Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

Why American ambulance rides are so expensive

davidoks.blog

Post reply on HN
Print view View original

281–290 of 536 posts

Re: Why American ambulance rides are so expensive

#281

Post by IG_Semmelweiss »

jjk166 wrote: post #179
xp84 wrote: post #173

Earlier quoted context omitted.

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.

That number looks low.

Re: Why American ambulance rides are so expensive

#282

Post by spzb »

charcircuit wrote: post #35
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…

>from everyone the service stands ready to rescue So compelled health insurance to use an ambulance? You could just as well make it optional and charge people without the insurance the full price.

One thing that's often overlooked is the cost of administering a billing system. If you're going to distinguish between the insured and uninsured you need a system that keeps track of who has insurance. You need paperwork (or digital equivalent). You need accounts payable staff to send invoices and chase up unpaid bills. It can, counter-intuitively, work out cheaper just not to charge anyone.

Re: Why American ambulance rides are so expensive

#283

Post by lazide »

socalgal2 wrote: post #227
indoorfish wrote: post #153

Earlier quoted context omitted.

"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

Not in my experience. Most LLM answers are bullshit; and they almost never say they don’t know. Most people would just look at you and say ‘I don’t know’ instead of just making something up.

Re: Why American ambulance rides are so expensive

#284

Post by hnthrow10282910 »

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…

I fainted once and my wife called an ambulance as I was unconcious due to Covid.

I was fully aware when the ambulance arrived and refused. They peer pressured me very hard anyways. It was a 1 mile drive and cost me $14,000

Re: Why American ambulance rides are so expensive

#285

Post by pjc50 »

NoMoreNicksLeft wrote: post #251
onion2k wrote: post #205

Earlier quoted context omitted.

I don't think the question is "Should ambulances be a thing?" though. It's a question of "Should someone in a situation where they need an ambulance have to balance the potentially life-threatening impact of saying no versus the potentially financially ruinous impact of saying yes?" The (fairly obvious) answer to that no one should be in that situation. It's horrible. Society should find a better way to pay for ambul…

[flagged]

We should go further with this and require troops to pay for their own medevac. /s

Re: Why American ambulance rides are so expensive

#286

Post by IG_Semmelweiss »

Great article. One item that it avoids touching even though it clearly insinuates it - the solutions.

And among the solutions, there's one that is briefly alluded to, but skipped around like a hot potato.

What if EMS were to refuse services for those who don't pay for the option on a monthly basis? And for the rest, if they choose to pay "on the spot" they can be OON like everyone is now? Why give out a free (or subsidized) option out, at all ? After all, I dont think it is illegal to turn away Medicare & Medicaid patients if you are not in-network with them.

We pay for other types of insurance. EMS insurance seems like a natural fit for a family.

Re: Why American ambulance rides are so expensive

#287

Post by secult »

Usually, when some system is getting outdated, the system gets replaced or updated to fit the needs. Does this system work for the majority of USA, or not? Do I read it correctly, that the poor people have medicare/medicaid and therefore it's fine for them, the average person has some health insurance and don't mind spending a few thousands of dollars once in a while when his life is in stake?

Re: Why American ambulance rides are so expensive

#288

Post by zhdc1 »

consp wrote: post #239
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…

Here in the Netherlands it is 877 euro for an A1 call (emergency, no delays), and 384 for B1 calls (non emergency, planable). You also get a 4.83 euro per km cost. You pay up to 375 euro if you haven't had any medical cost that year, otherwise zero. Stand by cost are about 154 euro/hour. E.g. for sport events. ICU transport is about 2500. All are law mandated. The total cost might be more as the insurers also put in…

Seems reasonable and closer to American averages than I would have expected.

Re: Why American ambulance rides are so expensive

#289

Post by master-lincoln »

wisty wrote: post #240
otherme123 wrote: post #212

Earlier quoted context omitted.

> Society should find a better way to pay for ambulances Society has this figured out, at least a decent solution that works until we find a perfect one. Only the US society seems to be unable to find a solution.

And the US also pays a TON of tax dollars to a broken, overregulated system. IIRC if you look at the cost of Medicaide, Medicare, VA, and other federal and state spending it's the same as most other countries per capita or as a percent of GDP. The US taxpayer pays about as much as Canadians to fund their public system, then pays the same amount again for private cover since it's not universal. No I'm not making a typ…

That's what a government would be for. You vote neo-liberal, you get it... (I consider both the US democrats and republicans neo-liberal)

Re: Why American ambulance rides are so expensive

#290

Post by master_crab »

ChrisMarshallNY wrote: post #265
grogenaut wrote: post #207

Earlier quoted context omitted.

Is this the common cost or is this an outlier blog story that hit it off. Talk real data to me. I don't get excited about any individual anecdote (unless it's me personally of course). No people shouldn't be bankrupted for a short cab ride that's not needed. I'm not arguing that.

It’s pretty common. I know that John Oliver is a bit of a “lightning rod,” for many folks, but he (or his staff, really) does his homework. He did a segment on it, some time ago: https://youtube.com/watch?v=Ezv8sdTLxKo

He’s a lightning rod only because some people get unnecessarily triggered by facts that don’t fit their world view.
Post reply on HN