A Public-Private Partnership

Your Feb. 12 article, “Ambulance Proposal Debated at Hearing,” states, “When private ambulances are dispatched to transport victims to hospitals, county paramedics often ride along to administer treatment. The patient is then charged about $300 for the service.”

That gives the impression the ambulance companies are billing for paramedic level transport, thus receiving some type of public sector subsidy, which is not the case. No such subsidy exists and never has. Ambulance services bill only for the service they were contracted by the fire department to provide, basic life support, even when advanced service is provided with a fire paramedic.

It is the Orange County Fire Authority that, since 1982, has continuously provided a direct multimillion-dollar subsidy to the health insurance industry, including Medicare, by continuing to provide paramedic services with tax dollars when health-care dollars have been available to offset paramedic program costs.

Although not currently done, it is possible for the private ambulance companies to bill for this service on behalf of the Fire Authority if they adopt a cooperative system of billing as suggested over 10 years ago. This would bill insurance companies for the recognized service level that the patient actually receives: basic life support when provided with an OCFA paramedic. This is the only rate structure approved by Medicare for reimbursement and does not require the OCFA to start their own ambulance service.

Government officials have stated that without these publicly paid services, private ambulances would have to be staffed with paramedics. Private ambulance services want to staff with paramedics. This will eliminate the need for the Fire Authority service and having to have another Fire Authority crew and vehicle move into the place of the first.

The OCFA is on record stating “. . . the relationship between the fire department and the [private ambulance] should generally be one of cooperation--not conflict--achieving the best possible marriage of the public interest with private motivation and expertise . . . to create a business relationship between the fire department and the [ambulance service] in which financial incentives are aligned. . . .” I support this philosophy and look forward to continuing the teamwork between Medix and the OCFA.

MICHAEL DIMAS, President, Medix Ambulance Service, Mission Viejo