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Voters considering whether to repeal the county's recently enacted EMS transportation fee would do well to keep in mind that this fee would not constitute a change to front-end service, but rather represent a shift in billing practices that would scarcely be noticeable if implemented correctly.

Thanks to a just and speedy ruling by the state Court of Appeals last month, voters will have the opportunity in the Nov. 2 general election to overturn what's commonly called the ambulance fee. The court's ruling allowed thousands of petition signatures that had been initially rejected on overly technical grounds; in its decision, the court sided with the spirit of ballot law, and prevented the hard work of signature collectors from going to waste.

The ambulance fee, which has been discussed for years, would range from $300 to $800 and be paid by insurance companies, with Medicare expected to be hit the hardest. It would generate about $12.5 million annually (about 7 percent of the county's fire and rescue budget).

The bulk of the opposition has come from volunteer fire companies, which claim that residents will be frightened by the potential costs of being transported and therefore avoid calling for help. Critics point to Fairfax County statistics, which show a decline in EMS calls following the implementation of a similar fee. In 2001, four years before Fairfax began billing, there were more than 92 calls per 1,000 residents; in 2008, there were 72 calls per 1,000. The decline was gradual and began dropping off even before the fees were enacted.

This is a statistic worth exploring, but also one that could have been influenced by several factors. Among them: an increasingly health-conscious population and residents who, with the explosion of the Internet, may be more likely to dismiss a health concern after obtaining more information.

This is where a comprehensive public awareness campaign can help. Without a complete understanding that residents will not be asked to pay any additional taxes or fees, there is potential for confusion. But, according to the county, residents with health insurance will not be responsible for co-pays or deductibles and those without insurance are also covered. County residents won't see any change to their service or taxes, and the county has an opportunity to recoup some much-needed cash.

At the heart of this debate is the county fire and rescue service's evolution toward a greater reliance on paid emergency personnel. The county's roughly 850 volunteer firefighters have a rich and commendable history of service to Montgomery, and their work is as invaluable as ever. Billing for ambulance transportation strikes at the core of what it means to be a volunteer, so it's understandable that would be a difficult pill to swallow.

But this fee would not take anything from volunteers. It's about the bottom line, and the county can't turn away from a chance for additional revenue with little to no adverse impact on residents.