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Why American ambulance rides are so expensive

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Re: Why American ambulance rides are so expensive

#291

Post by WJW »

lazide wrote: post #274
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.

Well over a decade ago, it was $6500 for a couple mile ride to the nearest hospital, no emergency medical care necessary (just supervision). This was in the Bay Area, in California. I can’t imagine it’s gotten cheaper.

That's wild. According to the website of my local ambulance organisation, a full on ambulance ride with all medical supervision etc runs between 400 and 900 euros. Typically this would be reimbursed by the (mandatory in this country) health insurance. This is in a large city in western Europe, I would expect it's cheaper in places with lower cost of living.

EDIT: their own website states "If the ambulance only comes and stabilizes you on the spot but you don’t need to be transported, there are no costs." https://ambulanceamsterdam.nl/information-in-english/

Re: Why American ambulance rides are so expensive

#292

Post by mstaoru »

Just a personal anecdote. I was living in China, my father was visiting and fell ill (anemia). We needed to go to the hospital and decided to call an ambulance vs. calling a car because it could enter the gated compound. For a 3 km ride the price difference wasn't even a concern. A car would cost ~$3 and an ambulance ended up about $30.

PS: An average net salary in that city was about $1700/month at the time.

Re: Why American ambulance rides are so expensive

#293

Post by pshirshov »

I worked at a company which was doing medical billing for ambulances among other things.

Essentially, the bills are always inflated so when the settlement comes the providers get 20..50%. The crucial procedure is so called "medical coding" where medical notes (sometimes - scrawled on paper with a pencil) are being turned into bills - and that's where additional codes are getting added and more expensive codes are selected. There are books and guidelines on how to do the coding and some automated logic which "fixes" filled forms to bump the amounts a bit.

If the insurance (less frequently - the patient) pays more - that's just a bonus.

Billing itself gets a small fraction of the bill usually amounting to $20..50, they don't profit from inflated bills directly but the clients would select you on the basis of average settlements. Dispatchers also get little fractions. Things are very different when it comes to helicopter ambulances, where the bill could easily get to hundreds of thousands and everyone involved gets a lot. In fact, all the operators prefer to work with helicopters because of that, everyone involved references ground operations as "crap" or so.

Can't say for whole industry but that's what I've seen at one particular place working with several providers/dispatcher companies.

From what I can remember about the ground reality, a $12K bill would mean that they expected to actually get $3..4K. A typical ground bill for some particular region the company operated at was settled at $500..$2K while an average helicopter bill was smth around $200K if I remember correctly, with spikes up to $500K.

Re: Why American ambulance rides are so expensive

#295

Post by RowanH »

King-Aaron wrote: post #238

Here in Australia, you can be 2,000km in the bush and an ambulance will fly out to you and fly you back to the city for free. That being said, we also have private ambulance companies here that will sting you for a huge bill if you don't have private ambulance cover.

We're getting taken to the cleaners in NZ!! I think it's $50 for a westpac chopper ride...

Re: Why American ambulance rides are so expensive

#296

Post by bestouff »

master-lincoln wrote: post #289
wisty wrote: post #240

Earlier quoted context omitted.

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)

I think only the US consider the US Democrats as leftists.

Re: Why American ambulance rides are so expensive

#297

Post by NamTaf »

fuckyah wrote: post #216
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]

"Just don't be poor!"

I feel like you have missed the entire point of the article.

Re: Why American ambulance rides are so expensive

#298

Post by chmod775 »

IG_Semmelweiss wrote: post #273
chmod775 wrote: post #225

> 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-liab…

[flagged]

Let's ask the thing whose mistakes I iron out all day to think for me.

Re: Why American ambulance rides are so expensive

#300

Post by NamTaf »

altern8 wrote: post #260
orwin wrote: post #248

Earlier quoted context omitted.

I dislike sentences like 'you still have to wait months for an exam or years for surgery'. Depends on the exam or surgery. - Blood test: wait time (after your 12 hour fast) is likely 15-30minutes in most of Europe (even eastern Europe. I should know, I do one every 3 month). - pet-scan/x-ray: at most a few hours if your area is truly underserved, in my experience, less than an hour (but I needed it 4 times, so it mig…

I'm not sure we're talking about the same thing. What I meant with "you have to wait months" is that if you go with the government-provided doctors and processes, they put you on a list and you have to wait for your turn. Getting an exam done can take months, and you can wait years for surgery, unless your condition is life-threatening. If you go to a private clinic, of course you can get test results the same day an…

The point is that list isn't first-in-first-out. Public waiting lists are constantly reviewed by domain medical expert committees in the public system to triage priority patients.

If you're truly urgent, you will get bumped up. If you're not urgent, you can get bumped down as others go above you.

Unfortunately, individual QoL and urgency can sometimes be disconnected, which is why pensioners getting hip replacements can get bumped down despite having loss of mobility due to heaps of pain.

Cumulatively for lots of non-urgent activities (diagnosis tests etc) that drag can add up.

Much like any commons, is no perfect system, funnily enough.

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