Why American ambulance rides are so expensive • Hacker News Board

Re: Why American ambulance rides are so expensive

#151

Post by Spooky23 » Fri, Jul 10, 2026, 2:55 AM UTC

arjie wrote: post #124

gruez wrote: post #9

As much as I like articles that tries to use economics or finance to explain stuff, the "options" analogy is a bit hamfisted. The article starts off by noting about how ambulance is an "option" for a rescue, but even though the analogy might vaguely work, it's not really needed to answer the question. That can be answered far more simply: "medicare and insurance companies pay them too little, so they have to charge e…

You’re right. The cost of the service not matching the direct cost is something we’re familiar with - that’s just fixed cost and entirely normal (happens with books, movies, etc). This just happens to be the case where you must transport people but most people are net losses. In this scenario, the only surviving companies would be those who charge the remainder sufficient enough that the blended population of clients…

That’s wrong. The poor people who don’t pay are Medicare and Medicaid patients, and both pay for medically necessary transportation.

Those calls essentially cover the base business expenses.

Re: Why American ambulance rides are so expensive

#152

Post by dodger-dog » Fri, Jul 10, 2026, 2:56 AM UTC

"On appeal, his insurance agreed to cover $9,967 of the charge—better than nothing, but it still left him on the hook for about $3,000."

Tell the insurance company to wait to release the funds until you talk to the ambulance company or to release the funds directly to you.

Tell the ambulance company they can take the $9,967 or get zero.

Re: Why American ambulance rides are so expensive

#153

Post by indoorfish » Fri, Jul 10, 2026, 2:56 AM UTC

socalgal2 wrote: post #143

jjk166 wrote: post #83

Earlier quoted context omitted.

> The average ambulance transport costs $2,673 to provide I think this ignores the 400 pound gorilla in the room. Why does an ambulance transport cost thousands for the operator? This is a short trip in an automobile, essentially a fancy uber ride. At first one might say that's flippant - obviously ambulances are specialized vehicles, and you have paramedics, and they need to get to locations quickly, and so forth, b…

You forgot the cost of insurance when you get sued by the passengers or when you get into an accident since you're racing down the road hoping people are paying attention and get out of the way. No idea what it costs but it's arguably more than an uber driver. 2x? 5x? There are a ton of other costs. You're not paying for one employee. You're paying for many since ambulances run 24/7. They are also driven hard which m…

"My LLM of choice" is like when the news reporter says "confirmed by someone not authorized to speak publicly". It's not a meaningful report.

Re: Why American ambulance rides are so expensive

#154

Post by coredog64 » Fri, Jul 10, 2026, 2:59 AM UTC

darth_avocado wrote: post #7

We’re all pretending this is an unsolvable problem when really most of the world has solved it by making ambulance (EMS) funding similar to fire and police departments. Somehow in any emergency I’ve seen, all three show up, often EMS before police or fire dept, and somehow that’s a service that has to be supplemented by insurance billings. The blog mentions it, but it’s one of those obvious things that somehow isn’t…

Story up thread is about an ambulance ride by the San Francisco Fire Department charging a grand. So in essence the EMS funding is the fire department funding and it’s still unsolved.

Re: Why American ambulance rides are so expensive

#155

Post by _DeadFred_ » Fri, Jul 10, 2026, 3:05 AM UTC

pclowes wrote: post #113

cogman10 wrote: post #85

Earlier quoted context omitted.

> It is not the government’s job to “take care of” anybody. That is literally the only job of government. The entire reason we have a government is to serve the citizens in some fashion or another. Even for most libertarians, they'll view the government in having a role resolving disputes. That is "taking care of" citizens by resolving conflicts. Subsidizing farmers so citizens continue to have cheap and consistent a…

I think what I’m saying is being misinterpreted. I should have been more clear. Everybody’s definition of “taken care of” is different. The government needs to balance the interest of the public with the interest of the individual. It is not intended to “take care of “people regardless of their asks. Otherwise, what if I am only “taken care of” if I have a beachside penthouse in Malibu and also a pony? The government…

Since the 1980s the Republican party had adopted a position of starve the beast, of screwing up these very numbers so that people can make exactly the argument you have.

What happens when half of government acts is bad faith purely to poison the well, one half of government and an entire political party make it so that the numbers don't work (and via the fiscal policy they intentionally inflict/structure/design) purely so that they can promote their policy position of 'the numbers don't work'?

How many unfunded tax cuts have we had recently? Those aren't acts of nature. The numbers you speak of not matching aren't acts of nature. They are intentionally designed to 'starve the beast' in the 1980s Republican way, and in newer ways the party has come up with since. All so the exact argument you gave can be made.

Re: Why American ambulance rides are so expensive

#156

Post by tedggh » Fri, Jul 10, 2026, 3:11 AM UTC

“ This time he didn’t have a choice. He was loaded into an ambulance for a six-mile transfer, evaluated without additional treatment, and sent home the same night.”

This is weird, why didn’t he have a choice? I have literally walked out of a hospital with IVs still attached to my arms when I disagreed on course of treatment that included hospitalization for a case of white coat syndrome. They also wanted me to wait one hour to sign a waiver, which I unkindly refused.

Re: Why American ambulance rides are so expensive

#157

Post by LanceH » Fri, Jul 10, 2026, 3:13 AM UTC

jasonjayr wrote: post #115

justonceokay wrote: post #106

Earlier quoted context omitted.

There’s the cost of supplies used during transport. Also the cost of maintaining potential supplies like blood even if they go unused. EMTs may make $23 but they are also getting benefits and have other overhead, making their real hourly cost probably closer to $50/hr minimum. There’s insurance, which I bet is out the wazoo expensive for ambulance. Ambulances have to be maintained and I would guess have much more reg…

TIL getting an elevator tech to just come out to look at your building's elevator is about $1600. If it's an easy fix, that's all you need to pay. If it's not, it goes up significantly....

He wouldn't be much of an elevator repairman if it didn't go up considerably.

Re: Why American ambulance rides are so expensive

#158

Post by Avicebron » Fri, Jul 10, 2026, 3:14 AM UTC

charcircuit wrote: post #141

Avicebron wrote: post #135

Earlier quoted context omitted.

Well then not everyone is covered.

To me covered means that the ambulance will drive to your location.

Hey man, don't worry about it, this is an international forum, English can be difficult. You seem kind of like a more junior/early in your career guy so, I'm happy to help out and explain.

Covered in this case means that they don't have to pay some third party to take that risk for them, they can just get the ambulance as part of the nominal fee everyone pays per year or whatever.

When you outline a problem statement, you want to map out what the person outlining the specs really mean. It takes practice.

Re: Why American ambulance rides are so expensive

#159

Post by wombat-man » Fri, Jul 10, 2026, 3:14 AM UTC

Spooky23 wrote: post #150

justonceokay wrote: post #106

Earlier quoted context omitted.

There’s the cost of supplies used during transport. Also the cost of maintaining potential supplies like blood even if they go unused. EMTs may make $23 but they are also getting benefits and have other overhead, making their real hourly cost probably closer to $50/hr minimum. There’s insurance, which I bet is out the wazoo expensive for ambulance. Ambulances have to be maintained and I would guess have much more reg…

EMTs are like veterinarians. Lovely people who get ruthlessly exploited. Benefits are garbage unless you’re a unionized public employee.

Yeah, every EMT I know was way underpaid for how crazy stressful it was. Especially considering how expensive the ride was

Re: Why American ambulance rides are so expensive

#160

Post by _DeadFred_ » Fri, Jul 10, 2026, 3:19 AM UTC

pclowes wrote: post #79

cogman10 wrote: post #69

Earlier quoted context omitted.

It's very often not a choice. But also, those rural areas are often the breadbaskets of the united states. Taking care of our farmers is important. Trying to frame it as a choice also misses a lot. It technically is, but you have to recognize there's a huge cost in uprooting your entire life and moving to a new location.

We give our farmers absolutely insane subsidies already. It is not the government’s job to “take care of” anybody. Everything has a cost, staying has a cost, leaving has a cost. The question is how much should the public be taxed to pay for individuals suboptimal decision-making? Or conversely, why am I subsidizing some billionaires remote horse ranch to have daily Postal Service and an ambulance standing by? Can I m…

Sweet, open the borders then. It's not the government's job to take care of that (we had government long before we had 21st century style closed borders, so it's definitely not a requirement of government). More people = more money coming in.