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Why American ambulance rides are so expensive

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Re: Why American ambulance rides are so expensive

#411

Post by Ntrails »

closewith wrote: post #362
Ntrails wrote: post #319

Earlier quoted context omitted.

> an average helicopter bill was smth around $200K if I remember correctly, with spikes up to $500K. Those numbers made me blanch somewhat! Having been in a helicopter (aka Air Ambulance) in the UK, all of which operate as charities iirc, I was curious about their costs. > The average cost of a helicopter mission is £4,748* and the average cost of a critical care car or rapid response vehicle mission is £2,054*[1]. h…

I tried to find the asterisk there to see the details, but could not. FWIW I think that HEMS cost is significantly under costed, as the London HEMS H135s run about £2,500 per flight hour on direct flight costs alone, so I suspect the £4,748 figure is referring to that alone. I think a closer estimate is probably total annual operational costs divided by total shouts, (£18 MM / 2,000) or about £9,000 per shout. Even t…

> I think a closer estimate is probably total annual operational costs divided by total shouts, (£18 MM / 2,000) or about £9,000 per shout.

That's a more useful estimate than merely the flight costs, agree - though the fixed operation costs don't change much in an 1800 vs a 2100 callout scenario.

> Still an order of magnitude less than the commercial US operators.

It's wild!

Re: Why American ambulance rides are so expensive

#412

Post by opo »

bestouff wrote: post #296
master-lincoln wrote: post #289

Earlier quoted context omitted.

That's what a government would be for. You vote neo-liberal, you get it... (I consider both the US democrats and republicans neo-liberal)

I think only the US consider the US Democrats as leftists.

This is a common claim, but it is a misleading simplification of US politics and European politics. (In simple terms, many of the economic positions taken by the Democratic Party would be considered centrist in Europe, but if you include positions that have been taken on immigration, identity politics, criminal justice, reproductive rights, etc. it would not.)

Re: Why American ambulance rides are so expensive

#413

Post by yamillove »

Der_Einzige wrote: post #335
yamillove wrote: post #62

Earlier quoted context omitted.

[dead]

Virgina is easily one of the worst, most authoritarian states in the USA and it’s not even close Worst driving laws in the USA by far. The entire existence of “the citadel”/VMI, the dog laws you mention, and a whole host of other authoritarian conservative nonsense.

[dead]

Re: Why American ambulance rides are so expensive

#415

Post by SoftTalker »

Spooky23 wrote: post #174
SoftTalker wrote: post #161

Earlier quoted context omitted.

Nobody makes (federal) minimum wage these days. McDonalds employees make double that.

I don’t live in a red state so we have a bizarrely low minimum.

The U.S. Federal minimum wage is $7.25/hr. Some states or localities might have higher minimums, but it's been a long time since I've seen any jobs paying that little. McDonald's here is about $15/hr to start and jobs go begging. CoL here is not the lowest but it's not like a major urban center either.

Re: Why American ambulance rides are so expensive

#416

Post by FireBeyond »

t-writescode wrote: post #210
FireBeyond wrote: post #129

Earlier quoted context omitted.

As an ex-paramedic and EMT, both with County Fire and private, there are absolutely those. But many-a-time, some of the blame falls on the physician. Medicare has, for one example, a lovely little form to fill out, just a few fields, mostly checks and multiple choice, to explain why the need for a "fully equipped BLS (or ALS) ambulance" was required, versus POV (private owned vehicle) or cabulance. The number of time…

> or cabulance I'm sorry, are insurance companies now demanding that people use Ubers to get to the hospital? ... do they reimburse those charges? Because wtf.

Cabulance - "wheelchair transport", often staffed by a EMR (emergency medical responder, a lower level than EMT). Someone who needs assistance and support getting where they're going, but is not in need of or likely to need medical treatment or support during the trip.

And they are reimbursed, or actually generally billed to insurance.

Re: Why American ambulance rides are so expensive

#417

Post by dghlsakjg »

refurb wrote: post #400
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…

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 dozen or so unrelated systems that do things very differently. The closest it comes is that there are interprovincial billing systems so you don’t have to do the paperwork to get covered for an urgent visit out of province, and not all provinces are signed on.

You can safely dismiss anyone that has reduced that complexity, or is completely ignorant of it. It’s a great way to tell when a foreigner is spouting talking points they picked up from an unreliable source and did not do even a minimal fact check on. “Canadian health care” as it is talked about in the US media is frequently fiction for propaganda purposes.

Canadians almost always talk about problems within a province. What's happening in the Maritimes has nothing to do with BC.

The feds set a minimum standard for a province to qualify for federal funding, and that's about the limit of their influence.

No idea if the rest of his statement is poorly sourced propaganda as the first sentence.

Re: Why American ambulance rides are so expensive

#418

Post by Alpha3031 »

lazide wrote: post #275
moritzwarhier wrote: post #253

Earlier quoted context omitted.

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…

Should == I wish.

For most nation states "should" in this case also corresponds to a certain treaty they are party to being highly inconsistent with treating health like a racket. Of course, the US is one of the few that never ratified said treaty. Too much like socialism I suppose.

Re: Why American ambulance rides are so expensive

#419

Post by Noumenon72 »

softdevca wrote: post #112
Noumenon72 wrote: post #42

Earlier quoted context omitted.

The article explains why; regulators sometimes can't foresee that their decision to consider something fee for service will eventually prevent it from being considered as a communal expense.

Fee-for-service doesn't prevent ambulances from being considered a communal expense, it just makes sticky. There is nothing preventing a government from making ambulances equivalent to fire or police except the will. From the article: "The most efficient way to fund ambulance services would simply be to pay for the option the way that options are normally paid for: with a premium, collected from everyone the service…

"Sticky" is what I was saying. It currently can't be done because of path dependence from historical regulation to industry structure to attitudes. No broader reason. I felt your post was setting up "If there's no logical reason, it must be because people with property are greedy". Sometimes things are the way they are because they got that way.

Re: Why American ambulance rides are so expensive

#420

Post by Alpha3031 »

refurb wrote: post #404
nekusar wrote: post #375

Earlier quoted context omitted.

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…

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.
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