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San Diego Rural/Metro EMT Ray Madrid recognizes a man who was found intoxicated and unconscious on a city sidewalk as a "frequent flyer', a term emergency service workers use for patients who use the emergency system more than 6 times a year, often at a high taxpayer cost. By law, the 911 system and emergency departments must treat all patients, regardless of insurance status. The average public cost of a frequent flyer in 2010 was nearly $200,000 and their conditions range from substance abuse, homelessness, mental disorders, to chronic conditions in which they have become disconnected from primary care.