Why do you have to pay for an ambulance?

Numerous media stories in the last year have highlighted the burden of ambulance fees for many Canadians.

There is the story of the Saskatchewan woman battling fatal cancer whose non-optional ambulance trips from one hospital to another amounted to more than $5,000.

There is the mom who had to call the ambulance several times when her daughter was struggling to breathe and faced almost $7,000 in fees at the time of her daughter’s death.

There is the Winnipeg man with epilepsy who racked up ambulance bills amounting to a down payment on a house.

And there are many more.

A recent CBC investigation revealed that the price patients pay for ambulances differs widely depending on where they live, ranging from $0 in the Yukon to over $500 in Manitoba. In Saskatchewan, add on fees, like per-kilometre charges can put single rides over $1000.

Should any fee be charged in the first place? Healthy Debate explores.

Ambulance services: a transportation or health service?

Most paramedicine programs opened their doors in the 1970s, and paramedics received far less training then compared to today. “In the ’60s and most of the ’70s, paramedics didn’t really exist.  It was ambulance drivers quite literally, maybe with St. John’s first aid,” says Penny Price, director of the Regional Paramedic Program of Eastern Ontario.

When the Canada Health Act was being drawn up in the early 1980s, ambulance services weren’t included as a medically necessary service because these services were still seen more as transportation than health care.

Today, however, paramedic services are much more integrated with the health system, and paramedics provide sophisticated health care at the scene and along the way to the hospital.

“More and more throughout this country, we’re becoming integrated with the health care system,” says Chris Hood executive director of the Paramedic Association of New Brunswick.  Still, the idea that paramedics provide medically necessary health care has been slow to catch on among health policy makers.

Several years ago, shortly after paramedic services had been integrated into Alberta Health Services, Price asked if the organization planned to get rid of the fees because  the services were now part of the larger health system. “I just got a blank look. I think at the time it was just too new a concept.”

The ‘inappropriate’ use justification – is it backed by evidence?

Across Canada, some policy makers argue ambulance fees reduce inappropriate use. For instance, earlier this spring, Roger Melanson, New Brunswick’s finance minister told the media that reinstating a charge would “deter inappropriate use so ambulances are available for emergency calls.” Carolyn Ziegler, public affairs officer for Alberta Health, explains the province’s $385 fee for ambulance transportation to a hospital helps ensure services are “available when they are needed the most” by reducing demand from people who don’t really need an ambulance. “There is international research to suggest that eliminating fees can increase the number of less urgent requests,” she writes in an email.

Ziegler pointed to two studies. In one, Japanese researchers asked participants whether they would call an ambulance based on various scenarios and fees. But this survey isn’t very useful, because it asks people what they would do in hypothetical situations, when they’re calm; it doesn’t look at what people actually do in real, stressful situations.

The second study looked at ambulance calls at a single facility in Queensland, Australia, where ambulance fees were abolished in 2003. The study found that arrivals by ambulance increased slightly, from around 5,150 visits in 2002 to around 5,900 visits in 2004. As ambulance users in 2004 were slightly younger and had slightly less serious health issues, on average, the authors suggested the “free” ride may have encouraged people with non-urgent issues to call the ambulance.

But other studies have found that ambulance fees don’t affect inappropriate use. Another study examining numbers from the entire state of Queensland over a longer time period found that the removal of the user charge for ambulances did not lead to a jump in calls.

In addition to the published studies, a CBC-commissioned survey of more than 2,000 Canadians released earlier this year found more than 19% said that fees had stopped them from calling an ambulance. We don’t know, however, if these decisions were made during serious emergencies or less urgent situations.

The province of New Brunswick has a history of removing and reinstating the fees (fees for many patients were removed in 2005, reinstated in 2009, removed in 2014 and reinstated again this past May). So we reached out to the government to see if they have any data on how non-urgent use of ambulances is affected by the removal of fees.

New Brunswick’s data is also inconclusive. For example, while usage increased by 4% the year before the removal of charges in 2005, it subsequently increased by 12% in the year after fees were waived. In 2009, when a $130 fee was reinstated, ambulance usage remained steady for the following four years. Then again, there was an 8% annual jump coinciding with the removal of the fee in 2014.

But Karen Scott, a communications director with the government of New Brunswick, cautions the changes may not be due to fees. Hospital closures and other service delivery changes that occurred in the province in the last decade could have influenced the fluctuations in ambulance calls. “The data is not broken down into that level of detail in order to conclusively determine the cause of an increase or decline in usage,” Scott writes.

It’s important to consider that New Brunswick doesn’t categorize calls by their level of appropriateness. So, even if the fees did lead to decreased usage, we wouldn’t know how much the growth was driven by inappropriate, versus appropriate, use.

The problem with trying to target inappropriate use

Inappropriate usage of ambulance services is an issue. Numerous Canadian and international studies have concluded that about 30% of ambulance calls were inappropriate, according to Deirdre DeJean, a postdoctoral fellow in the Department of Clinical Epidemiology and Biostatistics at McMaster University, who has summarized this research.

But there’s a reason why fees might not prevent the problem of inappropriate use. In order to be deterred by a fee, patients must know that the situation isn’t urgent. The 19 Ontario paramedics DeJean interviewed explained that a situation that a health professional sees as a non-emergency is often seen as an emergency by a patient. Patients don’t always have the medical knowledge necessary to differentiate between an emergency or non-emergency, and they’re not always aware of alternatives to ambulances.

According to Price, it’s “the extreme minority” that deliberately abuse the ambulance system – calling an ambulance to get a ride to a place near the hospital, for instance. Most of us call an ambulance when we don’t need it because we think we need it. As Price sees it, a fee isn’t likely to be a deterrent in the majority of inappropriate calls, because patients see their calls as appropriate.

Interestingly, even though Ontario has a fee for “inappropriate” use, it’s extremely rarely used – in large part because the doctors don’t think patients should be expected to know when a health problem is urgent or non-urgent. “I don’t think [the inappropriate use fee] is charged more than a couple times a year,” explains Dr. Michelle Welsford, an emergency physician at the Hamilton Health Sciences Centre in Ontario. DeJean’s research also found that doctors tend to only tick the ‘inappropriate’ box in the very rare, egregious forms of abuse.

But there’s a bigger problem with trying to use fees to stop inappropriate users from calling ambulances: it’s possible you also stop people who really need an ambulance from calling.

There are anecdotes of this happening. According to Hood, elderly people have called the ambulance saying things like: “I’ve had chest pain for three days and I’ve been trying to avoid calling an ambulance because I can’t afford it,” he says. “The longer some of these individuals experience the symptoms, the worse their disease becomes.”

Though not particularly looking at ambulance fees, the largest study on user fees in health care found that hospital user fees stopped people from accessing life-prolonging care just as often as it stopped people from accessing health services that weren’t necessary for them.

Is there a way to get rid of ambulance fees?

Aside from the ‘transportation’ designation, and the need to avoid inappropriate use, ambulance fees are justified on the basis that the system just can’t afford to cover the entire cost. To Hood, it’s a disingenuous argument. He points out the government of New Brunswick will only collect $750,000 per year out of a $110 million ambulance budget now that it has reinstated a $130 fee. “That’s pretty small potatoes,” he says, arguing the government could afford to cover the cost of the fee.

Overwhelmingly, the sources we spoke to argued that rather than charge patients, health systems should instead save money in other ways. For example, reforms to paramedic services can result in patients being directed to urgent care centres or community mental health services, when appropriate, instead of expensive emergency departments.

Such innovations are already well away in other parts of the world, and being experimented with in Canada. However, as of yet, there isn’t enough evidence to show whether these programs save money.

Following the lead of EMS reforms in the UK, Alberta has initiated programs where paramedics can treat patients on scene so a hospital visit isn’t necessary, or direct them to alternative treatment centres.

Dr. Francois Belanger, Calgary Zone medical director with Alberta Health Services, explains that for several years now, paramedics have been able to call a physician 24/7 for advice when they’re not sure if someone needs to go to the hospital.

Hood points out the new treatment and referral options for paramedics are being considered in a number of jurisdictions in Canada. “They’re clearly primary health care, and they have such huge potential to mitigate ER overcrowding and hospital bed-blocking,” he says.

Even before an ambulance is called, 911 dispatch systems can be designed to direct non-urgent callers to other services. In Alberta, a caller can be referred to a 24/7 poison control line, for example. But in most parts of Ontario, 911 responders have no choice but to send an ambulance in a health-related call.

Patient education can also help reduce inappropriate use. In Alberta, the Know Your Options service provides detailed information – including hours and locations – on alternatives to emergency rooms, such as urgent care centres.

But Price worries that such innovative  programs won’t be as successful if the fear of fees means people avoid calling an ambulance and simply show up in the emergency room.

“I don’t want people not to call a paramedic because of the fee, particularly as we become more mature, more sophisticated in the options available to paramedics,” she says.

The comments section is closed.

  • Susanne Hadden says:

    If you are admitted to the hospital, the ambulance fee should be covered by healthcare.

  • Norma Brown says:

    If my small town hospital is sending me via ambulance to a larger centre for a cat scan do I have to pay the ambulance fee?

  • George says:

    In Nova Scotia, the biggest user of ambulance service is the medical service itself. Ambulances spend hours at an emergency department waiting for a bed, and there are times when there are no paramedics available to attend new calls. Emergency beds aren’t being cleared because hospital bets are taken up by patients on a waiting list for a long term care bed, which is facing a critical shortage here.
    There is also an argument to be made that dispensing with fees would reduce administration costs by a significant amount.

  • Marietta Dodds says:

    Perhaps; it would help if a list were made of “appropriate” vs. “inappropriate” calls for an ambulance. For example, what about a broken leg or arm? Or what should the decision be if the person (say elderly) does not have anyone to drive them to an emergency department after a fall? Why should the payment for an ambulance not be under the Canada Health Act the same as emergency department services in a hospital? Some of these are “inappropriate” as well.

  • meddcoambulance says:

    This is amazing information. Very good effort with collecting and collating the information. The presentation is also very fluid. @

  • Martine Gilbert says:

    I would like to know when we take an ambulance in Alberta due to a work accident. Can our Quebec insurance company pay this invoice by filling out a special form?

  • medevac canadain says:

    Thanks for sharing such an amazing and valuable blog!

  • Bob says:

    As typical,i find excuses when comes to money and over charging.Hospitols are suppose to offer a service,instead they have become a burden of very long wait hours and poor medical care.
    Claiming misuse should be a simple task and should be free if needed.It really appears to be operating on a “piece work” system,idk but maybe the drivers are working on commissions.None the less,taxes are high,we pay a lot straight off our pay cheques and SHOULD be seeing some quality health care.

    Let’s not stop at the ambulance cost,then your loved ones want to see you in the Hospitol,let’s charge enormous parking fees and if your job doesn’t have a medical plan,pay for pills/medicine as well.Thank god OHIP covers a lot but i remember the days when the government tried to get used to pay for OHIP and my gut says those days will come back someday soon.

    Bottom line..higher taxes,higher cost of living,less services.

  • Brent says:

    I live in Winnipeg Canada and while at a restaurant I ate something that caused me to feel light headed. Someone at the restaurant (staff?) called an ambulance and by the time the EMS showed up I was feeling fine. Even so, EMS took my health card and assessed me by taking my blood pressure and doing an EKG. They found nothing wrong and it was a false alarm. They did not tell me they were going to charge me and I assumed because they took my health card it was all covered. Since I did not request EMS in the first place and I was never transported by ambulance I thought it was covered under my provincial health care. 2 weeks later the city sent me a bill in the mail for $213. I found out later that the City of Winnipeg EMS has a policy NOT to tell the person that there is a fee in case they refuse treatment and later decide to sue the city if they have a relapse. This of course is a cop-out because I had to sign a waver not to sue because I refused ambulance transport. Around 20 years ago the ambulance “Treatment No Transport Service” used to be free. But some time between then and now the City of Winnipeg decided to institute fees and did not tell the general public about it. The City of Winnipeg has the highest ambulance rates in the country (City rate $529 subsidized and $846 unsubsidized) because it is a cash cow. It is literally highway robbery. All revenues collected go directly into general revenues and can be spent on anything the city wants. Like the “new” police station that cost $213 million to renovate a 50 year old Canada Post building. Of course the bids went to friends of the ex-mayor like they usually do. I’m glad to see my money is being well spent and lining the pockets of friends of our politicians.

  • Steven says:

    Ambulance fees in Manitoba have dropped from 530 dollars to 425 this year which is definitely an improvement. However, I have been reading some of these comments where they say that being transferred from one hospital to another can cost literally thousands of dollars. That is pretty shocking.

  • Brendan Riley says:

    What I find outrageous is that patients are charged for medical transfer from one hospital to another. This is a tax on rural residents who cannot get specialized operations in their small town hospitals. In addition, medical transfers by definition are not abusive use of ambulances but they are charged nonetheless.

  • Madeline says:

    The cost of ambulance service should be based on the individuals income, and billed on a set percentage on that.

  • Ethan Fraser says:

    I have lived in Alberta for about 10 years now, and just recently I had to utilize the AHS ambulance service. While I was on my longboard headed to the store, I fell and completely shattered my lower leg. My foot was not only pointed the wrong way after this, but sagging as if it wanted to fall off. Obviously I couldn’t walk, I was in the middle of the road at the time and I had no means of communication (my cell phone had died). Luckily I was found by someone who lived close by, and she immediately called 911 when she saw what I had done to my leg and ankle. I went into shock and began to pass out just as the ambulance arrived. In this circumstance, an ambulance was my only option. There was literally not an alternative. I had assumed that in a situation where I was in immediate danger the fee would be waived, but just today I received my bill of $385. I just wish the system would account for individuals who have no other choice; some sort of guidelines that charge individuals based on the severity of the case. That way, the people who choose to use the service for a non-emergency would still be accountable to pay the fee, whereas someone who is in immediate danger or in critical condition can have those fees waived.

    • Albert Giesbrecht says:

      You were longboarding in the middle of the street. Ypu should be lucky the cops didn’t ticket you.

  • Roy Sallows says:

    Seems to me that this is a cracker-jack solution for dealing with the chronic shortage of cash that afflicts the Police and Fire Services. I mean, think of it! Cops be dragging drunks out of a bar for a healthy $350 per boozer! Or they be writing tags for those nasty shoplifters they have to pick up at the WalMart, bill the store for, say, $400 each. (Not everybody saves money at WalMart!) And think how happy the Smokies would be to be able to bill the idiots who pile garbage by their garage, and then freak when some maggots toss a match onto the pile. Or when a loving parent locks the kids in a car on a Winnipeg Summer Day!, Man, they could rake in $1,500 a kid!
    The scary part of writing this sarcastic aside, is that some brain-dead bottom feeder might have it read to him/her, and decide that this is, indeed, a clever solution to the appalling lack of money that isn’t there under the Golden Boy.
    Oh, and my solution to the ludicrous billing?
    Stiff ’em! Everybody!
    Or pay them off… a penny a week, and demand a receipt.
    Legally, in some jurisdictions, if you are making payments, ANY size payments on a debt, the debt holder cannot take legal action against you. Find out if Winnipeg/Manitoba/Canada is among those jurisdictions.

  • Roy Sallows says:

    Hmmm… I see a precedent being established here. What if the cops start charging for nuiscance 911 calls? Or for breaking up fights? What if Smokies start charging for false alarms? Same logic all over the place.

  • Len Ferns says:

    I should correct my previous statement…

    After a certain age there is a cap in Sask. ($275.00 after age 65)

    The trick is reaching that age!

    People slightly below that age, or unlucky in life…are looking to get out of Sask.

  • Len Ferns says:

    Everyone has a different level of what they consider to be poverty…(it’s within their own situation) but having said that…The fee danger is not likely to be felt as much in Ontario or BC
    (although, the argument of any fee is still relevant), as it is in some other places.
    This is a Country, and health should be a Country Level issue.

    I lived in Ontario. I now live in Saskatchewan…rural Saskatchewan…
    On my wealth factor…in Saskatchewan, a 30 mile ambulance trip is going to cost about $1000.00.
    I hate to think what a trip to a real hospital would cost. ($3000-$4000 ?)

    Under no circumstances, could I ever consider taking the ambulance and I believe most people in this area also feel this way.

    In the minds of most people in rural Sask – an ambulance is quite simply out of the question, because death would actually cause less problems for the other family residents.

    I truly believe (except for the grossly wealthy), no one I know of in my community would ever cause an ambulance bill to be charged to any of their loved ones.

    The elderly in this province are starting to leave if they can, and I am stunned and shocked that the federal government can allow one of it’s provinces to use a fee structure that is completely out of context with this country!

    Take back some Federal Control !

    • Sandi Miller says:

      You are so right. I lived for three years on an acreage 30 minutes from a small town hospital. When my son required an ambulance that I knew we couldn’t afford. My husband was at work in that town but was unreachable….believe me I called frantically to his place of employment but they refused to call him to the phone or to give him a message. I was forced to call neighbours and beg if they would give me a ride to the hospital with my very sick 6 year old boy who had a 105 F temperature and was as limp as a rag doll. I truly thought he might die or suffer brain damage because of a fever that high. At least now that I’m in the city of Winnipeg I could always call a cab. A system needs to be implemented whereby abusers of the system get charged and real users don’t.

  • Jim ball says:

    I’M a male quadriplegic 46 yrs 5-6c complete, for 23 yrs and highly decided to my disability .in all my years the system is so broke and managed poorly financially and ethnically and badly needing new blood to lead , when I need to go to a hospital to change a folly three days in a row because the folly was to small and taxis have no Hospital gurney there’s no alternative vehicles ,$, agencies or instead of a professional at home non-emergency call in. like European standards for a none emergency call. I rather die then being faced as a hostage for $626.00 = 3 trips. That did not include a hooker and concert ticket . really feeling like a hostage ..or being held hostage leaving a bed poorly need.when this procedure could be done at home.I couldn’t only imagine the stories you’re face with and our future looking pretty bleak, hopefully a solution comes quickly or a combination of both.

    Thanks for the ear. be safe folks.

  • dlo says:

    Working as a paramedic in a rural area of BC, we routinely get called to the various remote reservations in our jurisdiction for “abdominal pain”, only to have the issue magically resolved upon arrival at the hospital. The patient then proceeds to walk out of the emergency department after being triaged, hits up the liquor store and Wal-Mart, then hitches a ride back home. The ambulance bill is covered by the band.

    Conversely, I have had truly sick patients who refused to call an ambulance due to the impending bill. The only reason why they received a much needed ambulance was due to a call by a family member or third-party.

    The issue is complex and goes both ways. Will removing fees lead to a higher incidence of abuse and BS calls? Probably. Will it encourage people who DO need urgent medical care to call 911 who otherwise would not due to financial constraints? Yep.

    I don’t have a solution to offer, just some front line insight.


    • Courtney says:

      Why not make calls for those who need it for free – or who have been advised by agencies like telehealth that it is needed free (as long as the information provided proves accurate – calls for issues that magically disappear and do not require treatment would be considered unnecessary) but for those people who call and are treated should be free and a fee should be installed and charged to anyone who abuses the service.

      • Alyssa says:

        That depends what constitutes “needed”. When having a panic attack, the symptoms mimic those of a heart attack or stroke. Just because someone has anxiety doesn’t mean we can’t have a heart attack or stroke. Calling paramedics is necessary.

        Not to mention, what if a first aid attendant feels the need to call 911, and then the patient is successfully resuscitated before it arrives? A call to an ambulance without transportation should always be free,

  • Keith Meloff MD FRCPC Neurologist says:

    People who routinely use ambulances for personal transportation
    rather than for true medical emergencies are “Crying Wolf”.
    Ambulance service is not a “right”- and diverting an ambulance for
    trivial reasons may jeopardize the timely attendance of another REAL emergency.
    So, if there is no fee, there should also be the capacity to fine
    or otherwise punish those responsible for improper or vexatious abuse of this life-saving resource.
    Lest anyone think otherwise, there are serial abusers of the system,
    especially in rural, remote and underserved areas of Ontario.
    and I have no doubt, that some innocent person, will die as a result.

  • Dyson says:

    Well done, Brandon it s time that somebody had the nerve to ask that question. And I m glad it wasn t me. I think I can shed some light on this topic, even though the short answer is if you earn income, you probably have to pay federal income tax.

  • Anne Marie O'Dale says:

    As a resident in Ontario…with Cardiomyopathy…I have the impression that I should just get in my darn car and drive myself to the hospital or, alternatively, get ‘dinged’. IMO..this is wrong.

    I have never called a ambulance…the charges leave me with a very distinct impression that, if I have a need…I should not.

    Something is very wrong with the system as it currently stands.

  • Life in the North says:

    %featured%It is very interesting the ambulance fee debate. What is not mentioned is the cost of medevacs. In most jurisdiction in canada a medevac is between facility to facilities with higher levels of care. What is not known by most Canadians is medevac coverage is not covered if you are out of Province or Territory. The story refrenced there is no charge in the Yukon. This is true if you are a Yukon resident but if you are from out of Territory you end up paying the full cost which can be upwards of $20,000 dollars to be transported from a facility that is unable to provide the treatment required to a southern facility.%featured% This cost needs to be address as I would assume most hard working Canadians couldn’t afford a bill that large. I can understand and rationalize ambulance fees but not fees from a health care facility that can’t accommodate the medical emergency the patient is dealing with.

  • Dan Shannon says:

    Doug Williamson has stated it very clearly. In Ontario, this FEE does not come from the ambulance service, it comes from the hospital you were taken to or from and is imposed by the government, in this case the FEE structure is set by the Ministry of Health and Long Term Care. As a former paramedic we did not send out bills or receive funds for supplying ambulance service. Many people do not actually pay out of pocket however, most health insurance coverage that people have from their employers covers this fee, those being covered by Veterabs Affairs and those on Public Assistance (welfare) have this cost reimbursed. As well many native groups have Federal coverage for the cost of ambulance service.

    %featured%Even if there is a fee, is $45 really that much to have two college trained paramedics show up at your door with the finest in diagnostic and life saving equipment and medicines, ready to treat you and transport you safely and efficiently to the nearest appropriate hospital?%featured%

  • Deep Trivedi says:

    It’s not a bad idea for people to be charged a co-pay. the usual “I pay taxes” argument doesn’t serve to bridge the divide between the need for high quality services that we demand, and the costs for administering those services. Apart from addressing that, it could be considered a good intervention to limit erroneous calls for an ambulance which is a critical component of our health care system. That said, I would like to see a greater effort made at collecting these fees. The current setup after all ‘punishes’ those with a predisposition to comply with a bill arriving in the mail for fear of some recrimination vs. those that simply ignore and discard such a bills.

  • Doug Williamson says:

    In Ontario the $45.00 fee is split between the hospital the patient is transported to and the government. The $15.00 the hospital keeps as an adminstion fee. As most of the paramedic services are municipal, why is the hospital and provincial government taking the fee. The fee is not for the Ambulance it relates to nothing more than a tax grab and will not deter abuse. Those that abuse and many do, would simply throw the bill in the garbage. The full fee for service 345.00 is rarely used even when abuse is obvious.
    The reason….once the doctor checks that box …the patient will be on the phone complaining and the hospital administration does not want that call. The hospital still receives $15.00 even when the box is checked and that does not change for when full payment is charged. Many insurance companies will cover the fee charged by the hospital and government for the service provided by the Ambulance service . Car insurance, WISB, and many social service programs also cover the fee.
    So let’s set the record straight. This is not ambulance fee this an administration fee charged by the hospital for arriving by Ambulance, and a government tax.
    As a Paramedic in the province of Ontario I can tell you I am invoiced the same as everyone else if I call an Ambulance. If you still think this is a fee for service then please explain why this fee does not change if I provide Advanced care or simply drive the patient the the hospital.

  • Tom Closson says:

    %featured%I believe, rather than charging fees, Paramedics should be adequately trained, supported and empowered to make decisions regarding appropriateness of pickup and the potential for diversion.%featured%

    • Rick Verbeek says:

      Tom, we are looking exactly in this direction. In our Alternate Pathways Project we are developing a means to use Telemedicine to make a “3P” connection (Patient, Paramedic, Physician) to consider non-hospital destinations (or pre-hospital point of care treatment) for patients with minor conditions.

      • Marina Graham says:

        Brilliant strategy!

      • Andy says:

        |Unfortunately, at least in Toronto, Telemedicine always says to call and ambulance!

      • Andy says:

        Actualyy, I meant Telehealth!

      • Courtney says:

        yea I called 311 was forwarded over to telehealth and told that an ambulance should be called for my grandmother. They transferred us over and had the ambulance sent. She died but they are still charging her $45. I had no idea there was a fee for ambulances. If I had known we would have driven her there but telehealth gave us the impression that an ambulance was needed and the best option. Now she is gone we are stuck with a bill and it would have made no difference if we had driven her or if the ambulance had picked her up. – Not to mention it took forever for the ambulance apparently they drove from Oakville … and we are in Milton !

      • Jennifer says:

        I’m so sorry for this disgusting delay in healthcare to your loved one. This touched me because I know and live in the area and know the distance. There is no way they can say that there wasn’t a more available, closer ambulance? This is a farce! I hope you find peace and that those responsible for the lengthy delay and questionable distance be punished. Shame on who ever was involved

    • Marie-Julie Loranger says:

      Paramedics go through a rigrous two-year program, including almost 400 hours of preceptorship (riding and working with a crew, with one member being the “teacher”). A big part of the problem is a abuse (I’m a paramedic and have many disturbing stories of ridiculously useless calls), and the other is doctors refusing to let us perform medical acts (the get paid by the act, so less cash for them). I’m also not going to hide that the more training, skills we need, meds we give, we want to get paid better. Trust me, this is not an easy job!

      • Jennifer says:

        I agree ☝️ I’m not a paramedic but our (husband and I) best friend is a ambulance driver and you are under payed under appreciated, abused, tired of the same ppl calling or picking up the same ppl for overdoses causes a long term trauma to be present in your everyday life. People usually have one traumatic experience, paramedics see trauma daily, and death and disease, children hurt by idiots or drunk driving. It overwhelms me just speaking of what he has to deal with. We say quit but it’s all he knows and I’m worried his job is going to consume him completely. But it never takes away from him being an amazing person father friend and husband to his wife. Bless all of you

    • Christian says:

      I have been receiving bills from 1 ambulance ride my 3 month old daughter needed for over 1 year…I just don’t open the envelopes…but they send many many times. (Perhaps the $130 pays for their paper usages???) I have lived in 6 provinces, of which only 1 other province charged me for an ambulance call. ALBERTA the capitol province of Greed in Canada…I find charging a 3 month old for an ambulance ride to be the EPITOME OF GREED. When I received a letter from a Credit Company addressed to my child, I opened the letter. They are threatening my child’s credit score will be affected by non-payment of the ambulance bill! My child could not call for an ambulance – I had to call on the behalf of my child, and it happens to be the ONLY ambulance ride my child has needed and my child is now almost 2 years of age. WHEN DID EXTORTION OF BABIES BECOME OK IN CANADA???? I will be calling the Extortion agency to ask questions today, but I really feel strongly towards NOT PAYING. I will be recording the call I make to them and sending it to several News Reporting Groups. Hey, I was in a car accident and 1 of the paramedics stole my purse from between my legs while I was strapped down and could not do anything. I had to replace all of my identification cards and that cost ME almost the price of an ambulance ride and who paid for that? ME – but really the SJA should have paid that for me! I had to call an ambulance another time for myself having a severe asthma attack and they sent that very same ambulance attendant who when alone in my front foyer of my residence, he stole the gel pad from my bicycle seat and yelled at me that he was having personal marriage problems that effected his ‘sanity’ at work so I better not give him a hard time because he is not mentally stable! REALLY? I was not monetarily charged for either of those ambulance rides but my they decide to send my child’s name to a Collection Agency for the 1 ambulance she ever needed. WHAT DO YOU ALL THINK OF THIS>

      • Christian says:

        There should at least be a warning when people call for the ambulance service of the expected fee for using that service BEFORE PEOPLE get into the ambulance.


Wendy Glauser


Wendy is a freelance health and science journalist and a former staff reporter with Healthy Debate.

Sachin Pendharkar


Sachin Pendharkar is a respiratory and sleep doctor and an Assistant Professor of Medicine and Community Health Sciences at the University of Calgary.

Michael Nolan


Michael Nolan has served Canadians through many facets of Paramedic Services.  He is currently the Director and Chief of the Paramedic Service for the County of Renfrew and strategic advisor to Healthy Debate

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