Live data from Hacker News

Why American ambulance rides are so expensive

davidoks.blog

471–480 of 536 posts

Re: Why American ambulance rides are so expensive

#471

Earlier quoted context omitted.

[flagged]

This shit is exactly the problem with capitalism and capitalists. I've seen as long as I've been alive, "Communism killed hundreds of millions!!!" breathless claims. When Capitalism kills, oh wait, it never does! Its always "bad individual choices", and never a review of the terrible for-profit system that caused it to begin with. > Making poor medical choices that prioritize your own well-being over the financial so…

I'm amazed that in ~450 comments, the word "capitalism" is mentioned in just one - yours - and you've been downvoted for criticizing it!

It seems even a group that purports to be rational critical thinkers don't want to be rational critical thinkers to the extent of looking into the root causes.

Re: Why American ambulance rides are so expensive

#472

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…

I remember this came up during COVID. The government was worried that homeless people and illegals would be afraid to report symptoms. GPs are specifically free and don't have to ask for papers or insurance to combat these health crises.

Re: Why American ambulance rides are so expensive

#473
post #235

Earlier quoted context omitted.

I had an accident where I had a concussion and other injuries that put me in a lot of, and the people I was with called an ambulance for me, and I wasn't really in a state to decline, but if I had been, and knew how much it would cost, I would have. The ambulance ride was, of course, out of network. As were some of the doctors that treated me once I got to the hospital. It was the first time I dealt with a major medi…

Treating medical care like this, similar to a racketeering scheme, should not be a thing anywhere. Instead of punishing people for seeking medical care (or plainly requiring it), it would be preferable to have a robust protocol for rejecting patients that do not require care, whether at the hospital or before the ambulance ride. For this, people would need to want medical care be a humanitarian right and basic pillar…

I read a book once about doctors who went into the slums to treat cholera in the 19th century- noblesse oblige. We are now WORSE than the Victorians.

Re: Why American ambulance rides are so expensive

#474

Earlier quoted context omitted.

When you are bleeding out on the street, you don't have time to shop around for the best deal

Wont matter because nobody is going to be paying 12k for a ambulance ride if there are people doing it significantly cheaper.

Again, if you are busy dying, you (or, more likely, the bystander who calls EMS on your behalf) do not have time to check how much the bill will be, or who has the best response time to your location at that moment, or the best equipment, or the best training.

Re: Why American ambulance rides are so expensive

#475
post #404

Earlier quoted context omitted.

Even the Soviets had a label for people who are a drain on society. You can’t run a country pretending everyone makes good choices.

And yet, somehow, not every country that has offered free ambulance rides has fallen into financial ruin.

Strawman. Ask any ER about “frequent flyers” who use ambulances as taxis

Re: Why American ambulance rides are so expensive

#476
post #400

Earlier quoted context omitted.

Canadians don’t get the same care as Americans. McKinsey did a nice analysis of what is driving US healthcare costs. It compares category spending to OECD then compared price and volume. Turns out the US pays a bit more for drugs (relative to total spend), a little more for inpatient care and a TON more for outpatient care but half of the increase is volume, not price. As someone who works in healthcare globally, the…

A good tell that someone is utterly full of shit on Canadian healthcare is that they generalize all of Canada. “Canadian health care” is not a thing. Each province administers its own completely independent system. Someone on PEI is in a healthcare system that has as much to do with Alberta’s healthcare system as it does their neighbours in Maine. As a result, anyone referencing Canadian healthcare is talking about a…

You’re ignoring the fact that provinces can’t fund technology that the federal government hasn’t reviewed and negotiated a price for.

So yes there may be differences between provinces in terms of when they fund what restrictions are put on it, the overall trend across Canada is pretty consistent.

And as I said Canadians don’t get the same care as Americans so concluding the higher cost is entirely higher prices for the same thing is false.

Re: Why American ambulance rides are so expensive

#477

Earlier quoted context omitted.

Wont matter because nobody is going to be paying 12k for a ambulance ride if there are people doing it significantly cheaper.

Again, if you are busy dying, you (or, more likely, the bystander who calls EMS on your behalf) do not have time to check how much the bill will be, or who has the best response time to your location at that moment, or the best equipment, or the best training.

Again, if people are doing it cheaper, how could a 13k per ride company stay in business? 911 services would have to be steering them to an insanely bloated expensive company. That wouldn't happen. Competition brings better service and much cheaper prices, always does, without exception.

Re: Why American ambulance rides are so expensive

#478

I think the answer is very simple. Regulation. If there was no regulation or very little then anyone could open up an ambulance service and the cheapest costs and the best service would win. Unfortunately that’s not the case. It’s like day care. Day care is expensive because the government mandates it to be expensive. Otherwise you’d have grandmas down your street would gladly watch your kid but it’s generally not al…

The idea that everything gets better if we remove all regulation is one we know doesn't work. It's the model we've tested repeatedly, before each piece of regulation, and it always leads to negative outcomes.

Can you name some?

Re: Why American ambulance rides are so expensive

#479
post #475

Earlier quoted context omitted.

And yet, somehow, not every country that has offered free ambulance rides has fallen into financial ruin.

Strawman. Ask any ER about “frequent flyers” who use ambulances as taxis

It's not a strawman. Ruining entire countries is literally what the parent comment said would happen if we do something as outrageous as making ambulances free.

> But those same people, through one false rationalization or another, are more than happy to ruin the entire country.

You may not have agued it yourself but your two sentence comment is rather lacking in alternate arguments, so I can only interpret you as supporting said parent comment and now engaging in a motte-and-bailey now that you realise you don't actually like what they said.

Re: Why American ambulance rides are so expensive

#480

Earlier quoted context omitted.

Lots of policy in the US is hacking around the lizard brain idea of "We cannot have nice things because someone who doesn't deserve it might get it." My favorite example is universal school breakfast and lunch. Without fail, someone will argue that some kids don't deserve it. It doesn't matter that all of the data shows it is more economically efficient and the benefits to kids is overwhelming.

You essentially described the Republican and Libertarian perspectives in the US. The Republicans seem to see it as immoral to potentially give a few people support they don't need even if that means that most of the people who need the support actually get it. And, instead, they believe that having an inconsistent array of private interests will somehow be more able to service an enormous population than having an or…

> The Libertarians seem to either genuinely not care about the rest of the world or, more often than not, seem to be naive about how life can be for the less privileged

No, they just put boundaries on what services they want handled by the government. Government programs are the least efficient and most wasteful way of getting a job done, and there are endless examples of this.

Churches were historically the places people went to for assistance, and churches held people accountable and would push them to fix their underlying issues. Government programs have none of this, you can keep making the same bad decisions and nobody will hold you accountable and the benefits will keep coming in.

Post reply on HN