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Why American ambulance rides are so expensive

davidoks.blog

331–340 of 536 posts

Re: Why American ambulance rides are so expensive

#331

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.

[flagged]

Re: Why American ambulance rides are so expensive

#332
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 can get an ambulance for only $150k? A transit van with a few options is already $75k.

I agree. That number is bullshit. I Googled about it. It looks like 350K to 600K USD. Also, there is wild variance in vehicle sizes and the equipment you choose to carry.

Re: Why American ambulance rides are so expensive

#333

Last year I had appendicitis in Italy, where I live. I called a cab to reach the nearest hospital, since I didn't feel so bad as warranting an ambulance. I got accepted, visited, transferred to the larger nearby hospital by ambulance, appendectomy, 4 nights stay, and I was provided with the drugs for the convalescence. When I was dismissed I took another cab back. Total expense: ~25€ for the two taxi rides. Very happ…

This sounds like a great deal if your annual taxes are less than your annual unsubsidized medical expenses, and a terrible deal if your annual taxes stretch into the six figure range as a young healthy person.

Re: Why American ambulance rides are so expensive

#334

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.

> Only the US society seems to be unable to find a solution. Unwilling. It's absolutely feasible to find a solution, as seen everywhere else in the world.

Even some parts of the US have found solutions.

From the article:

> In Tulsa and Oklahoma City, meanwhile, the government buys staffed unit-hours from an ambulance operator, while households can prepay a few dollars a month on their utility bill and owe nothing if the ambulance ever comes.

Re: Why American ambulance rides are so expensive

#335
post #45

Earlier quoted context omitted.

But that’s socialism!

[dead]

Virgina is easily one of the worst, most authoritarian states in the USA and it’s not even close

Worst driving laws in the USA by far. The entire existence of “the citadel”/VMI, the dog laws you mention, and a whole host of other authoritarian conservative nonsense.

Re: Why American ambulance rides are so expensive

#336

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…

$500k? There entire helicopters you can just buy outright for less money than that. Does the $500k ride come with the helicopter itself included in the purchase?

Re: Why American ambulance rides are so expensive

#337

I spent a lot of time in healthcare finance and across most medical service industries the Medicare rate is actually not a loss. It’s a common thing said as it’s not super profitable, but it’s usually not a huge loss. It’s pretty close to what the cost of care should be. It just doesn’t give the extra padding for extremely fancy clinics, hospitals, admin and executive compensation, and often PE investor margin expect…

[if the article’s analysis is true] cost controls would reduce the supply of ambulances, since the article claims Medicare actually is a loss.

You have claimed it isn’t, but you haven’t really provided much evidence other than “there’s no way that’s true, trust me, I used to work somewhere in healthcare finance”

Re: Why American ambulance rides are so expensive

#338

Last year I had appendicitis in Italy, where I live. I called a cab to reach the nearest hospital, since I didn't feel so bad as warranting an ambulance. I got accepted, visited, transferred to the larger nearby hospital by ambulance, appendectomy, 4 nights stay, and I was provided with the drugs for the convalescence. When I was dismissed I took another cab back. Total expense: ~25€ for the two taxi rides. Very happ…

This sounds like a great deal if your annual taxes are less than your annual unsubsidized medical expenses, and a terrible deal if your annual taxes stretch into the six figure range as a young healthy person.

Doesn't this young person theoretically become older and less healthy as time passes? How many young people have six figures in taxes and not understand reciprocity?

Re: Why American ambulance rides are so expensive

#339
post #22

I tell this story every time ambulance costs come up because it might be helpful to anyone. I once lived in San Francisco in the mid-2010s. In SF, the SFFD operates the vast majority of ambulances in the city. As in, 80%+. I once had the need to go to the hospital urgently and called 911. The ambulance that showed up was SFFD. They transported me and I recovered safely. I then got a bill from them saying that my insu…

    > I immediately filed a complaint with the insurance company's California regulator (at the time it was the Dept of Insurance for this one, but it seems most or all now are under the Department of Managed Health Care) since insurance companies are by law obligated to pay at the in-network rate in the case of an emergency (which presumably is why you call an ambulance in the first place). Within 2 weeks I received a letter from the insurance company that all was completely fine and that they'd corrected the situation and paid the bill.
First: Hats off -- nice work.

What annoys me the most about this story: There should be a disportionately large penalty that the insurance must pay to the health care regulator for cases like this. It would discourage this kind of illegal behaviour.

Re: Why American ambulance rides are so expensive

#340

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 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…

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