A Nova Scotia woman says she refuses to call 911 again after she was saddled with a hefty ambulance bill, and she's not alone. A CBC Marketplace investigation found that fees have deterred one in five Canadians from calling an ambulance.
Colleen Hopkins is still shaken after a costly ambulance ride in April.
"I have no faith in the health system here at all now," she said.
The north Kentville woman was driving home from her doctor's office in Wolfville when she suddenly got a bad headache and became disoriented. She drove off the road into a water-filled trench in a farmer's field.
After 30 hours inside the truck without food or water, she crawled to a farmhouse and called 911.
Hopkins subsequently got a $711.60 ambulance charge from Emergency Health Services.
"Which is basically my monthly income," she said.
Since then, Hopkins refuses to call an ambulance, even after she fell and lost consciousness on Monday.
"I swore after that I wouldn't call 911 again and I wouldn't go to the hospital again," she said. "I would crawl home first. I would crawl home before I called."
It's a shared sentiment.
Ambulances aren't covered under the Canada Health Act, leaving it up to the provinces to deliver and fund. Most provinces charge a user fee, ranging from $45 to a few hundred dollars. In Nova Scotia, the base fee is about $142.
Marketplace commissioned a survey to find out how ambulance fees are affecting Canadians' health-care choices. The survey was carried out in December by EKOS. More than 2,000 Canadians answered questions online.
The survey found that fees have deterred 19 per cent of people from calling an ambulance. That number was higher in Atlantic Canada at 23 per cent.
Forty-two per cent said they might delay calling an ambulance because of the cost.
Watch the Marketplace investigation No Free Ride on Friday, Feb. 6 at 8 p.m. on CBC Television and online.
"Ambulance fees have been around since ambulances have been around," said Ian Bower, executive director of Emergency Health Services in Nova Scotia. "Nova Scotia generally finds itself middle of the pack, not at the high end of fee and not at the low end of fees."
Hopkins paid more because she was told her trip fell under the motor vehicle accident category, which she disputes.
Bower says there are options for people who can't afford their ambulance bill. The province introduced a fee assistance program for low-income users in 2012.
"I'd emphasize though if anyone has an emergency, the first response should be to call 911," he said.
Funds collected from the ambulance fee offset the costs of delivering the services.
'You don't pay for a fire department to put your fire out'
"Our budget on a yearly basis is $111 million to run our ground ambulance service. The fees represent about $12 million to offset the total cost of that service," said Bower.
Inter-facility transfers are free in Nova Scotia.
The Canadian Paramedic Association says ambulances should be covered under the Canada Health Act.
"You don't pay for the police to come to your house when you've got somebody breaking into it. You don't pay for a fire department to come and put your fire out when you have a grease fire in your house...Why is paramedic service or ambulance service any different? It's the same thing," said Chris Hood, president of the association.
"I would like to see that if the ambulance is really needed, it wouldn't cost," she said. "It wasn't like I was just asking for a ride to the hospital. It was an emergency."
According to the Marketplace study, 60 per cent of adult Canadians have called or used an ambulance service for themselves or someone else.