Prairie provinces spend less than the Canadian average on ambulance funding, say health officials.
Will Bartel, of Manitoba Health’s emergency services branch, said his province spends $5 per capita and Saskatchewan $12. An Alberta Health official said the per capita in his province varies between $9 and $12, compared to the Canadian average of $22.
Part of Bartel’s job is to deal with complaints about service.
“Overwhelmingly, it’s about cost,” he said. “Overall rural people are prepared to accept lesser training (of ambulance staff) and lower response time, but cost really kills them.”
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Prairie ambulance services have a range of prices that are set by health districts, municipalities and provinces.
Alberta’s government sets three levels of charges based on the training of ambulance staff. The basic pick-up fee ranges from $113 to $185 with a $2.20 per kilometre mileage fee that begins at the moment of the call. Municipalities can set fees higher than this and often do, especially to recover costs in rural areas, the official said.
Saskatchewan has a pick-up fee that ranges from $95 to $205, but averages $125. Its mileage fee averages $2.50 per km and the meter starts running when the ambulance is dispatched. Rural Manitoba has a $170 basic pickup charge and a fee of $2.50 per km, but that starts once the patient is loaded, not from the moment the call is made.
Transfer costs
About half of all ambulance trips on the Prairies are for emergencies. The other half are transfers between facilities or to drive them to larger hospitals for tests, said Bartel. Alberta and most other provinces will pay for transfers between health facilities.
Saskatchewan picks up the cost of inter-facility transfer in the cities, but not from a rural facility to the city. In Manitoba a patient only pays for the ambulance during a transfer if they stay overnight.
“I’ve seen ambulance bills of $3,000,” said Bartel.
But no one is ever refused ambulance service because they cannot pay, said Deborah Jordan, who is chairing the Saskatchewan Health committee that is reviewing emergency service. She said it is rare for people to appeal their ambulance bills.
Saskatchewan will provide $15.7 million to health districts this year to help pay for ambulance services, Jordan said. The province also pays the trip for those on social assistance, children under 17 and caps a senior’s bill at $250.
The seniors’ benefit cost $2.4 million in 1999 for 8,000 claims. Social assistance claimants cost $1.1 million and children $100,000.
Jordan said Saskatchewan Government Insurance covers ambulance fees for people in vehicle accidents. Worker’s compensation pays the ambulance for those injured on the job. Her committee, which should have a report by fall, has been looking at the standardized service issue, for fees and staff training.
Air ambulances, which operate differently from road ambulances, cost Saskatchewan $2.7 million for the 927 flights made in 1999-2000. While any person can call a road ambulance, only doctors and hospital staff can call for an air ambulance. Individuals or their insurance company pay a flat fee of $350.
