Somewhere between the inevitability of taxes and death, life’s little accidents (and sometimes major catastrophes) intervene. In most communities, EMS and fire rescue services play a vital role in the social safety net of US municipalities. In Florida, Tampa Fire Rescue (TFS) responds to thousands of emergencies, big and small, each year. But according to an article in The Tampa Tribune, more than 50 percent of TFS’ patients “stiff the city on the bill.”

Tampa finance director Sonya Little and other city officials acknowledge that continued economic pressures hinder patients’ ability to pay. [Associate Editor’s note: For a dramatic and artistic re-enactment, I direct you to this YouTube video of the trailer for the 1976 feature film Mother, Jugs & Speed starring Bill Cosby, Harvey Keitel, and Racquel Welch.] Sustained high unemployment not only puts affordable health insurance coverage out of reach for many residents, but individual job loss and subsequent elimination of employer-sponsored health insurance often means lack of coverage for entire families who may require emergency services. Despite municipal leaders’ sensitivity to patient circumstances, TFS’s bad debt predicament has reached a tipping point.

On average, TFS is owed $7M in EMS fees annually. But roughly $3.5M of those ambulance rides turn into free fares, a financial burden the city can no longer shoulder. Now, Tampa will turn to private debt collection agencies to recoup some of the money it is owed. Specific details of Tampa’s outsourcing strategy are still in the works, but it appears that a proposal to recover at least a portion of the $9.5M in outstanding receivables dating back to 2008 with the aid of third-party debt collectors will move forward.

Any measure to outsource TFS’s collections would have to be approved by the city council, but initial support for hiring an outside agency to collect unpaid ambulance bills already exists. According to The Tribune, councilman Mike Suarez backs the plan, but wants assurances that “the city doesn’t hire a company that ‘browbeats’ patients.”


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