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Why American ambulance rides are so expensive

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Re: Why American ambulance rides are so expensive

#311

Post by [deleted] »

WJW wrote: post #291
lazide wrote: post #274

Earlier quoted context omitted.

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…

[deleted]

Re: Why American ambulance rides are so expensive

#312

Post by mananaysiempre »

master_crab wrote: post #290
ChrisMarshallNY wrote: post #265

Earlier quoted context omitted.

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.

There’s a thin line between satire, which can convince, and sneering, which can only turn off. John Oliver, unfortunately, does end up on the wrong side of it from time to time, and can (together with his core audience) be something of a bully when he does.

I’d also be careful about his facts: they’re usually well-researched, but by the nature of the format he only ever presents those which fit his argument, and that’s just not good epistemology. I can think of a few times when the show made me feel safer about my beliefs than I should have been feeling.

Re: Why American ambulance rides are so expensive

#313

Post by LtWorf »

otherme123 wrote: post #212
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…

> 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.

You see, it's better to die than to help the coloured neighbour who lives across the highway. I don't believe in this but that's USA society.

Re: Why American ambulance rides are so expensive

#314

Post by tonyedgecombe »

deepsun wrote: post #208
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…

> but you make the choice No US doctor would ever tell you how much any procedure would cost (even though they know, at least "in-network" doctors). But if in your EMT you inform the patient of the potential costs of the ride, then yea, I agree they make an informed choice.

I’d argue nobody getting into an ambulance is making an informed choice.

Re: Why American ambulance rides are so expensive

#315

Post by uoaei »

cucumber3732842 wrote: post #309
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…

>But no one wants to fix it. US doctors are overpaid. US nurses are over paid. Dug companies. Admin. Lawyers. Everyone who makes the system work, and everyone who makes the system a mess are paid a fortune for it. 17% of GDP is healthcare. So between 1:10 and 2:10 people in this country are making more than they otherwise would (note I did not say wealthier) because the system is screwed up and hoovers up more of eve…

Earnings represented by GDP are not distributed evenly across a given population. That 17% of extra earnings goes to relatively few people in the States (I'm putting this very mildly, the concentration in reality is insanely lopsided).

Re: Why American ambulance rides are so expensive

#316

Post by anovikov »

This problem just doesn't exist anywhere else in the world. Ambulance is just another truck. There are some fees involved with having priority on the road and some regulations, but it's just another truck. It won't cost (to anyone - i mean OF COURSE it is free for the actual patient) over a hundred euros or so to do a simple across-city ambulance ride anywhere in EU, maybe 2x the price of a cab.

That's corruption and nothing more. End it and imprison everyone who ever had a tangential relationship to this system, for life - to ensure no one will try to pull this sort of "regulatory capture" again.

Re: Why American ambulance rides are so expensive

#318

Post by hnmullany »

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…

I worked in private equity as an analyst in the 90's - we looked at an ambulance service that was up for sale - the underlying operating margins (before you load on debt) were pretty reasonable, although I don't remember the details.

Re: Why American ambulance rides are so expensive

#319

Post by Ntrails »

pshirshov wrote: post #293

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 sel…

> an average helicopter bill was smth around $200K if I remember correctly, with spikes up to $500K.

Those numbers made me blanch somewhat! Having been in a helicopter (aka Air Ambulance) in the UK, all of which operate as charities iirc, I was curious about their costs.

> The average cost of a helicopter mission is £4,748* and the average cost of a critical care car or rapid response vehicle mission is £2,054*[1].

https://www.airambulancesuk.org/about-us/facts/

eesh

Re: Why American ambulance rides are so expensive

#320

Post by Der_Einzige »

pjc50 wrote: post #285
NoMoreNicksLeft wrote: post #251

Earlier quoted context omitted.

[flagged]

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

Go ask SF troops what the PJs require from them if they get saved by a PJ (a branded tattoo on your ass).

I’m sure plenty of those soldiers would rather pay some money for the evac instead of a lifelong ass tat.

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