Patchogue Ambulance Free or Billed Service
Ben Vitale

Patchogue village is currently considering alternate ways to finance our "free" Patchogue Ambulance service. I would like to share one of my ideas with the VOP, in an attempt to minimize the burden on our residents. 

We are currently paying taxes to the village of Patchogue. Part of these taxes are being used to support the Patchogue volunteer Ambulance service. Every resident in our village will eventually use this extremely valuable service... Not one person is exempt! "Free service?" This sounds as bad as the "Social Security entitlement!" Entitlement... I paid a huge sum of money toward Social Security! The word "Entitlement" carries with it the connotation of a "freebie" which it is not! So... The Ambulance "Free Service," is not free; every village resident is indeed paying for it!

 I personally like the Ambulance system, just the way it is! Where have I seen this before? A government takes something that works, and turns it into a disaster! I am not against having the VOP look into other possible ways to subsidize the Ambulance service; only if it's cost is distributed equally on every resident. I am totally against putting more burden on the backs of hard working people that already pay $700. dollars a week to maintain health care for their families. Many working class families are on the verge of collapse, as we speak! 

May I suggest a voluntary system of subsidized support for our Ambulance service! The VOP should send an annual letter, suggesting three levels of Ambulance service support, to every PV Resident! The people that are able to pay will select a level of payment and send a check to the VOP. Hopefully at least some of this money could be used to benefit our valuable volunteers. I am definitely against forcing a hard working family into bankruptcy! 

Please read the comments from John Rocco:
Ben, as you so eloquently put it…. “Nothing is Free”. I agree the cost of Emergency Medical Services has risen like all healthcare for many reasons. Our profession has seen expenses accelerated by things like new complex medical equipment needed in the advanced care we provide to patients, our insurance premiums, medications, government mandates, clerical costs to perform reporting requirements, Vehicle equipment, compensation insurance, physical plant, vehicle replacement cost, services, fuel, lighting and so-on rise and will continue to rise. Comparing the services required of the Patchogue Ambulance Company of today with that of yester-year is like comparing an apple and an orange. Over my 45 years of tenure we have used every conceivable means possible to raise sufficient funds to resist dependence on government contracts for service and we like all other similar EMS entities in the past have come to the realization that a “charity” based approached that you propose was and is unrealistic.

Several decades ago I along with several Company and government officials crafted funding avenues for the operations of the Company and as such we have been able to survive with dollars received from the tax base.

It is important to understand however that we are not controlled by local government and only have a contractual relationship with local government to supply needed funding. The Patchogue Ambulance Company since its inception in 1934 has been and always will be an independent non-governmental 501 C3 Not-for-profit entity charged with providing Emergency Medical Services in our catchment area.

So you may ask what has changed that is causing us to look at alternate means of funding. The Governor and State Legislature invoked Tax Cap which limits local Government from increasing taxes beyond the percentage evoked by the State. All Government is now responsibly looking for alternate funding streams to keep services from declining. We of course face many challenges to providing the service as our funding stalls our expenses do not. No State cap was imposed on vendors who we do business with, supplies and services we require are not capped and we become faced with the issue of keeping pace with the ever increasing demand put on us by an aging and growing community with diminishing resources.

Ben, Government simply does not have the additional funding required to keep all its programs in tact without piercing the tax cap (raising taxes), something they are loath to do.

What makes our situation special is that we have long ignored what the rest of the country does which is to charge a fee for service. While you may think this punitive in some way I can’t think of a more practical way to insure adequate funding for the users of EMS then to require those who make use of the service help pay for the service. In fact we here on Long Island have only served to make the coffers of the insurance companies a little richer by not billing for something we are already paying for in our insurance premiums! There is no special policy rate for those whose ambulance service costs are bourn totally on the back of the tax payer alone! We who do not bill in fact must be quite an oddity (if not a laughing stock) in the board rooms of most health insurers when they see that their policy holders in this area never get billed for service where all the rest of their customers outside of our geographical area do. The reality is that if you fall on the street in most every town in the USA the local EMS agency will show up, render care, transport you to a hospital and bill you for the service. This is the norm, not the exception! Go to Nassau County and be treated by the Nassau County PD EMS or go to New York and have any EMS agency (of which there are many) respond and render treatment and yup… you’re going to get billed. Most every jurisdiction in our country works in this manner.

Ben, a fee for service will not pay for all the costs for providing EMS because as you rightly noted there are the poor, the indigent, and the uninsured and just as these folks don’t pay for medical services at the local Emergency Rooms, they’re not going to be paying for EMS either. Traditionally the cost is paid by me and you through some tax revenue (in the case of EMS) or the famous $25.00 Dollar Aspirin (in the case of the emergency room) so that we like all health care professionals can treat all people equally without regard to whether they have the means to pay or not.

Ben, we know that the future for EMS is ever growing and changing. Our members responded to almost 3000 calls for EMS services last year. We do this quietly, without fanfare and expect very little in the way of accolades for the many lives we impact and save daily. Our members spend countless hours training in class, in the field, and on calls for help from a broad diverse community and this will not change going forward. What will change and continues to change are new and exciting procedures and techniques to preserve life, this as well as new onerous mandates from Federal, State and Local government will continue to increase is the cost of EMS and it’s a price that someone has to pay. We are not alone in this issue as all folks associated with providing health care seem to be in the same quagmire, but the very nature of being in the life saving business does not afford us the option of diminishing our level of service in order to meet a decreasing budget.

We’ve all heard of the heroin addiction problem plaguing our community, here’s just one item to think about…. 4 Years ago the cost of Narcan (the drug we use to reverse the effects of an opiate or heroin overdose) cost about $4.00 a dose, today it’s North of $45.00 a dose.

Ben if we could ask the taxpayer to dig in and pay more we would be justified…. But also we would be negligent if we didn’t first find all sources of income to defray the cost of providing service. The Village fathers are right in asking the question of us to consider helping defray these costs by any means possible after all I like you am a tax payer too and unless I were selfish and had a ton of Health insurance company stock in my 401K not making the insurance companies pay is just plain wrong.

As to the idea of a voluntary suggested level of service payment; every year the Patchogue Ambulance Company sends out several letters for donations to pay for those items not paid for by contract dollars. We indeed suggest a level of donation to help defray some of the cost of running the Company side of our business. We consistently receive less and less each year even though we have more and more recipients to send these requests to. If this was our only funding mechanism to fund the Company we would be in business for about 10 days and then have to close the doors.

The realities of a modern EMS system are very different, complicated and costly compared to the old days of a simple ride to the hospital.

John V. Rocco
Chief Executive Officer
Patchogue Ambulance Company

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