By Marcia Love
The cost of ambulance services in the province has raised questions not only from patients stuck with huge bills, but also the NDP.
Opposition leader Cam Broten criticized the province’s ambulance fees in the legislature last week, calling it a broken system.
But the provincial government argues it is already covering a substantial amount of the cost, with 71 per cent coming from taxpayers’ pockets.
Health Minister Dustin Duncan stressed that “free health care isn’t free health care.” Following question period, he told reporters the province pays over $5 billion for health care.
Greg Ottenbreit, minister of rural and remote health, said there are already a lot of programs in place to help cover the fees, as well as ambulance funding. While other provinces subsidize ambulance fees more heavily, there are a number of programs and health-related expenses covered in Saskatchewan due to the high demand for them that other provinces don’t cover. This includes cancer drugs and treatment.
“Some of these chronic illnesses that we do deal with in the province, other provinces maybe don’t have quite as high a demand for those services,” Ottenbreit said. “It’s all about balancing priorities and sometimes making a difficult decision. We already have 44 per cent of our provincial budget taken up by health, and again we have to make those priorities.”
Within the Cypress Health Region, residents are charged the $245 basic fee, $2.30 per kilometre for rural pick-ups and an $80 per hour fee for wait times.
In rural communities such as Maple Creek, the greater distance from facilities in larger centres can add substantially to the cost.
Betty Proctor knows this well. Both her husband Mac and daughter Chelzee have required ambulance services in recent years.
“It’s horrendous. It’s unbelievable what it costs to go by ambulance,” Betty said.
Between December 2010 and September 2012, Chelzee suffered seizures which required several ambulance trips. The total cost was $2,800.
Mac required an ambulance to take him to Swift Current in June 2014. Because Maple Creek ambulance services were unavailable at the time, one was called in from Gull Lake. Although he was only billed for the trip from Maple Creek to Swift Current and back again, the bill totalled nearly $900.
Betty is thankful her family has insurance that covered most of the costs, but for those who don’t she knows how costly it could be.
The three prairie provinces have the highest ambulance fees in the country, with rates starting at $245 in Saskatchewan, $250 in Alberta and $270 in Manitoba.
But in B.C., patients are charged $50 if treated on-scene and $80 if transported to hospital. Ontario residents pay $45 for medically-necessary EMS care or $240 if it’s deemed not medically necessary, and in New Brunswick and the Yukon, patients don’t pay a fee at all.
In Saskatchewan, a higher basic call fee is charged in larger centres – such as Regina where the fee is the province’s maximum $325 – as they provide 24-hour advanced paramedic-level care.
Patients served by ambulance operators in smaller centres pay the lower basic rate of $245 per call as well as $2.30 per kilometre for the distance in driving them to the appropriate health facility.
An hourly fee ranging from $50-100 is also charged to the patient if there is a waiting period at a health facility.
Ambulance fees are capped at $275 per call for seniors, and lower income families can have a portion or all of their fees covered through the Family Health Benefits Program and the Supplementary Health Benefits Program.
Ottenbreit said the $2.30 per kilometre fee has not been increased since 2006 when another 10 cents per kilometre was added on to reflect fuel and equipment expenses.
Funding is provided to ambulance services from two sources – grants provided to each privately-run service by a health region, which is a total of about $1.45 million per year, and user fees.
Fees for air ambulance, including STARS, are $350 per trip. Air ambulance is not an insured service under the Saskatchewan Health Benefit Plan, but it is partially funded by the Ministry of Health. The actual cost of an air ambulance flight is calculated at $5.29 per mile, however patients entitled to receive Saskatchewan health services benefits are only charged $350 per flight.
Betty and many others have questioned why it’s cheaper to travel by air ambulance. Chelzee was transported by air ambulance from Maple Creek to Edmonton and back again, which cost a total of $700.
“If they can cap air ambulance, why can’t they cap ground ambulance?” she asked.
Ottenbreit said the Ministry of Health funds STARS to the tune of $10.5 million, and the service also receives substantial funding from donors which keeps the cost to patients down.
Ottenbreit said the province’s ambulance system is reviewed on an ongoing basis, with information collected to see how it can be improved.
In the meantime, Duncan addressed the interest being charged on ambulance bills last week, and Ottenbreit noted the province is speaking with health regions about this.
“We’re talking to the health regions about how that interest is charged, what rates they’re charging at and what might be done in that respect,” Ottenbreit stated. “That’s something we’re looking at in the short-term, but long-term we’re always looking at different suggestions with ambulance services and trying to balance the suggestions with our priorities.”