Ambulance fee proposal raises fears of 'à la carte government' in Montgomery

By Mike DeBonis
Washington Post Staff Writer
Thursday, October 7, 2010; 10:31 PM

A ride to the hospital in a state-of-the-art ambulance has long been gratis for residents of Maryland's second-richest county. Now, after years of arguing over it, Montgomery County residents are faced with paying a fee for their emergency transport, and that has prompted plenty of questions about what exactly should come standard with your income tax and property tax payments.

"Any emergency is a basic function of government. It's guaranteed for everybody, with no bars," says Eric N. Bernard, executive director of the Montgomery County Volunteer Fire and Rescue Association, a group that has led opposition to the fees since they first were proposed by former county executive Douglas M. Duncan (D) seven years ago.

It's a principled, high-minded argument, one that is likely to appeal to voters - who, thanks to an 11th-hour decision by Maryland's highest court, will get to vote on the fee Nov. 2.

The reason county lawmakers have finally succumbed after years of resisting the fee is less principled but just as compelling: They sure need the money.

Montgomery peacemakers, once accustomed to yearly 10 percent hikes in spending, now have had to shrink the government for two years. Earlier this year, a major bond rater threatened to downgrade the county's long-held AAA rating if it didn't get its fiscal house in order.

When the economy tanks, there's nothing for local governments to do except scratch, claw and tick people off to cut expected services or find more money.

In the universe of fees, ambulance fees hold a special appeal, because proponents consider them essentially found money. The idea is simple: Soak the insurance companies.

For residents, the fee would be charged to ambulance riders' insurance; those without insurance would not have to pay. Under the proposal, only nonresidents without insurance would have to pay - and even then, the indigent would be able to apply for a waiver.

"If there's a choice between insurance companies hanging on to premiums you've already paid or your county fire and rescue getting those premiums back to save lives in the community, that's a no-brainer," said Patrick Lacefield, spokesman for County Executive Isiah Leggett (D). "In most places, this is not controversial," he added. And "most places" includes pretty much every jurisdiction surrounding Montgomery.

Each has its own breaking point when it comes to fees.

In the District in 2008, Mayor Adrian M. Fenty (D) proposed a "streetlight user fee" that would appear on the bills of all electrical customers in the city. The $51 yearly fee was intended to "cover the costs associated with the operation and maintenance of streetlights in the District."

Calling it a "user fee" struck more than a few as disingenuous - it's not as if the streetlight user has the option to switch them off rather than pay the fee. Legislators nixed the idea.

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