Some Canadians don't call an ambulance when they need one because they are worried about paying the fee, an investigation by CBC's Marketplace reveals.
And the life-saving service has left others with thousands of dollars in bills they can't afford.
Ambulance fees range from $45 in Ontario to more than $500 in parts of Manitoba. In Saskatchewan and Newfoundland and Labrador, you could also be charged for being transferred by ambulance from one facility to another.
Three-quarters of Canadians feel that people in Canada should not be charged to use an ambulance in a medical emergency, according to a survey commissioned by Marketplace.
But in most of the country, if you call an ambulance, you will get a bill. And if you don't have supplemental insurance that covers the cost or qualify for provincial exemptions, you are responsible for paying the fees.
Marketplace investigated the toll ambulance fees take on Canadian patients. Watch No Free Ride, Friday at 8 p.m. (8:30 p.m. NT) on CBC Television or online.
Sara Bucsis-Gunn's daughter Leandra was born with a severe respiratory disorder, which meant that she often required emergency treatment. By the time Leandra died in 2013 at seven, Bucsis-Gunn's ambulance bills in Saskatchewan had reached almost $7,000.
"You know, you're taught as a child, if there's an emergency, you call 911. You call 911. Nobody tells you there's a bill attached with that phone call," Bucsis-Gunn told Marketplace co-host Erica Johnson.
"You're just trying to do what you can in that situation when your child's not breathing. And you're trying to save money to pay your mortgage and your bills so that you can keep the power and the heat on."
Many delay calling an ambulance
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.
Many Canadians do rely on ambulances in an emergency, the survey found: 60 per cent said they have called or used one, either for themselves or for someone else.
But in those critical moments, many people worry about the cost. The survey found that fees have deterred 19 per cent of people from calling an ambulance. That number was highest in Alberta at 25 per cent.
And 42 per cent said they might delay calling an ambulance because of the cost.
'There shouldn't be a cost, period'
Those figures alarm Chris Hood, president of the Paramedic Association of Canada.
"The ability to call an ambulance when you require an ambulance shouldn't really be based on the ability to pay," says Hood.
Hood, who is a paramedic, says he's seen what happens when people let financial consequences guide their decisions in a medical emergency.
"We would hear from patients all the time that said, 'I was having chest pain and I couldn't afford the ambulance so I just got my spouse to take me to the hospital,'" he says.
"People would die in their vehicles. They would go into cardiac arrest in their vehicles because they decided not to take an ambulance because they couldn't afford the fees, and particularly the elderly people."
Patients in the Yukon are not charged for ambulance services.
In New Brunswick, those without private insurance don't pay ambulance fees, which is a policy meant to eliminate unreasonable out-of-pocket costs.
Hood says ambulance services should be covered under the Canada Health Act, which would mean there would be no out-of-pocket cost for people who call one.
"Governments need to talk about this. We need to get away from the fact that ambulance services in this country are not part of the overall health care system and aren't funded the way they need to be," he says.
"There shouldn't be a cost, period."
This story originally reported that Canada's three territories - Yukon, Northwest Territories and Nunavut - do not charge patients for ambulance services. In fact, patients in parts of the Northwest Territories and Nunavut are charged for ambulance services.Feb 09, 2015 4:59 PM ET