they don't charge fees for fires or robberies; that would just be insulting.

[bleachededen]

Considering this story, I think even considering a fee for emergency services is less insulting than disgustingly criminal:
news.yahoo.com/s/ap/20100228/ap_on_re_u ... w911_death

Imagine how much this couple would have had to pay, especially considering the outcome of the story?


(This happened in the largest metropolitan area closest to where I live, and I lived there for a few years while I was in school. Thank god I never needed emergency assistance. Scary stuff.)

[etudiant]

I’m always amazed when I hear these stories about a lack of funds for important services when they come from areas of the world that are relatively affluent. California is hardly the impoverished third world, and yet funding is an issue for many things. I think it is easier to spread the pain around, and have everyone chip in, in many of these cases. In BC, the 911 service is funded by a surcharge on phone bills, a little less than a dollar a month. Not too onerous if everyone pays. If everyone wants to horde their loot, then things can get more problematic.

In my neck of the woods there is a right-wing think tank called the Fraser Institute that comes out with a ludicrous announcement every year. They name a date called “tax free day”, meaning that they have added up all the taxes the average tax payer supports in one year, and deducted it from the average annual income, hence coming up with a date. This is usually around April or May, and the smirking suggestion is that all that has been paid to that date is waste; one has worked nearly half their time for little or nothing, and can then start to live. What they do not say, due to their ideology, is that many of those things financed through taxes are essential services, such as emergency medical care. They also offer no analysis of what it would cost to pay for all these things if they were provided by profit seeking corporations.

Many on the right insist that waste is inherent in government. But incompetence is a personal attribute, and knows no boundaries. If one is incompetent in government, instant enlightenment is not going to happen just because they take up a post in the private sector.

BC has a rather large ferry system that was formerly run by the provincial government. Today it has been semi-privatized, with a CEO brought in from the private sector to run it. The result? Rates are up, the system still needs tax subsidies, wages are stagnant…..oh, except for the CEO’s, who has been awarded $1 million/year salary. This is about double going rate for CEOs of equivalent size companies in this region.

I think ideology can get in the way of common sense.

[bleachededen]

I just found it absolutely horrific that not only once, but twice the paramedics were within feet of the dying man's door and refused to walk to him when he could not walk to them. That's beyond incompetance and somewhere in the realm of unfathomable inhumanity. They're paramedics, for f*^%'s sake! They are trained to rescue people from horrible situations, they take the job (presumably) because they want to help people, and then they get to a house and say, "6 feet of snow? I'm not walking through that. Let's make the guy who called 911 cause he's dying walk to us." Twice this happened, with two different ambulance teams. If a little snow scares you off from saving a person's life, maybe you'd be better off working in an office where you'll never have to get up from your chair except to pick up paper from the printer or get a cup of coffee.

I just found it sickening, especially since it happened in an area I know and had at one time been a part of. This incident only adds to the many good reasons moving was a good idea.

[Kevin]

I voted "Yes, with an explanation."

According to to Tracy's wiki page...

- the hometown of MC Hammer.

- agricultural, soil contamination issues as result of previous heavy use of DDT and other nasty chemicals, population growth fueled by those leaving San Francisco, four active earthquake faults, temp average 70s in the summer and 40s in the winter, a decent amount of rainfall. Population: (2007 census) 82,082 residents: 22.8% White, 17.1% African American, 2.2% Native American, 9.6% Asian, 15.7% Pacific Islander, 18.3% other races, with 5.7% from two or more races. Hispanic or Latino of any race were 36.9% of the population.

-the three listed politicians are all democrats (who may or may not have had anything to do with the 911 charge being implemented)

I have heard of California being liberal by the water and conservative by the land. Put differently, it's liberal in the big cities while conservative in the smaller communities. This reminds me of Texas, which isn't quite so cartoonishy conservative as it probably appears to be to many outside the state. The problem is, from my perspective, getting the cities to vote, and getting those most under attack to vote.

Here is a referendum that was on the Republican primary ballot for governor:

Ballot Proposition #1: Photo ID The Texas Legislature should make it a priority to protect the integrity of our election process by enacting legislation that requires voters to provide valid photo identification in order to cast a ballot in any and all elections conducted in the State of Texas.

Ballot Proposition #2: Controlling Government Growth
Every government body in Texas should be required to limit any annual increase in its budget and spending to the combined increase of population and inflation unless it first gets voter approval to exceed the allowed annual growth or in the case of an official emergency.

Ballot Proposition #3: Cutting Federal Income Taxes In addition to aggressively eliminating irresponsible federal spending, Congress should empower American citizens to stimulate the economy by Congress cutting federal income taxes for all federal taxpayers, rather than spending hundreds of billions of dollars on so-called "federal economic stimulus".

Ballot Proposition #4: Public Acknowledgement of God
The use of the word "God", prayers, and the Ten Commandments should be allowed at public gatherings and public educational institutions, as well as be permitted on government buildings and property.

Ballot Proposition #5: Sonograms The Texas Legislature should enact legislation requiring a sonogram to be performed and shown to each mother about to undergo a medically unnecessary, elective abortion.

Photo ID is voter suppression of Hispanics given a face scrub. Controlling Government Growth is newspeak for continued class warfare. Cutting Federal Income Taxes - - well, of course, how else can you starve all programs that are not security or military-related. Public Acknowledgement of God - the funny thing is that all these things are already allowed. What's not allowed is to present them in a showy, coordinated, artificial manner; something Jesus warned about. Forced Sonograms are for the barefoot and (obviously) pregnant.

Racism and sexism isn't necessarily so much a hatred or dislike of a certain race or gender as it is an active, mindful, working against its interests. This is what the Republican ballot initiatives present.

It is in this sense that I find the charging of 911-rendered assistance to be a good thing: how much clearer can it be that if you don't take part in your community you're nothing? I also find it to be a logical step along the individualistic mindset pathway that believes anything bad or unfortunate that happens is somehow the fault of those it happens to. I was recently in Arizona and a story there was how the state had closed 13 of its 18 rest stops due to lack of funds. I can tell you that Arizona is a far smellier place than it used to be. Good news though, there are high hopes that the state rest stops will again soon be opened for business under private ownership. I wonder if the state had considered charging for loos?

Everyone agrees that things are getting worse.

[bleachededen]

I voted "Yes, with an explanation."

It is in this sense that I find the charging of 911-rendered assistance to be a good thing: how much clearer can it be that if you don't take part in your community you're nothing? I also find it to be a logical step along the individualistic mindset pathway that believes anything bad or unfortunate that happens is somehow the fault of those it happens to.

Everyone agrees that things are getting worse.

What if you need medical attention and don't have the money to pay for 911 fees? Are you saying that people who don't have the means to contribute extra funds to public assistance that they don't deserve to be helped? I also don't understand this sentence:

I also find it to be a logical step along the individualistic mindset pathway that believes anything bad or unfortunate that happens is somehow the fault of those it happens to.

I don't understand what you mean by this, and how it pertains to the idea of paying for emergency medical services.

I'm aware that things are getting worse, but is that excuse enough to deny emergency services to people in need of them who simply can't make as much money as others who have cash to spare?

[Kevin]

Oh how nice - someone gave me an asterisk for my "Yes, with an explanation"!

What if you need medical attention and don't have the money to pay for 911 fees? Are you saying that people who don't have the means to contribute extra funds to public assistance that they don't deserve to be helped?

I don't believe anyone deserves anything - good or bad. But to put it in different terms, and ones I think are compatible with yours, I'll say that any human, regardless of her ability to pay, should be given assistance.

To say that you will be charged for requesting medical assistance, when, say, you have a kidney stone presents in as clear a way possible the idea that personal responsibility requires one to look out for herself. It is a logical conclusion of the individualistic mindset - if you have something you did something to cause it - good or bad. In this case, the reason you're finding yourself in the trouble you're in is because you failed to make enough money, or at least save/direct enough money to your medical energency fund. There is no one to blame but yourself. If you are robbed at gunpoint you are to blame because you weren't carrying enough firepower, or lacked the will to use it, to deter your aggressors. Keep in mind, this is the viewpoint of the individualistic mindset I am talking about. If you are cheated by Bernie Madoff, or in a humorous situation here locally by a wannabe Madoff who snared among others Chuck Norris and a local furniture king, Mattress Mack, who has become filthy rich through "saving you money" you deserved it for being so stupid and/or naive to believe that he was on the up 'n' up. Chuck Norris really is stupid. Mack is a genius - even if a bit naive.

I say charging fees for 911 is a good thing because it presents in as stark a manner as possible the view that assistance isn't something that the city (governing body, be it city, state or federal) has a responsibility to do. It is a commodity, just as much as anything else is. It is a privelege afforded to those who can afford it. It can't get clearer than this. I'd like to see it debated. That's why I think it's a good thing. If it can't be stopped when it's presented in a forthright manner there is no chance of it stopping it when it's masked by code words such as Controlling the Growth of Government and Voter ID.

I say it's a good idea because they're being honest about the value they place on those who don't manage to keep up.

[bleachededen]

And I say it's sickening to think that someone who is robbed or mugged "was at fault" because they didn't carry enough firepower. What about a young girl walking home from school who gets grabbed from the bushes, kidnapped, raped, and killed? What did she do that warranted her this fate? Surely you won't blame a 10-12 year old girl for walking home in her safe neighborhood like she has done for all of her life for suddenly being stolen by a psychotic pedophile who happened to make his way into the community?

I recall having this same discussion with an American turned Buddhist monk when a group of monks came to one of my political science classes in college. Of course I was outraged from the outset that he was American, but he then went on to explain reincarnation, saying that everyone pays for what they have done in this life in the next life, and that if someone is miserable in this life, they must have done something terrible in a previous incarnation. This idea made me furious, and I questioned him on it, asking, "What about rape victims? Are you saying that a young woman who is violently raped deserved it because she did something wrong in a life she can't even remember?" He pretty much repeated his claim without addressing my question, and ever since I have been very skeptical toward anyone who talks about karma and reincarnation.

If a state, city, what have you is providing services such as medical emergency services, anyone living within that city is eligible to receive these services. Even if one person makes less money than another, they still pay taxes to the same city, and therefore are already contributing and deserve emergency services when they are needed. They already pay ambulance taxes and healthcare taxes etc., so why should they go into debt because suddenly the city wants $400 per call (not to mention the medical bills that will ultimately follow) if something dire should happen? They didn't "fail to make enough money" just because someone else made more, and emergencies happen to everyone, regardless of race or class or wallet size. It's not like every family is calling 911 every day. That's why it's called an emergency. They're going to have to pay for the treatment, why would it be such a problem to at least give them a freebie on getting them to the hospital/rescuscitating them at home? Those paramedics get paid the same whether the sick person pays a fee or not, so what's the harm in helping people?

I can understand charging penalties for prank 911 calls, or for 911 calls where the problem has been solved before paramedics show up, because that is a waste of the paramedics'/government's time and resources. But to charge someone whose child comes down with a disease that could kill them? Or someone has broken in and shot someone? If you can assign fault to these people, then I'd have to say your life view is pretty skewed and extremely inhumane. I don't even like people, personally, but I feel that on a grand scale, when they live and work and pay taxes in a city, they are entitled, at least, to emergency medical care.

[Eyebrowse]

I don't live in the United States and so I'm pretty unfamiliar with how your govt actually works or how things are done over there. Basically my knowledge is pretty general and could probably be quite naieve as a result. I gather you don't get free medical care over there unless you have an insurance policy whereas over here the NHS is funded by the govt and everyone get's free medical care if they need it. This isn't to say that the standard of care would be the same as a wealthy person would receive paying for his own care. If I had a few million and I was sick I would definitely pay for private care as I'd get my operation done very quickly (the waiting list would be practically nil) and the after care would be of a far better quality. Basically going private and waiting on the NHS for an op could be the difference between life and death so you can't fault wealthy people for taking advantage of private health care. What is wrong though is to expect your average worker to have to compete on that level. By saying it's your responsibilty to provide yourself with the same care as a wealthy man and If you can't it's your fault is a pretty poor argument. The wealthy man should remember that his wealth didn't just happen on his own blood and sweat, all those workers created it as much as he did but the way capitalism goes just one or two individuals benefit personally on a grand scale from the wealth created with the cooperation of others. To hear capitalists talk you would think they created the very moon and the stars and the rest of us should thank them for allowing us to breathe the same air as them without charge.
I agree with what you say about charging for 911 though in principle as over here I do think we get too much for free and it takes a lot of the will and motivation out of people to take personal responsibility for themsleves. I mean for example you can live in Britain and do nothing and get a free place to live, free dental care, free eye care, free medical care, free travel, exemption from rates and taxes and all for just doing nothing. Which really must be a real smack in the teeth for folk who do work hard and because they work they don't get any of the above benefits but they really and truly are paying for others to get this stuff that they don't get on a free basis. Although they can get tax credit payments if they earn less than a set amount per year.
I was interested in your system of welfare and how you only get eight months of welfare and then you don't get any more. Is this right ? Personally I think a similar system would be good for Britain as there are lots of jobs people just won't do and it's the benefits they get that are keeping them from being hungry enough to do those unwanted jobs. Of course if a person truly cannot work it's not right to just cut them off and let them go under. This would need careful planning and I wouldn't want a three strikes and your out system that cuts people off entirely forever if they just aren't competent to survive without benefits.
Some of the examples I've read are happening in essence over here as well, the example about emergency people expecting a dying man to walk to them through thick snow ? Well just last week a woman over here fell down a disused mineshaft and the firemen were all set to send a paramedic down to treat her injuries but along comes "Fireman Sam" who isn't a real proper fireman, just a knobend who works for the fire service and is more of a politician than a fireman. He forabade the ambulanceman from going down just as he was poised to descend as he hadn't been trained in rope work or to work in confined spaces and so they would all get reprimanded and possibly sacked if he went down that shaft and saved that woman.
What can the firemen do ? They have families to keep and can't afford to lose their jobs by going against the top brass. It's disgusting but it's all red tape and bureaucracy these days. The woman was dead when they eventually were allowed down to get her six or seven hours later as reported in the newspapers. A year or so before this a police officer failed to do anything when he came across someone drowning as it would breach health and safety rules. Sometimes I think it's these rules that allow for people who don't really have what it takes to join services like these in the first place. I don't have what is needed but I wouldn't join as I believe you should have the type of courage needed to do this type of work or it's just a poor show and people suffer from keeping another more worthy man out of that type of job.
The main reason I think your argument for charging for your 911 service is sound is that over here people abuse the 999 calls to emergency services. They phone up and ask for a doctor as they have a mere headache and all sorts of other inconsequential nonsense things like that. If people paid for the calls they might start to value it more and respect it. Also people go into the mountains over here in Scotland in the middle of winter and get themselves lost and many of them die as a result. So that costs the authorities thousands of pounds for helicopters and rescue teams and when they do get to the guy he's all smiles because he's been saved, which is fine if we are talking about an experienced mountain climber who has become injured after taking all the necessary precautions, but the ones who go up there knowing nothing at all about the local climate and dressed for a summer outing really offend me.
I think maybe a charge for that type of stupidity or compulsory insurance would be a good idea for all mountain climbers and walkers. Then the careless ones would maybe think twice about the consequences of their actions. Hurt people in the pocket and they start to care that's how it is I feel. Giving it out for free just breeds contempt for all sense and decent behaviour in some people I tend to think.
A couple of years ago a schoolteacher (I think she was a foreign teacher) took a party of children up into the mountains knowing absolutely damn all about just how quickly hypothermia can set in if you don't dress right for a day out in the Scottish Hills. She too got of scot free but if she had to face some sort of charge or was made to pay something towards the cost of her own stupidity I think this would happen far less.