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Cities with Uber Have Lower Rates of Ambulance Usage

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Re: Cities with Uber Have Lower Rates of Ambulance Usage

#271

Post by shados »

mseebach wrote: post #243
shados wrote: post #232

Earlier quoted context omitted.

To be fair, a lot of stuff work that way. Take an HVAC maintenance plan for example. For some fee (based on the model and age of your HVAC and the condition it's in), you get routine maintenance covered. They do what they can to prevent major hiccups, but if it breaks down, they'll repair it (after trying to weasel their way out of it). It's pretty darn common across a lot of industries.

There's a pretty important difference between humans and HVACs, which is the reason the two systems end up being very different. You can always rip out the HVAC and put in a new, off the shelf unit with roughly the same specs (often better, because progress) at a fixed, known cost, and the customer will even often be happier if they end up doing that instead of repairs. If health care providers could trivially decide…

What you say is totally true, but completely irrelevant to the point I was making.

All i was saying is that it's pretty common/normal/etc for insurance (in any industry. Literal insurance or things that are insurance in practice but not literally) to offer routine exam/tests/maintenance/checks if it can prevent the worse case scenario $$$ from happening.

Re: Cities with Uber Have Lower Rates of Ambulance Usage

#272

Post by mjburgess »

dmichulke wrote: post #239
mjburgess wrote: post #174

Earlier quoted context omitted.

really-existing capitalism involves co-opting local power structures (parliaments, legislatures, dictatorships, puppets, etc.) to protect your cartel. If capitalism is only capitalism when there is no conglomerated power structure then capitalism is impossible. Often enough today its the left who are defenders of capitalism (ie., of disentangling power structures from coporate control) whereas the right seems possess…

> really-existing capitalism involves co-opting local power structures (parliaments, legislatures, dictatorships, puppets, etc.) to protect your cartel. I grew up in a communist country and guess what: politicians co-opted local power structures for their personal benefit. They drove the good cars, had the nice houses at the lakes and hard (= Western) currency. This is the case for (AFAIK) every single "socialist" st…

Really-existing communism is bad too. I think worse than really-existing capitalism as it had to pass through a dictatorship stage to be realised, and dictatorships are extremely hard to renounce when formed.

What I was saying was a defence of the fundamental economic model of capitalism, not a criticism of it.

> we are all suddenly better people?

Yes. People are largely ethical products of situations they find themselves in. Reduce the number of opportunities for bad behaviour and you get Good People.

unaccountable systems of power are the recurring situations causing bad-behaviour here.

A healthy democratic capitalism aligns the interests of those power with the people. So that capital owners do not seize control.

"Capital" is not capitalist. It is anti-capitalist, wanting to monopolize and dictate.

Re: Cities with Uber Have Lower Rates of Ambulance Usage

#273

Post by valuearb »

dpwm wrote: post #163
dantheman wrote: post #153

Earlier quoted context omitted.

The health insurance system in the US is about as far away as you can get from capitalism. It's heavily regulated, a cartel, the prices are not transparent, and there is no competition (existing hospitals have to approve new hospitals, etc).

You can't disown capitalism from its problems that easily. It's not hard to see that it is in short-term self interest to form cartels, lobby for regulation, crush competition and treat their (now captive) customers with contempt. This is a pattern we have seen time and again. Describing this as "about as far away as you can get from capitalism" is the no true Scotsman fallacy. Perhaps it doesn't match how you believ…

Because you label highly regulated markets as "capitalism" seems like you are the one who needs to own their own mis-definitions.

Re: Cities with Uber Have Lower Rates of Ambulance Usage

#274

Post by bckygldstn »

s_esser wrote: post #45

Correlation != causation

The title of the NPR article would be more accurate as "Cities See a Reduction in Ambulance Usage After Uber is Introduced".

The paper looks at 700 different cities, each with a different Uber market entry time over a two year period. The researchers also control for some seasonality effects.

Perhaps more covariates could have been considered, but this seems like a pretty decent design to measure a before/after causal effect.

Re: Cities with Uber Have Lower Rates of Ambulance Usage

#275

Post by valuearb »

pornel wrote: post #172
dantheman wrote: post #153

Earlier quoted context omitted.

The health insurance system in the US is about as far away as you can get from capitalism. It's heavily regulated, a cartel, the prices are not transparent, and there is no competition (existing hospitals have to approve new hospitals, etc).

US has a market for regulation: lobbying is legal and elections are funded by donors. So I'd say problems caused by the regulation are pure capitalism: it's just a new, more cost-efficient way of beating the competition.

It might be capitalism in that trade and industry are controlled by private entities (that's still debatable because in the US nearly 30% of GDP is controlled by government entities, and most of rest is tightly regulated).

But it ain't "free enterprise" whenever regulation limits consumer choice and market entry by competitive participants.

Re: Cities with Uber Have Lower Rates of Ambulance Usage

#276

Post by jopsen »

dazc wrote: post #150
jopsen wrote: post #143

Earlier quoted context omitted.

Free ambulances are always going to come with the problem of abuse, followed by a reluctance to send an ambulance. Resulting in news stories of how some people call of help and don't get any. But these stories are rare, it's seem better than letting poor people die. This said, we probably should add a tiny ambulance fee ($50), and apply a fine for inappropriate use.

'This said, we probably should add a tiny ambulance fee ($50), and apply a fine for inappropriate use.' I agree although reclaiming this fee from those who abuse the system is likely to prove difficult? I can remember a time in the UK when ambulance and, IIRC, fire service would bill you after the event for attendance. Not sure if this was every case or just where they deemed it appropriate? But, I do remember, it wa…

> I agree although reclaiming this fee from those who abuse the system is likely to prove difficult?

You assume everybody that abuses free services are broke. We need data to tell whether that's the case. I would assume that a significant portion of the abusers mostly just lack manners.

Anyways, the point isn't to kick the ones who are down (poor). It's only to limit abuse... But first maybe it should be assessed of abuse is a problem.

And maybe, having a deal with taxi company is a better solution...

Re: Cities with Uber Have Lower Rates of Ambulance Usage

#277

Post by scott_karana »

saas_co_de wrote: post #201
k__ wrote: post #131

Medical stories from the US always sound like from third world countries to me...

Yeah, most people don't tell the stories about how they go to luxuriously built hospitals that make most corporate offices and hotels seem cheap by comparison, with parking lots full of BMW's, Mercedes, and other 6-figure foreign cars, and are treated by teams of highly paid people using millions of dollars of the best equipment in the world ... As long as you have money the US is great.

"Best equipment in the world"? This is capitalism. They're going to use the cheapest "good enough" equipment they can get away with. And considering the domain experience a patient would need to tell a new MRI from an eight year old one... I'm sure they get away with lots.

I guarantee the hospital administration isn't going to pay the upcharges for the fanciest new MRI if they can spend it on themselves.

Re: Cities with Uber Have Lower Rates of Ambulance Usage

#278

Post by cookiecaper »

shados wrote: post #232
blhack wrote: post #82

Earlier quoted context omitted.

There is pretty much nothing that infuriates me more than the health insurance system. Here is just one example (other than your ambulance example, which is like some trolley-car problem come real): We use "insurance" for routine medical examinations which are supposedly to be done regardless of health. We use "insurance" for YEARLY checkups. The absurdity of this is on par with insuring yourself against getting hung…

To be fair, a lot of stuff work that way. Take an HVAC maintenance plan for example. For some fee (based on the model and age of your HVAC and the condition it's in), you get routine maintenance covered. They do what they can to prevent major hiccups, but if it breaks down, they'll repair it (after trying to weasel their way out of it). It's pretty darn common across a lot of industries.

Warranties are different because though they also depend on non-utilization, the defects they cover are generally likely to occur at some point (the guarantor is just hoping it will be after your warranty expires), and consequently higher utilization rates are expected.

Insurance is based on the assumption that only an extremely small number of insured persons will ever make [significant] claims against the policy; insurance is for expensive potentialities that are very unlikely. The entire industry and regulatory framework is structured around that assumption because that is what the word "insurance" means in all contexts outside of health care.

The problem is that pretty much everyone is going to need significant medical care at some point in their life, certainly as they age into their senior years if not earlier.

Would you buy a "health maintenance plan" under the stipulations of health insurance policies, which are basically "Pay us a lot of money, and we'll make some farcically big numbers look smaller for you, but you'll still probably owe a lot of money; we won't know how much until you already owe it"? Of course not.

The racket we call the American health system can only exist by masquerading as "insurance".

Re: Cities with Uber Have Lower Rates of Ambulance Usage

#279

Post by sitepodmatt »

aquadrop wrote: post #185
chrisseaton wrote: post #181

Earlier quoted context omitted.

I'm not defending the cost! Just saying you can't look at it and say 'that's more than the cost of the vehicle' because it's not about the cost of the vehicle.

Yes, I understand. That's why I wanted to take a look at components of the long term cost, not just one ride. And I'm really curious what's the cause for the difference.

I think ultimately the system is fcked across the board, private interests and greed combined with legal corruption (lobbying) to get their way and government guided by the people that line their own pockets. Weather it is pre-Obama, Obama or whatever Donald is planning all the pricing is insane compared against of any other developed country. None of the justification holds much weight, even "cross-subsidization" I don't see affecting it to this extent unless only 1 in 20+ actually ever pay anything.

Re: Cities with Uber Have Lower Rates of Ambulance Usage

#280

Post by api_or_ipa »

deepsun wrote: post #69
api_or_ipa wrote: post #61

Earlier quoted context omitted.

Crazy. Very recently I saw a guy get knocked out cold on his rollerblades and we called an ambulance. The question of cost never crossed my mind and I'm not sure I would ever want to make the utilitarian calculus: Am I helping this man or am I bankrupting him? IIRC it's $82 or something like that in Vancouver BC Canada.

Could he just said "I didn't call for ambulance, charge the guy who did"?

Maybe, but he suffered a concussion and reasonably wasn't in full awareness of the situation. Leaving him to suffer on the street until he made that decision on his own shouldn't be the morally correct decision. I stand by my behaviour and would do it again irrespective of the chance I might have to pay for it: there are some moral decisions I would rather not have to think about and instead just do the right thing. I lose enough sleep over more trivial things.
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