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Why American ambulance rides are so expensive

davidoks.blog

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Re: Why American ambulance rides are so expensive

#521

Earlier quoted context omitted.

You would do it before hand of course

Let me just schedule in plans for my future heart attack and car accidents.

Yes because you don’t have health insurance until you have a heart attack right? You never pick that before hand do you?

Re: Why American ambulance rides are so expensive

#522

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…

The government is in a bad position to be that kind of paternal - any sort of large machine is the worst possible judge of the difference between "shit happened" and "I am systemically making incorrect life choices".

I agree that what you need here is someone(s) with leverage and respect in your life to interfere with systemic bad behaviors if they exist, but that takes community, government merely gets leverage, and churches are often not a welcoming place to many people's eyes, rightly or wrongly, around the US.

As I get older, I'm increasingly of the opinion that the best you can do is unconditional support from the government (because it's the only kind you can rely on no humans in the chain acting in bad faith to condition), and well funded local support structures for people to subsist while fucking up their lives and also help them get out of that spiral if they want to.

Not because I believe in some fundamental good in man or something, but because I think that's the only way you can design this that isn't subject to people's bad faith manipulation, and I've personally seen too many cases go wildly differently for "objective" criteria where the main difference seemed to be whether the person reading it went into it assuming you were lying or not.

Re: Why American ambulance rides are so expensive

#523

Earlier quoted context omitted.

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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…

The problem with capitalists is that if you wanted, they'd let you go do your little commune thing somewhere. The problem with communists is that if you're not a communist and you can't be reeducated into becoming one, you must die. Or if you're the wrong kind of communist. Or if you're the same kind of communist, but you also want power. Or if you don't want power, but they think you might some day. Or if you're related to someone who might want power some day.

But no, I won't be a communist with you. And if you insist, things could get ugly. Fortunately for me, you're still in your hipster-college-champagne stage of communism, and you're both scared of violence and worried about the PR backlash of being found out to be a bloodthirsty savage.

In November when it becomes apparent that the Democrats won't win back seats, you'll all start to panic. But the real fun will come in 2028 or 2030, when Obamacare will be dismantled. I can hardly wait.

Re: Why American ambulance rides are so expensive

#524

Earlier quoted context omitted.

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 or…

It's interesting to note that very often these same Republicans have no issues at all with large tax-based incentives when they help their employers or knock some dollars off they yearly property tax bills.

It just boggles my mind how the poor are supposed to be continually punished just for being poor and should always be denied, almost by rote, any sort of government aid because, you know, did you hear that story about that fentanyl addict who was found with THREE active EBT cards in his wallet?

Yeah for sure...how dare some dirty addict should be able to eat!

Re: Why American ambulance rides are so expensive

#525

Earlier quoted context omitted.

This is just GDP, which isn't that relevant. If you add a million people and only one of them works, GDP will still go up. It doesn't take into account the following: - no-one's talking about immigration in general. They're talking about mass immigration. So any general "look how immigration can be good" is not addressing the issue. - mass immigration means that housing becomes scarce, driving up prices. This again m…

Net economic benefit is not only GDP, it includes net tax over government spending. Immigrants are younger so they have more regular taxable income (vs capital gains), while spending more of it (vs saving) and drawing less government benefits. The housing shortage is driven by NIMBY and regulatory capture. You are right that perpetual growth is unsustainable but we are not remotely near the possible carrying capacity…

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Re: Why American ambulance rides are so expensive

#526

Earlier quoted context omitted.

Again, if you are busy dying, you (or, more likely, the bystander who calls EMS on your behalf) do not have time to check how much the bill will be, or who has the best response time to your location at that moment, or the best equipment, or the best training.

Again, if people are doing it cheaper, how could a 13k per ride company stay in business? 911 services would have to be steering them to an insanely bloated expensive company. That wouldn't happen. Competition brings better service and much cheaper prices, always does, without exception.

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Re: Why American ambulance rides are so expensive

#527

Earlier quoted context omitted.

Again, if you are busy dying, you (or, more likely, the bystander who calls EMS on your behalf) do not have time to check how much the bill will be, or who has the best response time to your location at that moment, or the best equipment, or the best training.

Again, if people are doing it cheaper, how could a 13k per ride company stay in business? 911 services would have to be steering them to an insanely bloated expensive company. That wouldn't happen. Competition brings better service and much cheaper prices, always does, without exception.

There's a distinction between 911 emergency ambulance service (respond to people calling 911) and interfacility transfer service (transfer stable patients between hospitals and medical facilities).

When you are an ordinary person calling 911, you can't meaningfully shop around in that emergency situation. The competition that exists is between the possible organizations you local government could contract to run the system. The safety regulations and medical standards they set are part of them choosing what they feel is the best "deal" for their population. (In some places, all 911 calls are run by public fire departments; in others, the government contracts with private companies.)

At the IFT level, again it's not generally possible for patients to choose their service, because (as explained in the article) ambulance services inherently need extensive infrastructure with large fixed costs at every location they serve. You're not going to fit 20 ambulances from 20 competing companies in one hospital's ambulance bay, and those 20 competitors aren't going to be able to afford to pay employees to sit around for hours at that hospital on the off chance that maybe today patients will pick them and not the other guy. The costs for the ambulance company are not primarily per-call, most of the expense is to stand ready for a call whether it happens or not. Instead, competition generally happens when the hospital chooses which ambulance service(s) to contract with.

Re: Why American ambulance rides are so expensive

#528
post #515

Earlier quoted context omitted.

> I am not obligated to make your argument for you Are you just uncomfortable with debate? How do you debate the merits of the argument without defining the terms being used?

No, I just don't see any point in debating anything when you presumably agree that nobody is being bankrupted by free ambulance rides given that you called it a strawman. If you wish to defend what you called a strawman, which I didn't think people normally did in good faith but could be convinced otherwise, then I am willing to let you set the definitions you wish and make a case, as is standard for those instigatin…

I never said no one would be bankrupted by ambulance fees.

We’re talking about financial ruin of the government.

Re: Why American ambulance rides are so expensive

#529
post #528

Earlier quoted context omitted.

No, I just don't see any point in debating anything when you presumably agree that nobody is being bankrupted by free ambulance rides given that you called it a strawman. If you wish to defend what you called a strawman, which I didn't think people normally did in good faith but could be convinced otherwise, then I am willing to let you set the definitions you wish and make a case, as is standard for those instigatin…

I never said no one would be bankrupted by ambulance fees. We’re talking about financial ruin of the government.

I really don't see the point of playing these word games. I had assumed you meant the government, yes.

Re: Why American ambulance rides are so expensive

#530

Earlier quoted context omitted.

Again, if people are doing it cheaper, how could a 13k per ride company stay in business? 911 services would have to be steering them to an insanely bloated expensive company. That wouldn't happen. Competition brings better service and much cheaper prices, always does, without exception.

There's a distinction between 911 emergency ambulance service (respond to people calling 911) and interfacility transfer service (transfer stable patients between hospitals and medical facilities). When you are an ordinary person calling 911, you can't meaningfully shop around in that emergency situation. The competition that exists is between the possible organizations you local government could contract to run the…

Again, as I keep explaining, if companies were free to compete then even 911 is not going to redirect you to a 13k ambulance service. Why would they unless they are getting payoffs. It doesn't cost anywhere near that to transport you.
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