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September 27, 2011
Free treatment from Chicago ambulances protested
By Fran Spielman
CHICAGO — The Chicago Fire Department is hemorrhaging hundreds of thousands of dollars - and tying up ambulances - by administering free medication to patients with diabetes and asthma who then refuse to be taken to the hospital.
Last week, the City Council's most powerful alderman suggested that Chicago privatize collection of city ambulance fees to raise a dismal 37.5 percent collection rate that has created a $50 million-a-year debt.
Finance Committee Chairman Edward M. Burke (14th) described the ambulance fee debt as "low-hanging fruit" that would go a long way toward maintaining Chicago Fire Department operations at a time when Mayor Rahm Emanuel has demanded a 20 percent cut.
Now, a veteran paramedic who asked to remain anonymous is describing other ways the city is losing money.
Every day, ambulances are summoned to assist patients with diabetes who are suffering from low blood sugar.
They administer dextrose or sugar water. And when the patient's blood sugar rises, they refuse to go to the hospital. Paramedics try to persuade them to go, but they cannot force patients to do so.
They simply advise the patient to eat and call their doctor. The patient signs a refusal form and the ambulance takes off. The patient is never billed - either for the cost of the ambulance run or for the drugs.
"It happens 30-to-40 times-a-day and thousands of times a year," the paramedic said.
The same scenario plays out less frequently with asthma patients. The ambulance arrives. Paramedics administer a drug known as Albuterol. And when the patient stops wheezing, he or she refuses to be taken to the hospital. Once again, the city eats the cost of the ambulance run and the medication.
The paramedic also complained about what happens after an IV is started on the way to the hospital.
Chicago Fire Department paramedics put the needle in the patient's arm. But all the city gets is an IV replacement kit from the hospital. The hospital gets to bill the patient for the $400-to-$600 cost of starting the IV.
The bottom line is that, at a time when ambulance calls account for 80 percent of all calls to the Chicago Fire Department, the city is not getting nearly what it should from the service it provides.
"Diabetes is one of our top five calls, and fifty percent of all diabetic calls end up in a refusal," the veteran paramedic said.
"No business survives by giving you their product and not getting paid for it."
Chicago Fire Department spokesman Larry Langford could not be reached for comment.
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