Waiving ambulance fee for COVID-related emergency calls could lead to more changes

The Nova Scotia government's decision to waive ambulance fees for people in a COVID-related emergency could have lasting effects on the future of a bill some people see as a barrier to getting care in times of urgent need.

On Monday, the province announced the fees would be waived following reports of several people not calling for help when they needed it due to concerns about the bill they would face.

With the province in the midst of its third wave of COVID-19, and infected people getting sicker faster, Health Minister Zach Churchill said it was vital that no one think twice before dialing 911.

"This is a pandemic," he said in an interview. "This is an urgent situation and people that are having acute COVID symptoms and also those that are known positive cases, need not worry about that fee."

Between October and last week, 52 people who called for an ambulance due to COVID-related issues were charged a fee.

Nova Scotians with a valid health card requiring an ambulance to get them to hospital are billed $146.55. The cost is higher for non-residents and new Canadians. People can apply to have the fee reimbursed based on financial need.

The province collected about $13.5 million in ambulance fees last year, a fraction of the $166 million budgeted for the EHS system, and even less than the overall $5-billion budget for the Health and Wellness Department.

Given the small amount of money and Monday's decision, some people are questioning why the approach being taken for COVID-related emergencies should be different for any other type of emergency, such as heart issues or breathing problems.

NDP Leader Gary Burrill said it should not be.

Burrill has long advocated for doing away with ambulance fees. He praised the government's announcement and the reason for it, and said it's the same reason there should be no fees for any other kind of emergency situation.

"We don't want to have anybody not availing themselves of emergency services because of financial circumstances," he said in an interview.

"We've got this world-class ambulance system, we have a world-class hospital system, but none of it will work as long as people are worried about the money and are therefore hesitant to make that call and have the ambulance come."

The province often writes off several million dollars in uncollectable ambulance fees each year — many of which are presumably cases where people couldn't afford the bill, said Burrill.

"We don't ask questions about what you can afford when you get to the hospital, we don't ask any questions about what you can afford when you get to a clinic, so why are we asking questions about what you can afford with ambulances?" he said.

Tory MLA Colton LeBlanc, likewise, said the government's decision about COVID ambulance calls opens the door to a wider discussion about the affordability of the system.

LeBlanc, who worked as a paramedic before being elected, said there were times when he arrived at calls wondering why the call for help hadn't come sooner, only to learn there were financial considerations at play for the patient.

"For them, that [bill] is a significant hurdle for them because it could be the difference in paying their power bill, paying for groceries, or paying for medication in many instances," he said.

While the focus right now is on COVID because of the severity of the situation, Churchill said he expects this will be another situation where the system evolves based on the experiences of the pandemic.

"There will be, I think, an ongoing conversation around this and what we learn from this experience will contribute to that," he said.

"These are important questions, I think, that we always have to ask ourselves when it comes to the delivery of, particularly, health services. And if there's ways that we can further enhance access and save more lives, those are decisions that we have to make."