The helper would surely maintain that he did it on the victim’s behalf and has no interest in the ambulance service for himself. Nevertheless, if he was the one who made the call, then he effectively hired the ambulance and medics and should have to pay the expenses.
This, however, would make many people think twice before calling for help. Performing the mitzvoh could cost them a significant amount of money. There is an exemption for a person who has to damage property in order to save someone. ((ב”ק קיז: וסנהדרין עד. רודף להציל ששבר כלים של כל אדם פטור שאם אי אתה אומר כן אין לך אדם שמציל את חבירו מיד הרודף. )) For example, if a baby is locked in a car and Reuven needs to break the window to save the baby, although it is permissible to damage the property, were it not for the special exemption Reuven would have been required to compensate the owner of the car for the damage. This, however, would have the effect of making people hesitate before saving lives; therefore Chazal made a dispensation for such circumstances and ruled that no money is owed for such damage.
The Bobover Rebbe, Horav Shlomo Halberstam, used this argument to explain why he was not halachically responsible for repaying loans he took out during the war in order to save Jews in Europe.
It would seem that this exemption would be appropriate for the person who called the ambulance. If they were going to be held financially responsible for an ambulance call, people might hesitate to respond to medical emergencies.
However, this exemption may not be applicable. Rav Moshe Feinstein told the Bobover Rebbe that he had erred in his interpretation of the Gemoro. According to Rav Moshe, the only dispensation is for damage to property blocking the way to saving a Jew. If one took out a loan or stole in order to save other people, he must pay it back. ((אגרות משה ח”מ ח”ב סימן ס”ג. ע”ש דאפילו נזק אחר שעשה להצלת נפשות חייב אלא א”כ היה נזק שנעשה על דבר המונע דרכו של המציל להגיע אל יעד ההצלה או להציל. אבל כגון מה שמסופר בב”ק ס: לרב הונא שהפלשתים הטמינו א”ע בגדישי שעורים של ישראל ללחום נגד ישראל, ונשאלה שאלה האם מותר להציל רבים מישראל בממון חבירו, והתשובה היא שאסור רק משום מלך פורץ גדר, וכתב ר’ משה דגם לאחר התקנה שפטור על מזיק להציל נפש, מ”מ כה”ג חייב, דאי”ז אלא מזיק כדי לגלות האויבים ואינו מזיק כדי להציל. )) A person who calls 911 or Hatzoloh is deemed to be employing a service-provider and, according to Rav Moshe, there is no dispensation in such circumstances.
Still, it seems to this writer that the Nesivos Hamishpot supports the position of the Bobover Rebbe. The Nesivos applies the exemption to someone who borrows a sword without permission (which is akin to stealing) and in the course of battle to save others, the sword is seized by the enemy. According to the Nesivos, he is not responsible for paying the owner due to the exemption mentioned above. ((נתיבות המשפט סימן ש”מ סק”ו. חיובו בכה”ג הוא מדין גזלן או שומר שנאנס ומ”מ פוטרו ע”פ התקנה, ולפי דברי הגרמ”פ זצ”ל כיון דאי”ז חיוב מזיק שנעשה כדי להגיע אל ההצלה, חייב. )) It would seem to follow that if the Nesivos extends the dispensation to stealing, it should be extended in the case of the Bobover Rebbe and in our cases as well.
If so, the patient is not responsible, nor is the caller. Must the medics suffer a loss of income for the work they did?
If the patient were exempt because he didn’t benefit, and the helper is exempt because of the enactment to indemnify all who act to save lives, then the poor medic and ambulance service would have no one to claim the charges from. By default, they would be unsuccessful in a Beis Din.