3rd world country.
Why American ambulance rides are so expensive
421–430 of 536 posts
Re: Why American ambulance rides are so expensive
#422I 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.
So the argument is that any piece of regulation will always lead to a positive outcome?
How is that possible?
Re: Why American ambulance rides are so expensive
#423Why? Because fuck you, that's why.
Welcome to America. It's a business. Gimme my money.
Re: Why American ambulance rides are so expensive
#424It's simple. Ambs in the US are all private companies. Everywhere in the world private ambs are also extremely expensive and public ones free of charge. There is no truly public amb ride in the US.
We don't even have public toilets. We do have laws criminalizing homelessness though!
Re: Why American ambulance rides are so expensive
#425[deleted]
Re: Why American ambulance rides are so expensive
#426We’re all pretending this is an unsolvable problem when really most of the world has solved it by making ambulance (EMS) funding similar to fire and police departments. Somehow in any emergency I’ve seen, all three show up, often EMS before police or fire dept, and somehow that’s a service that has to be supplemented by insurance billings. The blog mentions it, but it’s one of those obvious things that somehow isn’t…
Well, thank goodness we don't price Fire Department response the same way.
For my city of Ann Arbor, Michigan from https://www.a2gov.org/media/4glhvywf/2025-aafd-annual-report...
FY2026 budget: $20,810,234 Structure Fires: 58 Cooking Fires: 75 Vehicle Fires: 30
So should we somehow recover roughly $127,000 from the victims of each fire?
Of course not. I and my neighbors pay taxes to maintain the Fire Department and have it ready when needed. Many may argue that we pay too much, but those unfortunate enough to actually need its services would probably say they got a great deal.
Re: Why American ambulance rides are so expensive
#427Earlier quoted context omitted.
Even some parts of the US have found solutions. From the article: > In Tulsa and Oklahoma City, meanwhile, the government buys staffed unit-hours from an ambulance operator, while households can prepay a few dollars a month on their utility bill and owe nothing if the ambulance ever comes.
billed for buying unit-hours from an operator... that's very carefully worded to make it sound like a corporation customer relationship and not socialism .
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.
Re: Why American ambulance rides are so expensive
#428Re: Why American ambulance rides are so expensive
#429Earlier quoted context omitted.
> 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.
Oh, ok. When I posted that I genuinely thought they wanted people to call Ubers, etc.
This is less terrifying, thank you for clarifying!
Re: Why American ambulance rides are so expensive
#430Earlier quoted context omitted.
That paragraph is somewhat incoherent at that point in the article: margins are razor thin — at a price tag of $12,000 per 6 miles or $2,000 per mile. (Yes, there is some other stuff, much, much, much later that maybe cuts into that …)
The cost isn't about the actual mileage though, it's having two paramedics each earning about 100k/yr per ambulance, while having coverage 24x7x365. So fully loaded, the labor for one ambulance might be in the high six figures to seven figures.
Even if we assume we need to cover their downtime between rides, at a conservative estimate of "we're the only call today" that's $2400 of labor at your rate (≈$400/d, 2 paramedics, 3 shifts). TFA suggests they're not paid well.