We can't afford it
Published Friday July 3rd, 2009
In our view: Ambulance fee reinstatement is good fiscal management
Opposition Leader David Alward says it's a sad day for health care in New Brunswick.
We say this: it's a good day for fiscal responsibility in New Brunswick.
The issue in question is the reinstatement of ambulance fees after four years of free ambulance service.
The Progressive Conservatives, under Bernard Lord, abolished the fee while still in office. The Shawn Graham Liberals announced on budget day in March that as of July 1, it would cost $130.60 to call an ambulance.
While the Opposition is expected to make political hay from such a decision - and they are doing so - that doesn't mean the reinstatement of the fee is a bad move.
New Brunswick was the only province in Canada to have such a service. We're not exactly on the top of the provincial heap, wealth-wise, so we see this is an example of the responsible spending of taxpayer dollars, particularly at a time when financial responsibility is at the top of everyone's priority list.
Can we afford to be the only province that has this free service? No.
In the time that ambulance service was free, its use jumped by 20 per cent each year. Some would argue that was because genuinely sick people who couldn't afford to call the ambulance in the past were doing so.
The government, however, says the service was being abused. While they don't present any specific cases to back that up, there is plenty of anecdotal evidence to suggest there was some abuse. A sore back, a headache, a free ride from the north side to the south side are all stories we've heard.
Quite likely there was some abuse, and quite likely the number of calls will drop. Whether that will be because the abusers stop abusing the system or sick people get themselves to the hospital another way is anyone's guess.
But the new payment system is impressive in its fairness. There is a long list of people who won't be paying: those being transferred between hospitals, those using air ambulance service, social assistance clients, those in foster care and eligible clients of the extra-mural program.
As well, when you get the bill, if you truly can't pay, you can call a number on your bill and explain why. Each instance of hardship will be looked at individually.
And for many people, their private health-care provider will be paying the bill as part of their coverage.
Of course there will be a few who will find this fee difficult to pay, but there is always the appeal process.
How much more fair can the system get without being free?
The fees collected are expected to raise $6 million a year. That's $6 million that could be spent on education, social workers, legal aid or roads.
Wouldn't it be great if services like a ride to the hospital were free? Sure, but in a province that can ill afford such a service, the next best thing is an ambulance service that's affordable, fair and accounts for the hardships of the truly needy.
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Which I'm sure there was previously as well. Before coming to conclusions with no information, perhaps the government could actually provide the rationale for their decision? Is that too much to ask?
I'd point out that if they know there has been a 20% increase each year, surely they know what conditions the service user was dealing with and could determine the actual amount of waste.
I'd also suggest that a 20% increase might not be all that unusual. Look at our population. By definition of the age profile ambulance service requirements will be increasing every year.
A little information goes a long way. Perhaps the DG would indulge us with an editorial based on some.
In 'fairness' a 20% increase in use is not the same as the 50% that the government officials were stating, so 'anecdotal evidence' is hardly sufficient evidence for a policy change. Just because you've HEARD of somebody misusing the system does'nt make it relevant.
Its ironic to read an Irving paper that continuously talks about 'the need for lower taxes', then writes editorials about how 'the province can't afford' a better health care system.
Ontario has an ambulance service paid by taxes (not 'free). BC charges, but charges only half of what NB will charge. Manitoba is far more expensive, and Alberta is solid proof that once charges are in place, look for them to keep increasing. Either way it gets paid for, one solution is not more 'fiscally responsible' than the other.