Why American ambulance rides are so expensive • Hacker News Board

Re: Why American ambulance rides are so expensive

#171

Post by michaelmrose » Fri, Jul 10, 2026, 3:59 AM UTC

justonceokay wrote: post #106

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…

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…

Most people live in urban environments. Approaching zero are over an hour. As with most people being in urban environments most ambulance rides are in urban environments and go to the nearest hospital meaning that most rides should be under 10 minutes.

There is zero reason to compare cost of ambulance rides to a plumber and "vibe" on how much more expensive an ambulance ride instead of actually looking at the component costs. They aren't remotely related and one tells you nothing about the other.

Both the actual analysis you responded to and this one are also missing the fact that the ambulance is already subsidized and that usage fees aren't actually paying for the ambulance which makes the fees charged more onerous yet.

It might be instructive to look at what Canada charges non-residence as non-residents pay the unsubsidized rate of about $400-$600 Canadian.

https://www.cma.ca/resources/healthcare-real/answers/healthc...

Re: Why American ambulance rides are so expensive

#172

Post by dripdry45 » Fri, Jul 10, 2026, 4:08 AM UTC

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…

That 150k figure I believe is quite outdated. New ones are running 300k or more. The ambulance vehicle providers have been bought up by private equity and the lead times are now years to get one.

Re: Why American ambulance rides are so expensive

#173

Post by xp84 » Fri, Jul 10, 2026, 4:13 AM UTC

jjk166 wrote: post #83

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…

> 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…

Some of your estimates on this seem fine, but not this:

liability, both for the vehicle and for the medical treatment; that's about $12k per year.

Insurance on my SUV is close to $3,000 a year, but with the understanding I drive it about 12k miles, and I'm not allowed to speed or run red lights whereas they're guaranteed to be speeding, and driving it around all day and maybe all night. And the ambulance is worth 5x as much as my car is. So I'd be shocked if the combo of their auto insurance + insurance against being sued for rescuing someone wrong is that cheap.

Re: Why American ambulance rides are so expensive

#174

Post by Spooky23 » Fri, Jul 10, 2026, 4:18 AM UTC

SoftTalker wrote: post #161

Spooky23 wrote: post #149

Earlier quoted context omitted.

Ambulance crews are almost never 2 paramedics. Most often they transport and do BLS only. If they are it’s because a local government is paying for that service. EMTs make minimum wage. The people who own ambulances typically have a little cartel like business in a region and print money. They refuse to sign insurance contracts so they are almost always out of network and will not accept direct insurance payments. Wh…

Nobody makes (federal) minimum wage these days. McDonalds employees make double that.

I don’t live in a red state so we have a bizarrely low minimum.

Re: Why American ambulance rides are so expensive

#175

Post by kyleee » Fri, Jul 10, 2026, 4:21 AM UTC

jjk166 wrote: post #83

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…

> 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…

All in cost of the employee is probably double or more of your example $23 an hour wage, just to flesh out your napkin math

Re: Why American ambulance rides are so expensive

#176

Post by uwagar » Fri, Jul 10, 2026, 4:23 AM UTC

its horrible to think when u are caught up in something serious that calling an ambulance could ruin your life later.

better to live in uk where nhs takes care of all this compassionately for free.

Re: Why American ambulance rides are so expensive

#177

Post by grogenaut » Fri, Jul 10, 2026, 4:25 AM UTC

jjk166 wrote: post #83

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…

> 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…

[dead]

Re: Why American ambulance rides are so expensive

#178

Post by jjk166 » Fri, Jul 10, 2026, 4:26 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…

I didn't forget the cost of insurance.

Re: Why American ambulance rides are so expensive

#179

Post by jjk166 » Fri, Jul 10, 2026, 4:26 AM UTC

xp84 wrote: post #173

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…

Some of your estimates on this seem fine, but not this: liability, both for the vehicle and for the medical treatment; that's about $12k per year. Insurance on my SUV is close to $3,000 a year, but with the understanding I drive it about 12k miles, and I'm not allowed to speed or run red lights whereas they're guaranteed to be speeding, and driving it around all day and maybe all night. And the ambulance is worth 5x…

The 12k per year includes medical liability insurance.

Re: Why American ambulance rides are so expensive

#180

Post by jjk166 » Fri, Jul 10, 2026, 4:28 AM UTC

justonceokay wrote: post #106

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…

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…

Medical supply costs for transport are very small. The labor overhead costs are overhead. Insurance is included in the estimate.

A plumber charges you $200 to come to your house, it costs the plumber $20 to come to your house. The latter value is what we're discussing here.