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Ambulance ramping: What happens when you can’t afford to even get on the ramp?

MEDIA RELEASE: As ambulance ramping takes centre stage in the SA state election campaign, key community service groups are highlighting the problem of the cost of ambulance call-outs, with many people not calling an ambulance when they need one because of fear of the costs. 
The cost of an emergency call-out and trip to hospital in South Australia is currently $1,064, plus $6.10 per kilometre travelled. There is a 50% discounts for age pensioners, but not for other Centrelink recipients or other people on low incomes. This base rate for emergency ambulance transport is equivalent to 1.3 week’s pay for someone on the minimum wage, and more than two-and-half weeks of JobSeeker payment. 
Ambulances in South Australia are paid for by a combination of direct government funding, payments from the Ambulance Cover insurance scheme, and by user-pays fees as above. South Australia’s emergency ambulance transport fee is the second highest in the country (after Victoria). Emergency ambulances are free in Queensland and Tasmania, and the cost in NSW is less than half of the SA fee. 
Michelle Kemp, CEO of St Vincent de Paul Society in SA said: 
“Many of our volunteers report receiving requests for assistance from people who had received invoices for over $1000 for an ambulance callout, which they are unable to pay. That creates immediate financial hardship, and often leads to a reluctance to call for an ambulance in an emergency. That is a bad outcome for the patient – but also for the health system as health problems can spiral over time and require much more complex treatments later on.” 
James Hill from the Louisa DaCosta Trust said:
“The Louisa DaCosta Trust provides financial assistance for both unplanned illnesses and also for lifelong illnesses where government support is not available, and we see that ambulance costs are a significant cost to people who have been hit by a sudden medical emergency. It is hardly surprising that many patients receiving a $1,000 ambulance transport bill have trouble paying for it. Many can’t pay, and while they may be put on long-term repayment plans, the SA Ambulance Service writes off approximately $20m each year in bad debts. It is difficult to even begin to imagine the number of South Australians represented in this figure, or the full extent of the distress caused by ambulance transport bills.” 
Ross Womersley, CEO of SACOSS said:
“Ambulances are a vital public service which should not be run on a cost recovery basis. We would not expect a public hospital or public school to fund themselves by recovering core costs from patients or children, and we should not expect it for ambulance services.” 
“We need a commitment from all parties at this election to address the issue of ambulance affordability and ensure that everyone who needs an ambulance can call one without worrying about cost. Expanding the concessions available on ambulance cover would be a small first step, but ultimately we need a fundamental rethink of ambulance funding and costs. We need ambulances to be free, at least for those on low incomes, if not for all South Australians.” 

8 March 2022