Why American ambulance rides are so expensive • Hacker News Board

Re: Why American ambulance rides are so expensive

#101

Post by cogman10 » Fri, Jul 10, 2026, 12:53 AM UTC

jjk166 wrote: post #83

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…

> 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…

I think the main expense you are missing is medication and disposable equipment and insurance for the ambulance and medical malpractice.

Otherwise, yeah, I suspect the other major cost is the "It's the mayor's brother's business" cost and the "private equity has figured out how to extract maximum value" cost.

That said, there's no reason the patent should be charged anything. It should be entirely a tax burden of the citizens. It's crazy to make some decide between death and crippling debt.

Re: Why American ambulance rides are so expensive

#102

Post by js2 » Fri, Jul 10, 2026, 12:54 AM UTC

> There are parts of the U.S. that do this already. Ambulance rides are already subsidized by taxpayers in most places, thanks to public funding for fire departments; and a growing number of places have taken this further.

Indeed, in my county that's the case along with a $60/year subscription program to indemnify yourself against further costs:

https://www.wake.gov/departments-government/emergency-medica...

Re: Why American ambulance rides are so expensive

#103

Post by JumpCrisscross » Fri, Jul 10, 2026, 12:56 AM 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…

> As much as I like articles that tries to use economics or finance to explain stuff, the "options" analogy is a bit hamfisted

Idk, my takeaway is ambulances look like a solid market for a subscription model. Ideally, one that taxpayers pay for. But also, potentially, as a private one that you can pay e.g. $50/month to know you won't be billed $12,000 by idiots.

Re: Why American ambulance rides are so expensive

#104

Post by [deleted] » Fri, Jul 10, 2026, 12:57 AM UTC

jjk166 wrote: post #83

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…

> 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…

[deleted]

Re: Why American ambulance rides are so expensive

#105

Post by [deleted] » Fri, Jul 10, 2026, 12:58 AM UTC

jjk166 wrote: post #83

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…

> 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…

[deleted]

Re: Why American ambulance rides are so expensive

#106

Post by justonceokay » Fri, Jul 10, 2026, 12:58 AM UTC

jjk166 wrote: post #83

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…

> 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…

There’s the cost of supplies used during transport. Also the cost of maintaining potential supplies like blood even if they go unused. EMTs may make $23 but they are also getting benefits and have other overhead, making their real hourly cost probably closer to $50/hr minimum. There’s insurance, which I bet is out the wazoo expensive for ambulance. Ambulances have to be maintained and I would guess have much more regular service than your car at home. Ambulances have to be stored somewhere and secured-access parking isn’t cheap. Many ambulance rounds-trips can be well over an hour considering so many of us live far away from urban centers.

Is it $2600? Probably not. But I think you are low-balling pretty significantly.

Put another way, just getting a plumber to vibe to your house is gonna cost you $200 easy. It’s within reason that an ambulance ride might cost much more than that.

Re: Why American ambulance rides are so expensive

#107

Post by mlsu » Fri, Jul 10, 2026, 12:59 AM UTC

jjk166 wrote: post #83

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…

> 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…

Ah, but you forgot private equity, that's about $2473 of profit per ride that needs to be accounted for. This high cost is what we must pay to keep our economy dynamic and efficient.

Re: Why American ambulance rides are so expensive

#108

Post by JumpCrisscross » Fri, Jul 10, 2026, 12:59 AM UTC

SpicyLemonZest wrote: post #91

xp84 wrote: post #71

Earlier quoted context omitted.

Be that as it may, the law in California forbids the insurance company from refusing to pay at the in-network rate in an emergency. As evidence, I'd submit the claim they immediately paid when called out on this. If the insurance company weren't cynically exploiting people's lack of knowing their rights, they'd at least send a form letter to the patient saying "Please send us whatever proof from the hospital that you…

But isn't the California law requiring the insurance company to act as a sin-eater here? They seem to be the only people you were frustrated with, even though they are not the ones who charged you $1000.

> isn't the California law requiring the insurance company to act as a sin-eater here?

American healthcare providers have done a pretty good job at transferring PR liability to insurers. Cost inflation, in America, is mostly a problem at the provider level.

Re: Why American ambulance rides are so expensive

#109

Post by asdff » Fri, Jul 10, 2026, 1:01 AM UTC

Waterluvian wrote: post #11

arjie wrote: post #5

You don't have to pay them unless they're specific. I got a bill 3 years after being in an accident and I asked them for the documentation they legally have to provide me (itemization, the legal basis, detailed incident record, attempts on their part to contact insurance) of how they arrived at the sum. It's been a year since and they haven't given me anything. Besides this kind of billing is banned in California now…

The last thing I want at that time is to have to reason about any of this. I think I’m realizing that what I cherish about the healthcare system up here is not just that I don’t pay bills, but that I don’t even see a bill. Not that the bankruptcy inducing costs aren’t wretched, but I just cannot even imagine being put into a fucked up bureaucratic hell while my family is in a life altering crisis.

Medicaid is actually like this incidentally. No copays really. Too bad the electeds don't want to roll it out. The a lot of the most expensive risk pools are already on medicaid or medicare.

Re: Why American ambulance rides are so expensive

#110

Post by asdff » Fri, Jul 10, 2026, 1:02 AM UTC

yamillove wrote: post #50

burnhamup wrote: post #15

Earlier quoted context omitted.

Yeah, my family was hit by two ambulance bills in California in 2024, and tried to balance bill us contrary to the law. It was a really frustrating experience trying to get them follow the law. One of the ambulance companies waited an entire year to even file paperwork and still tried to get insurance and me to pay.

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