Why American ambulance rides are so expensive • Hacker News Board

Re: Why American ambulance rides are so expensive

#381

Post by veunes » Fri, Jul 10, 2026, 1:03 PM UTC

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…

Thin operating margins don't really settle the greed question when the ownership structure is complicated

Re: Why American ambulance rides are so expensive

#382

Post by philipallstar » Fri, Jul 10, 2026, 1:04 PM UTC

jeremyjh wrote: post #349

philipallstar wrote: post #327

Earlier quoted context omitted.

[flagged]

The US has always been a nation of immigrants, but now its largely a nation of ignorance.

All nations are nations of immigrants other than maybe the cradle of humankind. They stop being that generally when the state and benefits get so expensive that administrating them and paying for them becomes a huge burden. The original immigrants to America fought the land and many died to tame it. Coming now to take is not the same thing. Particularly when you can fly in, give birth to an American, and fly out again.

Re: Why American ambulance rides are so expensive

#383

Post by quentindanjou » Fri, Jul 10, 2026, 1:07 PM UTC

If there is no emergency way to contact an ambulance in network then there should be no in- or out-of-network.

Calling 911 does not give you an in-network and there no way to know in advance unless calling your insurance (in business hours, giving that you are not dying... which you probably are)

Re: Why American ambulance rides are so expensive

#384

Post by veunes » Fri, Jul 10, 2026, 1:11 PM UTC

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…

Most of the cost is keeping crews, vehicles and equipment available for the call that may or may not come

Re: Why American ambulance rides are so expensive

#385

Post by spzb » Fri, Jul 10, 2026, 1:15 PM UTC

charcircuit wrote: post #356

spzb wrote: post #282

Earlier quoted context omitted.

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.

That is not required complexity. You can just send the bill to the customer.

Who is the “you” in this scenario?

Re: Why American ambulance rides are so expensive

#386

Post by JKCalhoun » Fri, Jul 10, 2026, 1:17 PM UTC

I was handling my moms bills when, at an independent living home, she was sent twice by ambulance for minor falls.

As the article says, thousands of dollars for these 5 minute drives.

(Fuck "credit score") I sent a check for $20 for each of the two bills. And I then did the same the next month when the bills came again.

I repeated this $20-a-month routine for a few years before, in both cases, they ended up closing the accounts-billing after perhaps $500 or so was paid.

Re: Why American ambulance rides are so expensive

#387

Post by thisislife2 » Fri, Jul 10, 2026, 1:18 PM UTC

alistairSH wrote: post #367

anonym29 wrote: post #336

Earlier quoted context omitted.

$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?

Uh, a new Bell 407 is north of $4 million and that's before it's equipped for medical flights. You aren't buying one of these for $500k used, at least not one that's air worthy. Eurocopter EC135 are a bit cheaper, but not by much.

-> https://www.globalair.com/aircraft-for-sale/helicopters

Re: Why American ambulance rides are so expensive

#388

Post by everdrive » Fri, Jul 10, 2026, 1:21 PM UTC

Can anyone explain why coverage networks even exist? What exactly makes it so expensive for an insurance provider to deal with an out-of-network health care provider? That same health care provider would not be expensive for an in-network insurance provider. I have no sense whatsoever for why the same health care provider would be expensive in one case and inexpensive in another case.

Re: Why American ambulance rides are so expensive

#389

Post by jeremyjh » Fri, Jul 10, 2026, 1:23 PM UTC

philipallstar wrote: post #382

jeremyjh wrote: post #349

Earlier quoted context omitted.

The US has always been a nation of immigrants, but now its largely a nation of ignorance.

All nations are nations of immigrants other than maybe the cradle of humankind. They stop being that generally when the state and benefits get so expensive that administrating them and paying for them becomes a huge burden. The original immigrants to America fought the land and many died to tame it. Coming now to take is not the same thing. Particularly when you can fly in, give birth to an American, and fly out agai…

Immigrants provide a net economic benefit on average. If they work here, they spend here. They tend to be younger and with our aging demographics it’s really important that we have more young people entering the workforce.

Re: Why American ambulance rides are so expensive

#390

Post by pornel » Fri, Jul 10, 2026, 1:26 PM UTC

3D30497420 wrote: post #334

x______________ wrote: post #308

Earlier quoted context omitted.

> 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.

billed for buying unit-hours from an operator... that's very carefully worded to make it sound like a corporationcustomer relationship and not socialism.