"Insurance really works well when it's a random distribution," Tanaka said. "It doesn't work well when you have highly concentrated usage. We can end up having a 'heavy-user' program, (where) all the people who buy are heavy users."
Fire Department staff aren't particularly concerned about facing that scenario. Cameron noted that most of the people who are heavy users tend to be elderly residents who are covered by Medicare. As such, they are unlikely to enroll in the insurance program.
A more likely participant would be someone who is on commercial insurance such as Kaiser Permanente or Blue Shield of California, which cover some of the ambulance cost but still leave an individual with a bill totaling hundreds of dollars.