# Tax-paying man refuses to pay 911 bill



## MMiz (Apr 15, 2010)

*Man refuses to pay 911 bill*

SAN BERNARDINO - To Edward Poffek, paying $200 for paramedics when he already pays taxes is just ridiculous.

A 30-year resident of San Bernardino, Poffek never had to call 9-1-1 for medical service until Sept. 16 of last year.

The first time he ever heard of the charge was when he got the bill in November.

"I refuse to pay," he said. "I'm not going to pay it. They can take me to court. They can file a lien."

"The Police Department doesn't charge if I call 9-1-1. It's a public service," Poffek said later.

Charging for emergency medical services has become an increasingly populary way for local governments to shore up their budgets. 

*Read more!*


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## medic417 (Apr 15, 2010)

Good for him.  But I hope he loses as the public is going to have to realize that even if no transport happens if they call they pay.  Not like you go to the doctor and if he doesn't hospitalize you, you get out of paying.  Whats funny is he will lose more money fighting than that bill is.


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## Shishkabob (Apr 15, 2010)

Funny, I pay taxes and I still pay for city water, city garbage, school supplies at public education institutions, and other so-called "public services".


Why isn't he complaining about that?


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## 8jimi8 (Apr 15, 2010)

cause of the "free" babysitting i'm sure.


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## 8jimi8 (Apr 15, 2010)

you have to admit, he has a point.

The way we explain all of these "taxes," it makes it sound like 911 should be free.  

I mean, that is what I grew up thinking... pay taxes for school, fire/police/ems for the public services...

anyone disagree that that is the idea that was put into your head, growing up here in the USA?


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## DrParasite (Apr 15, 2010)

The problem is multi fold.  

1) many places charge lower taxes for EMS, and have those who use the service pay for the rest (in forms of insurance, billing etc).

2) you can't charge one person and not charge everyone who calls; that is called discrimination.

3) EMS MUST MAKE MONEY.  Fire and Police are known black holes for taxpayer money.  This is known and accepted.  EMS has to make money, because it is often thought of as part of the healthcare system, not public safety.  So you must bring in some revenue to offset expenses.  Don't agree with it, but many governing bodies do

As an aside, I love volunteer EMS agencies that don't bill patients, because that's wrong.  They rely completely on donations.  Doesn't matter that ALS is gonna bill them, as is the ER, the hospital, the specialist, the doctor, and any Xrays that are taken.  but volunteer BLS should rely completely on donations (not tax money) to stay alive.

4) He called for 911.  He requested the service.  He used the service.  He should have to pay for said service.  many FDs are going toward billing for MVAs and other previously free services.  PD charges for reports to be given to people.  You want a service, pay for it.


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## bstone (Apr 15, 2010)

The solution is simply- just add $200 to the general city tax for every citizen and send it over to the ambulance service. This way they won't know what it is going for.

If the fellow doesn't want ambulance service then he ought not call 911 when he has a medical crisis.


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## JPINFV (Apr 15, 2010)

To be fair, I wouldn't want to pay for someone who wants "to deliver medication directly into the bone marrow if a patient's lungs are collapsed. "



> Horak said San Bernardino paramedics have recently taken on training to detect heart attacks with what's called 12 lead EKG technology and to deliver medication directly into the bone marrow if a patient's lungs are collapsed.


So $200 per response and you've finally entered the 1990's? You're proud of being this far behind in medicine? Maybe this "advanced paramedic services" is too advanced if you're almost 20 years behind in the times. 

Additionally, isn't this one of the arguments for EMS based fire suppression? That it's cheaper? Yet they somehow get off on charging for a $200 response, regardless of transport? Screw that. If I'm paying $200, I expect the person who can give the happy drugs to ride along, not hop back into the express bus back to the recliner.


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## reaper (Apr 15, 2010)

Most people do not realize that the taxes they pay are there for the "what if's".

Your EMS tax is there to provide that there is an ambulance and crew at the ready. It does not cover the actual use of said service.

I think all EMS should be free of charge. But, we will raise their taxes by a 100% to cover all the costs.

FD and PD is a black hole of taxes and that is known. But, they do not have the reoccurring expenses that EMS has. When FD or PD run a typical call, they are not using $1000 worth of supplies. Those supplies have to be covered by someone!

Most people start to see this, if you take the time to explain it to them.


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## EMSLaw (Apr 15, 2010)

Municipal EMS is usually sold as either a profit center or, at least revenue neutral.  Which is fine with people, until they get a bill for services.  How did they think that was magically going to work?

I do find it somewhat ironic that in this thread we are "a public service" while in others we are "healthcare providers" who should not be lumped in with police and firefighters.


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## Shishkabob (Apr 15, 2010)

LE and Fire are public services.  The public at large has something to gain by fire or LE doing something on a call.

EMS is for the individual gain.


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## MidwestFF (Apr 15, 2010)

I can see both sides of the coin. I know our department call volume is in record territory and incresaing every month, yet our budgets have been cut several times in the last two years. I have personally seen ambulance bills for well over $2,000.00 when I lived in Southern California so $200.00 doesnt seem too bad to me.

The general public wants increased, limitiless service but yet does not want to pay higher taxes. I like the option that is breifly explained in the article, you can either pay an extra $24.00 per year, or be out of pocket $200.00 per occurence. I honestly wish they would do the same for the fire service.

On the fire side a typical MVA will cost thousands by the time we have to properly dispose of the absorbents used to clean up the fluids, and replace the supplies that we use. Yes, use the tax base to keep the agencies alive, but the people that use and sometimes abuse the services should have the burden of paying for them either by insurance or directly out of pocket.

Just my 2 cents.


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## Veneficus (Apr 15, 2010)

Linuss said:


> LE and Fire are public services.  The public at large has something to gain by fire or LE doing something on a call.
> 
> EMS is for the individual gain.



I don't think that is entirely true.

As I have tried to point out many times, the purpose of medicine in society is to keep people productive members of society, so they can work, pay taxes, raise their families, etc. 

Anytime you provide medicine to an individual you promote the public good. Whether it is keeping somebody active into their 80s or 90s, treating an STD so it doesn't make the rounds infecting the population, or something as mundane as a physical examination to make sure people aren't about to code and cost all kinds of money and resources when they start their weight loss plan. 

Public health vs. public safety is an individual agency matter. Showing up emergently and taking somebody to the hospital is public safety. But from EMS prevention and education programs, to the actual patient care it is all a function of healthcare. While not mutually exclusive, the more resources you spend on one takes away from resources from the other. As has been demonstrated around the US and other parts of the world as well, EMS as a public safety simply cannot work anymore. The need outstrips the resources that are given. The only way forward is to move away from public safety towards healthcare and its strategies. Otherwise, eventually the need will consume all the resources there are and still not be enough.


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## Tincanfireman (Apr 15, 2010)

MMiz said:


> "I refuse to pay," he said. "I'm not going to pay it.  They can file a lien."


 
Which is exactly what happens in my county. Don't pay the bill, and the amount is deducted from your annual tax return.


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## 46Young (Apr 17, 2010)

I can see this guys point. In addition to income taxes, the gov't likes to add on additional taxes to everything, as well as hidden taxes. We never paid for water, sewer, or garbage in NYC as renters, but you pay for all that down South. We have to pay property tax on cars every year in VA and SC, but not NY. We don't pay tax on regular food items such as bread, milk, meat, and such in NY, but you're taxed on everything in the south. There's that phone tax to pay for the Spanish-American War, as well as many other taxes and surcharges: 

http://www.usatoday.com/money/industries/telecom/2006-05-25-phone-tax_x.htm

Think about all of the toll booths still collecting for bridges, tunnels, and highways. They were only supposed to be temporary to pay for the construction, but they're still in effect, probably for good, I'm sure. It costs me between 25-30 bucks each way from VA to Queens NY, and I need to take the Verrazano in and the Holland out, otherwise it would be even more. We're being nickle and dimed to death. 

A clear exemple of hidden tax would be the new VAT proposal. This ought to be a replacement for personal income tax, but it's being proposed as an addditon to income tax. The VAT would force illegals and entitlement schemers to pay tax through the increased price of goods and services. This would be a good thing if these increased prices were offset by the elimination/reduction of income tax, but it's not. If you wanted to save and invest, you could keep more of your money by not making purchases. This won't be possible since federal income tax will still be in full effect. The VAT would be good when combined with income tax reduction/elimination since 47% of Americans pay no federal income tax whatsoever.

When you think about it, we pay out way more than the 1/3 or so in tax that we give up. I can understand this guy's outrage.

Having said that, though, I can see there being a fee structure for EMS. Unlike fire and police, EMS exists as a for profit enterprise in many areas, and uses more supplies and resources than other public services. The vast majority of 911 EMS calls aren't appropriate for EMS eval/txp by ambulance in the first place, so it would stand to reason that there should be a fee structure in effect to offset what would be a financial black hole otherwise. It would be nice if these fees discourage 911 abuse, but it probably won't, since the poor are generally excused from paying anyway.


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## fortsmithman (Apr 17, 2010)

Linuss said:


> LE and Fire are public services.  The public at large has something to gain by fire or LE doing something on a call.
> 
> EMS is for the individual gain.



Here in my town EMS is considered a public service.


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## rescue99 (Apr 17, 2010)

MMiz said:


> *Man refuses to pay 911 bill*
> 
> SAN BERNARDINO - To Edward Poffek, paying $200 for paramedics when he already pays taxes is just ridiculous.
> 
> ...




Never agreed with paying twice for the same services. The Fire Chief here would love to ring my neck because I tell anyone and everyone who will listen that after the FD bills twice with no response, they write off the rediculous over charge. I go to township meetings every chance I get to voice my concerns about departmental waste and wasteful spending...such as a multi-milion dollar state of the art station that gets but 4-5 calls a week and new trendy coats twice a year at $400 a pop (for over 60 FF). Voters are not responsible for wasteful spending. The FD was given a sweet millage...they need to remain within their financial limits.


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## 46Young (Apr 17, 2010)

Oh, I almost forgot, with this new healthcare thing it's basically a tax on being alive. That's right, if you don't buy insurance, you owe the gov't. 

Also, Lotto is a tax on the poor, in a sense. You don't generally see the affluent or gainfully employed playing lotto, maybe once in a blue for a goof. But go to any poor neighborhood and you'll see lines for Lotto when the jackpot gets up there. Say the average person spends five bucks a week on Lotto, maybe even more on scratch offs and such. Some spend that almost every day. Anyway, that's around $260/yr per person. I think the gov't keeps half of the proceeds or so, I'm not really sure. If this is accurate, the gov't gets this voluntary "tax" to the tune of $130 or so per person every year.


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## 46Young (Apr 17, 2010)

rescue99 said:


> Never agreed with paying twice for the same services. The Fire Chief here would love to ring my neck because I tell anyone and everyone who will listen that after the FD bills twice with no response, they write off the rediculous over charge. I go to township meetings every chance I get to voice my concerns about departmental waste and wasteful spending...such as a multi-milion dollar state of the art station that gets but 4-5 calls a week and new trendy coats twice a year at $400 a pop (for over 60 FF). Voters are not responsible for wasteful spending. The FD was given a sweet millage...they need to remain within their financial limits.



It's three times and they leave you alone over here. County residents aren't billed past what their insurance pays. No out of pocket. Out of county residents are billed fully, however. There are hardship waivers that you can submit if you're legitimately poor and show an inability to pay.

Assuming your dept is career, I would caution the line personnel that this frivolous spending may result in layoffs, brownouts, downstaffing and such in the future. Not to mention pay raises, COLA's and other benefits. Get them to take a broad look at things and think about where their priorities are.


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## Veneficus (Apr 17, 2010)

46Young said:


> Oh, I almost forgot, with this new healthcare thing it's basically a tax on being alive. That's right, if you don't buy insurance, you owe the gov't.
> 
> Also, Lotto is a tax on the poor, in a sense. You don't generally see the affluent or gainfully employed playing lotto, maybe once in a blue for a goof. But go to any poor neighborhood and you'll see lines for Lotto when the jackpot gets up there. Say the average person spends five bucks a week on Lotto, maybe even more on scratch offs and such. Some spend that almost every day. Anyway, that's around $260/yr per person. I think the gov't keeps half of the proceeds or so, I'm not really sure. If this is accurate, the gov't gets this voluntary "tax" to the tune of $130 or so per person every year.



They are in the 50%+ group that doesn't pay taxes anyway. With earned income credit of $1000+ a year it is still a net loss.


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## JPINFV (Apr 17, 2010)

46Young said:


> We never paid for water, sewer, or garbage in NYC as renters, but you pay for all that down South.



You pay it either way. Either you pay it directly to the government, or it is included in the rent set by the property owner.


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## 46Young (Apr 19, 2010)

JPINFV said:


> You pay it either way. Either you pay it directly to the government, or it is included in the rent set by the property owner.



Partly true. Rents are still subject to market demands. In Queens NY some landlords tried to pass on the heating costs to the tenant within the lease, but were then unable to find any renters. Not when many other owners, who have owned their buildings for many years with a low/paid off mortgage were not trying to add on that cost.

Oh yeah, I like your EMS TLA in your signature.


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## 46Young (Apr 19, 2010)

Veneficus said:


> They are in the 50%+ group that doesn't pay taxes anyway. With earned income credit of $1000+ a year it is still a net loss.



True, but at least it's a little something being given back to the system.


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## atropine (Apr 19, 2010)

Linuss said:


> LE and Fire are public services.  The public at large has something to gain by fire or LE doing something on a call.
> 
> EMS is for the individual gain.



Not true what about MCI's and natural disasters, everybody gains in those situations.


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## Shishkabob (Apr 19, 2010)

atropine said:


> Not true what about MCI's and natural disasters, everybody gains in those situations.



Still for the individual when it comes to the medicine aspect.  And even than, significant MCIs and significant natural disasters are a relatively rare occurrence for any individual area.


Now if you would have made the argument of public health, such as vaccines and the like, maybe.


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