What are the margins on an ambulance ride?
Why American ambulance rides are so expensive
431–440 of 536 posts
Re: Why American ambulance rides are so expensive
#432Earlier quoted context omitted.
> 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…
Here in the Netherlands it is 877 euro for an A1 call (emergency, no delays), and 384 for B1 calls (non emergency, planable). You also get a 4.83 euro per km cost. You pay up to 375 euro if you haven't had any medical cost that year, otherwise zero. Stand by cost are about 154 euro/hour. E.g. for sport events. ICU transport is about 2500. All are law mandated. The total cost might be more as the insurers also put in…
For citizens or do you charge higher for tourists? In for example Sweden only eu citizens get the cheap price.
Re: Why American ambulance rides are so expensive
#433Earlier quoted context omitted.
Yeah, every EMT I know was way underpaid for how crazy stressful it was. Especially considering how expensive the ride was
EMT now is often used as a stepping stone to a career with a liveable wage, like physician.
This is fairly funny to me because I reckon most residents only had to do research to get in. EMT and tech experience are negative differentiators in getting into medical school, which is a shame.
Re: Why American ambulance rides are so expensive
#434Earlier quoted context omitted.
> but you make the choice No US doctor would ever tell you how much any procedure would cost (even though they know, at least "in-network" doctors). But if in your EMT you inform the patient of the potential costs of the ride, then yea, I agree they make an informed choice.
I’d argue nobody getting into an ambulance is making an informed choice.
Under distress, yes. But honestly, I did piloting a little (airplane and various soaring aircrafts), and think that thinking there is also under distress, and that's ok, you still need to make decisions, that's life.
Re: Why American ambulance rides are so expensive
#435Earlier quoted context omitted.
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.
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 organization (like government...) that is large enough to match that population's needs.
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.
It's the lie of the "rugged individualist" in America. Most "successful" people come from successful families. Social mobility, in the US, is part of that lie. Here, we celebrate the person who rises from poverty to become wealthy as a member of a sports team, or as an actor, or similar, while disregarding that these massive successes are outliers.
I'm so often disappointed in my own country.
Re: Why American ambulance rides are so expensive
#436I spent a lot of time in healthcare finance and across most medical service industries the Medicare rate is actually not a loss. It’s a common thing said as it’s not super profitable, but it’s usually not a huge loss. It’s pretty close to what the cost of care should be. It just doesn’t give the extra padding for extremely fancy clinics, hospitals, admin and executive compensation, and often PE investor margin expect…
[if the article’s analysis is true] cost controls would reduce the supply of ambulances, since the article claims Medicare actually is a loss. You have claimed it isn’t, but you haven’t really provided much evidence other than “there’s no way that’s true, trust me, I used to work somewhere in healthcare finance”
Thats fine, I'm a passerby making a comment on their work on a platform that they may not even be aware of. If you look closer I’ve done more than they have by simply raising the concern and I’m not authoring an article attempting to educate people on the industry. I think it’s perfectly fine to question someone’s assertion based on experience alone. Basically you’ll have to do more to convince me what you’re saying is true is what I’m saying. That’s the same feedback a teacher would give a student on their homework. It takes data that I don’t have to do the analysis which is probably also why they didn’t do it. But I don’t think it’s completely off the mark to mention that I’ve been an insider at multiple healthcare service companies that like to claim they lose money on Medicare yet they opt to accept Medicare patients. When we consider denying Medicare we realize they are such a large part of the mix that they allow us to be as profitable as we are. It’s almost always a misconception of what “losing money” means. Price gouging the few patients that can afford it, is only profitable if all your expenses are already covered and economies of scale are at play, which is what Medicare is good for.
Re: Why American ambulance rides are so expensive
#437Earlier quoted context omitted.
> but you make the choice No US doctor would ever tell you how much any procedure would cost (even though they know, at least "in-network" doctors). But if in your EMT you inform the patient of the potential costs of the ride, then yea, I agree they make an informed choice.
You’re getting in an ambulance, not calling a cab. You’re probably unconscious, maybe at least disoriented, overwhelmed, concerned about what’s happening more than doing math. Also you’re there on the floor bleeding, what’s your alternative? “Nah don’t worry, I’ll figure out this exposed fracture in the uber, I got points with them so it’s cheaper”?
Parent talked about conscious and aware.
I had fractures several times, and I did think about the costs. In fact, the last one was pretty bad, andy first thought was "good thing I'm in a country with good medical care, even though expensive".
Re: Why American ambulance rides are so expensive
#438Earlier 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…
>rejecting patients that do not require care,
You end up just building the lawsuit against you.
Re: Why American ambulance rides are so expensive
#439Earlier 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…
There are stories where the air ambulance sues patients who are still in ICU because getting paid depends on being first in line to file the lawsuit.
Personally, I've never seen anything like this. Usually it's billing company who sues, not providers dierctly - again, from my experience.
Re: Why American ambulance rides are so expensive
#440Earlier quoted context omitted.
> Society should find a better way to pay for ambulances Society has this figured out, at least a decent solution that works until we find a perfect one. Only the US society seems to be unable to find a solution.
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…
> US doctors are overpaid. US nurses are over paid.
Median pay for a Nurse Practitioner is $132K/yr [0]. I think that's reasonable.
Average pay for physicians ranges from $220-450K depending on specialty. [1]
Personally, I think doctors should be paid more than software engineers, so I think those numbers are all reasonable, especially when you consider what it takes just to enter the field. Nurses require a Master's degree. Physicians need a Bachelor's degree PLUS another 4 years of med school AND THEN a residency program that lasts 3-9 years depending on specialty before they finally earn their medical license.
IMO, the idea that nurses and doctors are overpaid is quite simply ludicrous.
[0] https://www.bls.gov/ooh/healthcare/nurse-anesthetists-nurse-...
[1] https://www.bls.gov/ooh/healthcare/physicians-and-surgeons.h...