I’ll be honest…I was all for it at first.
When I heard about Douglas County charging a fee for EMS calls where a patient is treated but not transported, it made sense to me. We use medical supplies, we spend time on scene, and we send out trained professionals. From that point of view, it feels fair to recover some of that cost. On top of that, I thought it could help reduce the number of non emergency calls that tie up units.
But the more I sat with it, the more I started thinking about the people we actually serve every day in Clayton County. That’s when my perspective started to shift. It’s easy to look at this from a system point of view, but when you look at it from the community’s side, things become a lot more complicated.
The truth is a lot of people are already struggling just to keep up with everyday expenses. We’re talking about seniors who can’t easily get to a doctor, families without reliable transportation, and people who don’t have insurance or consistent access to care. For many of them calling 911 isn’t just about emergencies it’s about access. It’s the only option they feel they have in that moment.
Now imagine adding a fee on top of that. Even if it’s $100, that’s not small to everyone. That could be groceries for the week or part of a utility bill. If people start thinking about that cost before they call, we could be putting them in a position where they hesitate. And hesitation during a medical situation can make things worse. Our job is to respond when people need help so anything that creates doubt in that moment has to be looked at carefully.
At the same time, I understand the pressure on the EMS system. Call volumes are high, units stay busy, and hospitals are often overwhelmed and overcrowded. A lot of calls are not true emergencies, but they still require a response. Departments are dealing with rising costs, staffing challenges, and burnout. The system has not really evolved to match the demand we see today. So when a county like Douglas County makes a move like this, I understand why. They are trying to find a way to manage the load and recover some of the cost.
The question is whether this kind of change actually fixes the problem long term. In my opinion, it feels more like a short term solution. It might bring in some revenue or “recover” cost, but it doesn’t address the bigger issue. We already see people who don’t pay ambulance bills or hospital bills not because they don’t care, but because they simply can’t afford to. So adding another bill into the mix may not have the impact people expect. It could help some, but it won’t solve the root problem.
That said, I’m not against charging altogether. I still believe there is a place for it, but I think we have to be smart about how we introduce it. Starting with specific situations like lift assists or clear non emergency service calls makes more sense. In those cases, we can be upfront with the public and let them know ahead of time that a fee may apply. That kind of transparency gives people the chance to understand the system instead of being surprised by it later.
If we really want to make a long term impact, I think we have to start looking at how we deliver care differently. Not every call needs a full EMS response or a trip to the hospital. There should be other options available for people who need help but are not dealing with a true emergency. Expanding things like mobile clinics, community paramedicine programs, or even virtual care options could make a big difference. If people had better access to care in their community we might see fewer calls that end up tying up emergency resources.
I’ll be the first to say I don’t have all the answers. I’m not sitting at the top making budget decisions, and I understand that programs like these cost money to run or even expand. But I do think we need to start thinking about ways to meet the community halfway. Instead of focusing only on charging, we should also be focused on providing better access. Key word is access, they NEED better access. Rather its a van pick up for those with no transportation or we go to them with a mobile clinic.
At the end of the day, I still believe charging can be part of the conversation. But it shouldn’t be the only solution. What Douglas County is doing might help in the short term but long term, we need a bigger plan. We need to build a system that supports both the people who need care and the responders providing it.
Because no matter what changes we make one thing has to stay the same people should never feel afraid to call for help when they truly need it.
