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RED DEER, Alta. March 9, 2016/ Troy Media/ – What happens when a charity takes on fundamental social tasks better performed by government and then donations can’t keep pace with demand?
Alberta’s STARS air ambulance is struggling to sell out its annual lottery, for the first time in 23 years. The lottery raises about $11 million a year for the service and is one of its key fundraising avenues.
In an ideal world, given the essential nature of the work STARS does, government would step in to fill the void – or government would never have allowed such a necessity in the first place.
In a less than ideal world, say Alberta in 2016, a quick, large and sustainable injection of cash seems unlikely. But, in the case of STARS, a gradual increase in government funding is both needed and defensible.
While Alberta is shuffling its way toward a $10-billion provincial deficit and there are desperate economic and social needs at every turn, we can’t turn away from STARS, which flies an average of five missions a day in Alberta (1,839 missions last year, serving about 270 remote communities). This essential service quickly brings those in dire need of medical care to the source of that care, saving and repairing lives.
For 22 consecutive years, the air ambulance’s fundraising lottery has sold out. This year, ticket sales are lagging, as is its corporate support. That’s not difficult to understand: fewer Albertans are employed and many of those who are employed aren’t getting raises, or are worried about the longevity of their jobs. And the corporate world is just as shell-shocked.
But the need to fund air ambulance services isn’t going to go away just because times are tough.
At issue is how STARS survives in the short-term, so that in the longer term the province and Ottawa can fill the void as part of a broader retooling of the system, from ground ambulance to air ambulance service.
Since the delivery of health is a provincial responsibility, so too is the operation of ground ambulance services. There is no clear mandate for air ambulance service. And in every province the models differ. The federal government does not directly fund for ambulance service of any kind.
Ambulance services aren’t free, regardless of the source of that infrastructure – someone has to pay. And as those services are not covered under the Canada Health Act, individual Canadians or their insurance companies must often foot the bill.
In Alberta, the cost of ground ambulance service is $250 if you are treated at the scene and $385 if you’re taken to the hospital. In Ontario, the rate is just $45 (or higher if it is deemed your call wasn’t medically necessary). In Manitoba, you could pay more than $800 for ground ambulance if you are in a rural area and more than $500 in Winnipeg.
Similarly, air ambulance operations differ from province to province. Ontario funds 100 per cent of air ambulance costs. Alberta’s provincial government covers 24 per cent of STARS costs in a deal that runs through 2020. The remainder of funding comes from public and corporate donations.
It cost about $30 million to operate the three STARS bases in Alberta (Calgary, Edmonton and Grande Prairie). The average flight costs $5,400 and the specially-equipped helicopters cost $5 million apiece.
STARS does not bill patients for service, so it has no revenue source except donations and government support.
The province needs to gradually increase its air ambulance funding until it bears complete responsibility. An essential service like this can’t be in a vulnerable economic position. So STARS and the province need to rewrite the existing deal to gradually increase public funding. At the same time, the province needs to move toward a model that funds all ground ambulance trips.
It may be that we won’t reach this level of universality until the federal government steps in, amending the Canada Health Act to ensure it.
In the meantime, we need to keep STARS in the air.
Today, that means digging a little deeper individually and corporately. It means buying a STARS lottery ticket or, better yet, making a direct donation. It means the province increasing its funding by a few percentage points now, and again year after year — until STARS doesn’t have to fundraise to survive.
Because asking charitable groups to pay for fundamental social services is just too risky.
Troy Media columnist John Stewart is a born and bred Albertan who doesn’t drill for oil, ranch or drive a pickup truck – although all of those things have played a role in his past. John is also included in Troy Media’s Unlimited Access subscription plan.
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