It doesn’t matter the circumstances — car crashes or chronic illnesses — Scott Koehler often hears the same plea from patients: “I can’t afford to go to the hospital.”

Some patients would rather drive themselves to the hospital, hitch a ride from family or friends or skip medical attention to avoid ambulance costs, said Koehler, East County Fire and Rescue’s chief.

The average tab for an ambulance ride in Clark County is about $750, but can escalate to $1,000, depending on mileage and other factors. Insurance can cover most, if not all, of the costs but leaves the uninsured with a hefty bill.

Refusing ambulance rides is an ongoing issue for all emergency personnel, both locally and nationally. And as more people tighten their belts during the economic downturn, some responders expect that number to grow.

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