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Why American ambulance rides are so expensive

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Re: Why American ambulance rides are so expensive

#461

Post by bjustin »

gruez wrote: post #407
ajuc wrote: post #325

Earlier quoted context omitted.

The time for this debate was 100 years ago. Now only people who can't be convinced aren't convinced, so there's no point convincing. So why not make fun of them? There's no downside.

>So why not make fun of them? There's no downside. ...except the populist right backlash, triggered in part by their resentment at coastal "elites" (think yuppies, not people who fly to davos annually) sneering at them.

The "coastal elites" they resent are made up by conservative media. No behavior changes by the yuppies can affect the ever-increasing resentment people feel in response to this sneering bully, because the bully is made up and the tendency of RW media to use ever-more-dire portrayals of supposed societal ills.

As an aside, I think the culture which produces this result is related to people in the US always thinking crime is increasing, regardless of actual crime trends.

Re: Why American ambulance rides are so expensive

#462

Post by jeremyjh »

philipallstar wrote: post #458
jeremyjh wrote: post #389

Earlier quoted context omitted.

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.

This is just GDP, which isn't that relevant. If you add a million people and only one of them works, GDP will still go up. It doesn't take into account the following: - no-one's talking about immigration in general. They're talking about mass immigration. So any general "look how immigration can be good" is not addressing the issue. - mass immigration means that housing becomes scarce, driving up prices. This again m…

Net economic benefit is not only GDP, it includes net tax over government spending. Immigrants are younger so they have more regular taxable income (vs capital gains), while spending more of it (vs saving) and drawing less government benefits.

The housing shortage is driven by NIMBY and regulatory capture. You are right that perpetual growth is unsustainable but we are not remotely near the possible carrying capacity of our land and resources. We have had periods of much greater population growth that were accompanied by greater prosperity overall.

Immigrants are not the problem, they are the convenient scapegoat of the business interests that have systematically hollowed out the middle class over the last 50 years.

Re: Why American ambulance rides are so expensive

#463

Post by Hnrobert42 »

Planktonne wrote: post #272
Hnrobert42 wrote: post #36

Earlier quoted context omitted.

But do they really? Can you point a real, evil villain saying that?

Here you go: https://news.ycombinator.com/item?id=48857068

Do you really not understand the difference between the one you cited and the one to which I was responding?

The one to which I was responding was capricious. The one you cited has reasoning, even if you disagree with it.

And that was the whole point of my comment. That by reducing the other side to a farcical strawman, you diminish your own argument. It just becomes a yelling match.

I would rather debate the person you cited than sit complacently with the cynic to whom I responded.

Re: Why American ambulance rides are so expensive

#464

Post by spicymaki »

gruez wrote: post #92
spicymaki wrote: post #46

Earlier quoted context omitted.

I think we are all villains here. Good healthcare coverage is just another status symbol to be attained. If the poor have it then it becomes less of a value. To some degree we are all wired this way and we all suffer because of it.

>I think we are all villains here. Good healthcare coverage is just another status symbol to be attained. Seriously? How many conversations have you been in where people were bragging about how good their health coverage is and trying to one-up each other? The extent I've experienced is stuff along the lines of "thank god I had my health plan, because otherwise it would have cost [6 figures]", but it didn't give the…

Funny enough I have had this conversation during the ACA “Obama Care” national (US) debate in the early 2000s. I have had one of my colleagues say if we give healthcare to everybody then it will affect his care negatively. He would rather limit it to people who deserve it (through merit) so he can have his pick of quality doctors. These people absolutely do exist.

Re: Why American ambulance rides are so expensive

#465

Post by orwin »

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…

To get standard blood exams (cortisol, insulin, triglycerids, HDL/LDL) reimbursed in France/Spain/Germany/Romania you only need a doctor note (and not even that if you test for STD).

Of course if you need specialized blood tests that need spectrometry or dna analysis or any expensive analysis you need a specialist appointment and that takes longer, but bureaucracy is the only way to make sure no one abuse the system. In worst case scenario, if the doctor thinks you should have priority, you will get it. And sometimes they are wrong. But it's a choice made to reduce overall cost, to avoid abuse.

Re: Why American ambulance rides are so expensive

#466

Post by ajuc »

gruez wrote: post #407
ajuc wrote: post #325

Earlier quoted context omitted.

The time for this debate was 100 years ago. Now only people who can't be convinced aren't convinced, so there's no point convincing. So why not make fun of them? There's no downside.

>So why not make fun of them? There's no downside. ...except the populist right backlash, triggered in part by their resentment at coastal "elites" (think yuppies, not people who fly to davos annually) sneering at them.

They will do that anyway. No amount of pandering will change their minds.

Re: Why American ambulance rides are so expensive

#467

Post by sgerenser »

Sohcahtoa82 wrote: post #440
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…

> US doctors are overpaid. US nurses are over paid. Median pay for a Nurse Practitioner is $132K/yr [0]. I think that's reasonable. Average pay for physicians ranges from $220-450K depending on specialty. [1] Personally, I think doctors should be paid more than software engineers, so I think those numbers are all reasonable, especially when you consider what it takes just to enter the field. Nurses require a Master's…

You might find those salaries reasonable, but they’re probably double what those same occupations pay in many other (first world) countries with lower healthcare costs. Maybe the trade off is worth it, but it’s not something that can be ignored when people complain about how much more expensive healthcare is in the U.S. compared to Europe (for example).

Re: Why American ambulance rides are so expensive

#468

Post by harmmonica »

vineyardmike wrote: post #197
harmmonica wrote: post #117

Earlier quoted context omitted.

Probably an obvious/dumb thing to say on HN, but I just want every medical service to have this exact type of breakdown. And then we can at least somewhat pierce the veil of health care costs. The thing I can't figure out is why this doesn't already exist, or, if it does, why it's not more widely known amongst laypeople. Everything from ambulance rides to MRI's to surgeries can be baselined and then we can talk about…

> I just want every medical service to have this exact type of breakdown Check out the "No Surprises Act" https://www.cms.gov/priorities/key-initiatives/hospital-pric...

Hi there, I’ve used this for hospitals local to me but correct me if i’m wrong but those are only the prices for services. What I’m talking about is unit economics for the service. The difference being pricing is opaque (or rather pricing alone is not transparent enough) until you know the cogs and then you can evaluate how profitable the pricing is.

edit: clarity

Re: Why American ambulance rides are so expensive

#469

Post by MAustriaGA »

scbrg wrote: post #241
yamillove wrote: post #62

Earlier quoted context omitted.

[dead]

Foreigner from the socialist Nordics here, so perhaps I'm brain washed or something, but I don't get it. After some brief Googling it appears that you mean they have proposed a tax on a service that for some reason used to be tax-exempt. Why was it tax-exempt? Why should it be? What sets it apart from any other service where you pay someone to do something for you - such as cook you a meal, transport you somewhere or…

[dead]

Re: Why American ambulance rides are so expensive

#470

Post by phil21 »

ButlerianJihad wrote: post #44

I had an ambulance ride on Thanksgiving Day last year. And the punchline was that with my ACA insurance, the "ambulance run" co-pay was $1,200. (Of course my total ambulance bill was around $1,310.) There was a long period of back-and-forth with calls and website visits, where they were insistently billing the wrong insurance, and so forth. But I'm grateful that I used the ambulance at that point in time. The key adv…

> The key advantage to an ambulance ride is bypassing the Triage Nurse.

This is going to depend on where you live/the particular hospital. A lot of "frequent fliers" figured out this loophole and started abusing it where I previously lived, so there was no way around the triage nurse.

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