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Monday, September 13, 2010

Amanda Fritz is also looking at your wallet

An alert reader who followed our link of the other night to the Portland commissioner's blog scrolled and clicked around a little and discovered that Nurse Amanda is pushing to have the city start billing people for the medical treatment they get from the city's firefighters who respond to 911 calls:

I proposed dedicating $100,000 in the 2010-11 budget to implement the Office of Finance and Management's suggestion to look at charging patients' medical insurance for medical services provided by PF&R, a request that Nick [Fish] and Dan [Saltzman] supported. The money for that study was reduced to $25,000 during discussions, then disappeared from the adopted budget. OMF said charging insurance companies could bring in $7 million annually, which would be more than enough to fund equipment replacement. [Portland Fire and Rescue's] study in 2008 suggested much lower projected income. An independent study should be funded either now from contingency, or in the 2011-12 budget, to find out whether billing insurance could be a significant revenue recovery mechanism.
Gee, I thought that sort of thing was covered by all the property taxes we pay. Guess I was wrong again -- the tax money must go only to bike paths and streetcars. Ah, me -- time for another $25,000 (or $100,000) study! Keep studying it until the consultants give the politician the answer she wants to hear, I guess.

As the alert reader points out:

All this could be answered in a phone call to someone in the business. Medicare doesn't pay for this. Oregon Health Plan, even if it will, pays a token amount. (Ask any medical provider.) Uninsured patients don't pay anyway. So it's up to the big area players: Kaiser, Blue Cross, Providence. And since a high percentage of 911 callers end up not going by ambulance, my guess it that they too will say no.

The projected $7 million of revenue is based on this: Estimated $7 million revenue / PFB runs about 45,500 medical calls a year. If everyone pays, about $155 for the fee. If half pay (still generous), the fee becomes $310. The public is going to LOVE this.... And the city is going to send the citizens to collections over it? Not if the Council wants to get re-elected.

There's your $25K study.

Opie Sten and Mother Vera may be gone, but the dopey ideas live on City Hall. It must be something in the water down there.

Comments (20)

Great, this is sound public policy. Make people who can't afford it think twice before calling for medical help because they won't be able to pay the bill.

Jack, you forgot: All the services such as Fire and Police comes from the City's Discretionary Fund. You know, the one we use to find the money to the movies with... after paying the important bills.

Calls to 911 exhibit a power law distribution -- that is, since 911 cannot refuse, there are a certain number of folks who call 911 a lot.


"Gee, I thought that sort of thing was covered by all the property taxes we pay."

No that just pays for pensions. Services are paid for through new levies.

I'll agree to this, when the City charges all of those event promoters such as the Komen Race for the Cure, Bridge Pedal, the Portland Marathon, the Rose Festival, and all of the high school/college sporting events for paramedics and police officers simply to be on standby at those events.

I also want to see a full accounting of how much was charged to the event promoter, versus how much the service actually cost.

If the revenue doesn't meet the costs, the promoter must cover the shortfall, or the event next year will be charged a fee to cover both the actual costs plus the prior year's shortfall.

If they refuse to pay, our cops and firemen are needed to respond to regular calls. When I did Bridge Pedal last year, I saw so many preventable bike collisions - why should I as a regular taxpayer have to pay for enhanced police/medic response to events were participants knowingly engage in a high-risk activity (sort of like climbing Mt. Hood and then having to be rescued by the Air National Guard)?

PJB--absolutely. In my hood in SE, a small group of transients receives a disproportionate amount of city services. I shudder to think what kind of bills (which will never be paid) they've racked up at local hospitals.

Jack: . . Opie Sten and Mother Vera may be gone, but the dopey ideas live on City Hall. It must be something in the water down there.

Maybe the real plan here is to put "something" in our water too -
so we will not be on their case anymore.
We will all know if that has happened when Jack starts writing glowing reports about our council! Jack will be like the "canary in the mine".

On the other hand do you want to pay a bill for a hook and ladder truck that shows up when a call to 911 is answered? I have seen one of those trucks answer calls more than once in the Mt. Tabor area. Efficiency is not something the fire boys understand.

It sounds like Portland wants to copy Eugene/Springfield. Except it will lead to the same problems as discussed in this RG article from Sunday. http://www.registerguard.com/csp/cms/sites/web/news/cityregion/25217526-56/ambulance-springfield-says-eugene-fire.csp

"Efficiency is not something the fire boys understand."

No but they understand politics. The truth is that thanks to modern building techniquest there aren't enough fires now-a-days to justify the size of the Fire Bureau. So they train half the fire fighters as EMT's to fill in the time. Of course a firefighter has to be with fire fighting equipent at all times so ... they spend their time running around in the big trucks visiting fender benders.

But if your house catches on fire you do want a station just down the street right?

Anon Too if my house catches fire I don't want them to send a hook and ladder. The department needs to look at other alternative systems maybe a well equipped truck on something like a pick up bed. And yup they do send those hook and ladders trucks to fender benders and medical calls. Those trucks are not the fastest out of the gate. Kinda slow pokes.

Not only is it a dumb idea, it ignores the real waste in the system. Portland Fire's response to many medical emergencies is unnecessary as the private ambulance/paramedic service is typically primary. Cut out the duplicate personnel and vehicles and save taxpayers a few (million) shekels. Don't care if PFR or the private company is on point, but Amanda could direct her attention here rather than antagonizing folks who already pay for PFR.

Jack, in regards to your comment, "Gee, I thought...tax money must go only into bike paths and streetcars", you're right.

In today's Daily Journal of Commerce they have an article how Sam Adams, Schrader, Wu and DeFazio lobbied Fed Transportation Department for $233 Million recently. They asked for $163 Million for the trolley to LO, $24 Million for Union Station remodeling, and $25 Million for Bike Boulevards. All mass transit endeavors and NOTHING for roads.

Then if you combine this with last weeks JPACT meeting where Sam and others once again asked for over 95% of proposed projects to be mass transit we now get a clear picture that your summary is correct.

When will this insanity ever stop? Start honking your horns, 95% of us that still drive, when you pass your city halls. And ask pertinent questions and give your followup opinions to our state legislators.

And times are coming when urban renewal and its use as a major tool to perpetuate trolleys, light rail and bike boulevards without public approval is near.

Amanda - How about just notifying private ambulance services who are trained as well as fire people for medical emergencies instead of having both of them show up.

The ambulance has to be there anyways (for hospital transport), I could never figure why you needed both anyways besides the more the merrier.

Amanda and the rest of the bureaucrats at city hall, listen up... stop going to work, stop walking through your office doors, and most importantly, quit thinking up NEW ideas like charging for 911 calls. Please, GO ON VACATION. It's the only way we can stop the foolish thinking coming from you, Slimmy Sam, King Leonard and others. If we could get through your thick heads that you are spending more than we want to give you, then we might be able to move forward. But I don't think you would consider this OLD idea.

Tualatin Valley Fire and Rescue seems to be on the right track in responding with staff and equipment appropriate to the call.

Abe - That moves up unincorporated close in WA county as an escape plan from the insanity of PDX.

Disclosure: My dad is a retired Portland firefighter.

TVF&R is certainly thinking outside of the box responding to medical calls with those little cars. The Oregonian says they're even considering sending paramedics to calls on motorcycles. They seem to be leading the way when it comes to looking for efficiences, but:

Fire departments nationwide respond to medical calls with fire engines. Here in the metro area, fire departments respond to medical calls along with ambulances because they frequently beat the ambulances to medical calls by several minutes. Because fire stations are strategically placed through a city, they're better positioned to get to an incident faster. Most of the time, those few minutes don't make a huge difference. But in the case of a stroke or cardiac arrest, it could mean life or death.

So why do firefighters take their engines to medical calls? Because if they get to a medical call (or fender bender) and then there's a fire nearby, they can respond and put it out.

I agree that it can seem silly when an ambulance and an engine show up to a fender bender. But when I'm having a heart attack, I don't want to have to wait an extra few minutes for a paramedic because you all think firefighters shouldn't respond to my emergency.

Should Portland charge for medical calls? I don't know. But we all pay when they keep shipping the same homeless guy to the ER for a tummy ache.

Here's the thing. I thought my property taxes paid for fire fighters, cops, road repair, and other essential services. And for a long time, they did. Until the scammers at kiddie hall decided to divert that money to their pet projects and weasel cronies. So hell no, we should not pay for medical calls. The weasel scammers should pay for their own g.d. projects and get off the dole from the city.

PS - Was driving around in WA county yesterday running some errands. Went by a gorgeous new TVFR station (I think it was near Hall and Scholls Ferry). My nearest PDX fire station is tiny and looks like a dump and is is poorly equipped by comparison.

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