Live data from Hacker News

Why American ambulance rides are so expensive

davidoks.blog

491–500 of 536 posts

Re: Why American ambulance rides are so expensive

#491
post #486

Earlier quoted context omitted.

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 su…

What do you consider financial ruin? Last time I checked most of those countries are desperately trying to contain their healthcare spending.

The increase in healthcare costs is more a function of an aging population, rather than people (mis)using ambulances too much. However in these countries, although the rates are fairly low, misuse of ambulances is often heavily linked to poor levels of health literacy or lack of transportation options - though the caller often genuinely perceives it as an emergency - both of which can be improved through other programs such as education and public transport provisions. It’s almost as if providing good public education and transportation makes the population more productive and less wasteful.

Re: Why American ambulance rides are so expensive

#493
post #486

Earlier quoted context omitted.

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 su…

What do you consider financial ruin? Last time I checked most of those countries are desperately trying to contain their healthcare spending.

I refuse to play these games. If you wish to make the argument that universal healthcare (including cheap or free ambulance coverage at point of use) necessarily leads to financial ruin you are free to make that argument, along with all the necessary support such a position requires. If you do not wish to do so, then I have no issues and thus decline to make any argument otherwise.

I am not obligated to make your argument for you, and I am not inclined to calibrate your motte-and-bailey merely because you feel like interjecting your support for a position you would call a strawman when called out.

Re: Why American ambulance rides are so expensive

#494

I had to call an ambulance in Switzerland where ambulance prices are freely set by the operator (except in a few cantons which are enforcing reasonable flat rates) A 5 minutes ride cost 1500.- (more or less the same in USD) Because I had used a good broker to pick my insurance plan, I was left with “only” 500.- to pay out of pocket for the ride. In Quebec, as a resident, going 3 blocks in the ambulance cost us about…

Similar story here in Switzerland, with a 0 minute ride (they decided I didn’t need to be transported) that resulted in a bill of about 600-800 CHF.

Re: Why American ambulance rides are so expensive

#495

I had to call an ambulance in Switzerland where ambulance prices are freely set by the operator (except in a few cantons which are enforcing reasonable flat rates) A 5 minutes ride cost 1500.- (more or less the same in USD) Because I had used a good broker to pick my insurance plan, I was left with “only” 500.- to pay out of pocket for the ride. In Quebec, as a resident, going 3 blocks in the ambulance cost us about…

Similar story here in Switzerland, with a 0 minute ride (they decided I didn’t need to be transported) that resulted in a bill of about 600-800 CHF.

Oh wow. They were cool with me they said if we transport you it’ll be expensive. I didn’t have a car, I was living pretty high up a hill, it was midnight, and I had lost quite a bit of blood already so I thought “fuck it I’ll find out how expensive it is once I’m fixed”. But they wouldn’t have charged me if they hadn’t transported me (at least that’s what it sounded like)

I guess I made the right call because I fainted in the ER later from blood loss.

Re: Why American ambulance rides are so expensive

#496

I had to call an ambulance in Switzerland where ambulance prices are freely set by the operator (except in a few cantons which are enforcing reasonable flat rates) A 5 minutes ride cost 1500.- (more or less the same in USD) Because I had used a good broker to pick my insurance plan, I was left with “only” 500.- to pay out of pocket for the ride. In Quebec, as a resident, going 3 blocks in the ambulance cost us about…

Similar story here in Switzerland, with a 0 minute ride (they decided I didn’t need to be transported) that resulted in a bill of about 600-800 CHF.

To add, Switzerland is a little weird with accident vs disease.

If it’s an accident (ie sudden, unavoidable, unpredictable, more or less) it’s great because you have nothing to pay, you don’t even need to worry about the bill and there is no deductible and everything is covered no questions asked.

If it’s a disease, then it’s the regular insurance rules which can be quite arcane and you’re never sure what’s going to be covered and how much.

My transport was from adverse consequences of a surgery and so they deemed it not an accident, and that’s why I had to pay.

Re: Why American ambulance rides are so expensive

#497
post #489
post #484

Earlier quoted context omitted.

The US healthcare system just upsells on unnessessary crap. It's junk volume or at best it's heroic high tech solutions mostly making up for the fact that people stay away from hospitals until it's too late. Life expectancy shows that while the US is the best place to have stage 4 cancer, it's probably not the best place overall. Most places do the 80/20 stuff better. But yeah, you are right that the US does some stu…

US care is highly aligned with international guidelines. Saying "it's junk volume" just tells me you're not that close to the data. Life expectancy doesn't measure quality of healthcare, there are far too many confounding variables like genetics, diet, accidental deaths, etc. No serious study of healthcare quality relies on it. Look at 5-year cancer survival rates. The US is better (significantly better) in many of t…

Now do maternal death rate. Like I said, a good place to have cancer but they aren't good at stuff that matters.

The US leans aggressive on tests and heroic end of life care. I doubt you really disagree (except maybe on whether you think it's the right call). That is where the money is, since the insurance company can be forced to pay. It's kind of good for the rest of the world though if the US wants to pay (in both money and other issues) to be early adoptors.

Read "When doctors die", the US is the total opposite - everything goes to the big ticket aggressive (and yes, modern and cutting edge) treatment where it's hitting diminishing returns. https://pmc.ncbi.nlm.nih.gov/articles/PMC6179868/

Re: Why American ambulance rides are so expensive

#498
post #385

Earlier quoted context omitted.

Who is the “you” in this scenario?

The company offering the ambulance surface. Similar to how a pool cleaning company will send you a bill if you call them and have them clean your pool.

Generally, people who want their pool cleaned do so when they are conscious and have their pool very close to their home address. People who need ambulances are usually in a very different condition. That makes it a different prospect trying to chase payment.

Re: Why American ambulance rides are so expensive

#499

Earlier quoted context omitted.

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 p…

Christianity died in my country because people got tired of the judgemental, hypocritical cunts. The child abuse scandals that hit later only confirmed it.

Re: Why American ambulance rides are so expensive

#500
post #483
post #379

Earlier quoted context omitted.

Most doctors and nurses are not overpaid. Certain specialities probably are overpaid (orthopedics), but others like pediatricians or general practitioners usually aren’t. And nurses!? From the nurses I know they are underpaid for what they deal with. The ones making loads of many are willing to travel around the country and uproot their life once or more every year. Not exactly a lifestyle without its drawbacks.

Everyone is gonna say nurses are underpaid. It's a caring, female dominated profession, it's a motherlove sentiment. And they are not paid as well as doctors. Yeah, most pink / blue collar workers in the US are badly underpaid, but IIRC ones in the health sector are some of the best off, relative to medium salaries. Compare teachers and nurses. In most countries they make about the same AFAIK (and I'd say nurses do d…

I don’t dispute this, but I also don’t think it matters. An underpaid profession being paid more then a severely underpaid profession doesn’t make the former overpaid.
Post reply on HN