Recently, the County Commission published a FAQ sheet - that stands for Frequently Asked Questions - apparently in response to the public uproar that the enactment of the new ambulance fee has caused. The County calls it a fee. I call it what it is - a tax. The uproar seems to have caught the Commission by surprise - I say that because the document appears to point fingers at the public. It states that the public hearing regarding the fee held on May 22, 2014 occurred “with no comments from the public” highlighted in bold type. So I guess we’re all out of line for expressing outrage now instead of on their schedule.

The FAQ begins by saying “The County Commission has received many concerns and questions about the recently enacted ambulance fee. This letter addresses many of the enquiries we have received.” The first frequently asked question it addresses is “Why do we need this fee?” Makes sense. Their answer? “Unfortunately, volunteers…are at an all-time low” and because of that “adequate County coverage for medical emergency coverage is not always available. THEREFORE, ALL THE MONIES FROM THE AMBULANCE FEE (of $40 per residence and $85 per business) WILL GO TOWARD HIRING ADDITIONAL CAREER STAFF” (their emphasis and capitals, not mine). So the County is going to use the new tax money to add people to the County payroll.

The FAQ goes on to assert that “the County can no longer support emergency services from the general budget. Due to declining revenues and budget deficits, the Jefferson County Commission reduced overall budget expenses by $2.7 million dollars for the fiscal year. One of our largest expenditures is emergency services with Jefferson County funding JCESA (Jefferson County Emergency Services Agency) at $1,447,562 per year.”

Faced with these realities, the County Commission’s response is to expand government and raise taxes. Perhaps we need to start thinking outside the box and challenge even the most basic of assumptions. There are those that tell me that providing emergency medical services “is what government does”. Call me crazy, but perhaps we should revisit “what government does”. In light of the fiscal realities presented by the Commission, going into the ambulance business with taxpayer money might not be the way to go.

In many jurisdictions, ambulance service is provided through the private sector. San Diego is one of them. Last year the local firefighters union proposed that the city bring ambulance service “in house”. The reasoning was that since the private sector is profit driven, money could be saved by providing the service through the public sector. That’s a common misconception. Government is not generally an efficient provider of services. The counter argument that start-up costs and capital outlays would be prohibitive won the day. There’s also the tendency of government to waste taxpayer money.

Jefferson County has recently voted to purchase a Computer Aided Dispatch (CAD) system to dispatch the county’s emergency services vehicles. The County will be paying more than $600,000 for it. CAD systems are something I know a lot about having spent more than 35 years in the ground transportation industry in management and as a logistics consultant. I was president of a company that purchased one of the very first commercially available CAD systems - nearly three decades ago. Today, a private paratransit or livery company would pay less than $100,000 for a system that can handle many more vehicles than Jefferson County has, or would need in the foreseeable future, even if the rosy projections for growth in the new comprehensive plan were exceeded.

The fact is, government isn’t price sensitive. Unlike the private sector, elected officials are not risking their own money, they are spending taxpayer money. Further, it is impossible to have expertise in all industries to be able to make the right decisions with regard to capital expenditure. That should be left to the folks that do it for a living - in the private sector.

Let’s go back to the FAQ for another quote, “This Ambulance Fee is not being assessed because you used ambulance service in the past; instead, it is being implemented to respond to our citizens’ requests to better serve you and your family should you need emergency medical services now or in the future. Once the fee is collected, the hiring process will begin and we expect new career folks to be on board by the end of the first quarter of 2015”. The fee is expected to raise $600,000, of which $360,000 is for salaries, $210,000 is benefits and $30,000 is for training. Does the County really know how to run this business cost effectively? If the county is responding to citizens’ requests, are they going to respond to the requests to eliminate this new tax?

The new ambulance fee is a tax increase and we are taxed enough already. No one can opt out of paying it. We are indentured customers of the county whether you like it or not. No choice. If you never need an ambulance you still have to pay.

And here’s the punchline. If you DO need ambulance service, you still have to pay for the ambulance service, despite the fact that you’ve paid the fee! Re-read that sentence until it sinks in. I pay the fee, then when I need an ambulance I have no choice but to call the county. Then I’m billed for the service. Where does that money go?

Yet another concern is that there is a significant amount of money donated by county residents to emergency services annually. Anecdotally I’ve heard from a number of volunteer providers that they are concerned that the fee will cause a drop in donations. This is yet another potential unintended consequence of instituting this new tax. The money has to come from somewhere - and the fee has the potential to actually lead to a decrease in revenue. Which then leads to raising the ambulance “fee”?

Our county owes a debt of gratitude to the many volunteers that have served so unselfishly and have given so much to our community. It is certainly understandable that people want to get paid for what they do. What isn’t understandable is having to pay the new ambulance fee and then having to pay for the ambulance. As local government reaches ever deeper into our wallets it appears to like having its cake and eating it too.