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Why American ambulance rides are so expensive

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Re: Why American ambulance rides are so expensive

#221

Post by gkmcd »

defrost wrote: post #72
ethersteeds wrote: post #43

Earlier quoted context omitted.

> most of the world has solved it by making ambulance (EMS) funding similar to fire... About 65% of the more than one million firefighters in the U.S. are volunteers, with nearly 19,000 fire departments being run completely by volunteers.

St. John's Ambulance service in Australia is a hybrid of core paid positions and volunteers (varying by region and demand). In rural Australia most of the fire, ambulance, and emergency response service are volunteer manned and (locally) run, with federal and state assistance for equipment and costs. Costwise AU Ambulances are either free (if you're a St. John's member - cheap per annum OR if covered by private / wor…

I don't think this is true everywhere. Queensland has the QAS[1], operated and funded by the state government. There are no (direct) fees.

[1]https://www.ambulance.qld.gov.au/

Re: Why American ambulance rides are so expensive

#222

Post by sitharus »

milleramp wrote: post #211
grogenaut wrote: post #170

He refused to go in an ambulance the first time. He could have refused the second ride. You can refuse transport or medical care at any time as long as you are able to make rational decisions. As an EMT if you're A&Ox4, alert to time, place, person and event, you make the choices. You do sign a release so we have proof we didn't abandon you, but you make the choice. If we move you without your approval, it's kidnappi…

The physician can mandate ambulance transfer.

Really? Where I live a patient is always able to refuse any medical procedure or treatment, unless they’re unconscious or otherwise mentally unable and the procedure is considered necessary to save their life. They certainly can opt for a non-ambulance transfer, though here it would be free even though a regular ambulance service typically isn’t.

Consent for treatment is a core principle of medical practice.

Re: Why American ambulance rides are so expensive

#223

Post by kaelwd »

Avicebron wrote: post #4

> The most efficient way to fund ambulance services would simply be to pay for the option the way that options are normally paid for: with a premium, collected from everyone the service stands ready to rescue. That’s how it’s done in the rest of the rich world. Some places, like the United Kingdom or Japan, simply fund ambulance services directly out of taxes; others, like the Australian state of Victoria, sell membe…

> “Ambulance Victoria,” with unlimited exercise at the cost of about $70 a year

And even if you don't pay this it still isn't that expensive - US$12873 is more than a helicopter transport would cost here. US healthcare companies somehow get away with charging insured patients 10x more than civilised countries charge uninsured ones.

Re: Why American ambulance rides are so expensive

#225

Post by chmod775 »

> The standard answer is greed: rapacious ambulance operators, owned by villainous private equity firms, exploit patients at their most helpless. But I don’t think that’s actually what’s going on. Ambulance providers are chronically unprofitable businesses; margins are thin, crews are underpaid, and operators exit the industry every year.

The author does not understand how private equity extracts money. The high-liability and heavily scrutinized business is intentionally left with little profit: the actual profits are funneled up the supply chain. This is why private equity buys "nonprofit" hospitals - they can now control who that nonprofit buys services and equipment from.

Re: Why American ambulance rides are so expensive

#227

Post by socalgal2 »

indoorfish wrote: post #153
socalgal2 wrote: post #143

Earlier quoted context omitted.

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.

It's arguably more reliable than some rando above doing napkin math and zero actual experience or evidence

Re: Why American ambulance rides are so expensive

#228

Post by pjc50 »

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…

Comparable UK costs: https://www.kingsfund.org.uk/insight-and-analysis/data-and-c...

Estimate for an ambulance call is about £450. I suspect the main reason the US costs more is wages.

Re: Why American ambulance rides are so expensive

#229

Post by ornornor »

I had to call an ambulance in Switzerland where ambulance prices are freely set by the operator (except in a few cantons which are enforcing reasonable flat rates)

A 5 minutes ride cost 1500.- (more or less the same in USD)

Because I had used a good broker to pick my insurance plan, I was left with “only” 500.- to pay out of pocket for the ride.

In Quebec, as a resident, going 3 blocks in the ambulance cost us about 500 CAD if I remember correctly.

Re: Why American ambulance rides are so expensive

#230

Post by pjc50 »

SpicyLemonZest wrote: post #91
xp84 wrote: post #71

Earlier quoted context omitted.

Be that as it may, the law in California forbids the insurance company from refusing to pay at the in-network rate in an emergency. As evidence, I'd submit the claim they immediately paid when called out on this. If the insurance company weren't cynically exploiting people's lack of knowing their rights, they'd at least send a form letter to the patient saying "Please send us whatever proof from the hospital that you…

But isn't the California law requiring the insurance company to act as a sin-eater here? They seem to be the only people you were frustrated with, even though they are not the ones who charged you $1000.

The insurer is being forced to act as an insurer, by paying the $1000 they're supposed to cover.
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