*How about people that were diagnosed with not needing medical treatment less than 24 hours ago but are really cold(unspoken coincidence) and want to go back for the same reason they went(and were discharged) earlier?
*This may be location dependent, and I’m not sure how big of a city you’re in or how much homelessness you have.
Sure but this isn’t everyone. And even a lot of people who aren’t idiots don’t know if they truly need an ambulance or not or the cost involved. And that cost as the articles said varies widely on a variety of factors. And then it’s on people who don’t understand health care to go through their bill and try to figure out what they can contest.
But taking profit or making things less confusing would be socialism and we don’t want that.
I don’t have the answers. I don’t get as angry at the bullshit as a lot of EMS providers. I was older when I started this and had done a lot of ride-alongs etc so had some idea of what I was getting into.
I do see a lot of good providers get frustrated and burnt out by it. Which is a shame because EMS doesn’t pay very well and the best people do it because it is a calling, not for the money.
I believe that there is no perfect solution, that the perfect is the enemy of the good, and that we actually have a pretty good system. It costs a lot because you’re paying for more than just yourself. But if it was “free” you’d still be paying quite a lot for it, and the people who abuse the system still wouldn’t. When you’re having a heart attack, you might still end up waiting 40 minutes for an ambulance because the last one in your area was tied up by a guy with a toothache.
I’m on duty so don’t have time to give a better response.
“On July 2, 2018, a Boston woman fell into the gap between a subway car and the platform. Passengers rocked the train back and forth, eventually extricating her. Her leg was cut down to the bone. Still, she begged her rescuers not to call an ambulance. “Do you know how much an ambulance costs?” she sobbed. Because there was no choice but to call an ambulance, though, one eventually arrived.”
Private equity–owned ambulance companies are also driving the cost curve. A 2017 GAO report noted that between 2010 and 2014, the median price for air ambulance services doubled, from $15,000 to $30,000. That number continued to rise; by 2017, the median price was over $36,000. And unlike many medical services, the patient is often exposed to the entire cost.
Air ambulance providers often fail to contract with insurers, leaving more than two-thirds of patients out-of-network. This number has increased in recent years, likely indicating that the air ambulance providers are purposely refusing to negotiate with insurers, preferring to instead bill patients exorbitantly.”
Just as long as people are making a profit I’m ok with it. People tend to make really poor decisions in life and death circumstances and that’s the perfect time to get paid. And as long as these firms are making sure that the people doing the work (EMS) aren’t very well compensated they won’t have to worry about things like good wages getting in the way of that.
No, it’s primarily a cultural issue, stemming from the underlying issue of what healthcare actually is - whether it’s a right or a commodity. And it’s an understatement to say that the issue was addressed differently in the New World than in the Old.
From what I can tell from this side of the pond the services rendered to those whose health care is a right receive are no better than the services rendered to those whose health care is a commodity.
The people on this side who don’t pay their bills still get an ambulance and a fire truck every time they call 911, and they get to see a doctor. They also get a ride across town and a free sandwich, which is sometimes all they really wanted.
The people who are in such bad shape that they really need an ambulance, but are still thinking about cost are very rare.
Maybe that’s a good litmus test. It looks like you broke your arm when you wrecked your 4-wheeler, but aside from that you’re pretty sure you’re not going to die? Maybe cousin Darryl can drive you to the ER.
Furthermore, in my part of the world every ambulance service I know uses soft billing, meaning, if you can’t pay the bill it doesn’t go to collections. You’re not going to lose your house or your car if you can’t pay up.
66.5% of all personal bankruptcies are due to medical bills. Hospitals can sue for unpaid bills.
Unexpected medical costs are pretty much the number one financial fear of all Americans. I’m middle class and prepared for essentially any type of financial issue that could come up from home fires, destroyed vehicles, etc. Even with insurance medical bills could wipe out everything we have.
I’ll bet a lot less people went bankrupt due to medical expenses when a lot more people died from their issues.
I’ll bet labor costs were lower when we could just own slaves.
I like this game.
Don’t think I want a slave giving me medical care.
Good chance. This sounds like the mindset that would come from a right wing poor people suck ass but abortion is awful viewpoint. Pull yourself up by your own bootstraps poor guy with chemo keeping you from working. I shouldn’t have to pay taxes for him.
I’m not saying you feel this way btw.
Thankfully profits are incredibly high in the health care industry. That’s most important to me.
There’s a lot going on in your post, and I’m only going to respond to what I have seen from my perspective.
Helicopters: all the medevac flights in my part of the State used to be provided by the State police. There were also a couple of larger hospital networks that had a helicopter, but they were pretty far away, and in high demand. The state police more or less got out of the business and private companies moved in. The difference is that now you can actually get a medevac when you need one. The patient who is going to die very soon if he doesn’t get specialized care, like a vascular surgeon, can get to a hospital with an on call vascular surgeon <30 min, rather than a 2 hour + ride in an ambulance. Before all of the private helicopters showed up the helicopters were few and far between, and it was a roll of the dice as to whether you could get one at all.
Yes the cost is outrageous. But helicopters, maintenance, insurance, and paying 3 person flight crews to sit around 24 hours a day, even on days when the weather is too bad to fly is expensive. And again, a lot of people who use the services never pay the bill.
A friend of mine suffered a broken leg in a motorcycle accident, was airlifted to the hospital and refused to pay the bill for $15,000. He said he didn’t ask for the helicopter, and after a few years they stopped bothering him. He said it didn’t even mess up his credit, and he is pretty well off.
Should he have paid? Whoever was in charge of the scene called for the helicopter. Unlike what you asserted in your post, it wasn’t so they could steal his money. Due to the mechanism of injury, and the possibility of unseen internal injuries calling for the helicopter was very justifiable.
Private Ambulances: 20+ years ago, all of the Ambulances came from Volunteer Agencies staffed entirely by Volunteers. They were mostly founded by Vets who came home from WW2, saw a need in their community and made it happen with help from the community, and little or no help from the government. That’s why ambulance rides used to be free. Flash forward to the present day, Call volume is up, and there aren’t enough volunteers to cover the calls. Ambulances are expensive, and you can no longer pay for them with raffle tickets and spaghetti suppers.
So you have to bill for services and most people don’t pay. Medicare and medicaid pay a pittance, which barely covers fuel. Most Agencies that I know of use soft billing, meaning if you can’t or just don’t want to pay, it never goes to collections and probably won’t even show up on your credit rating. They occasionally try hard billing on people who abuse the system, but you can’t get blood out of a turnip.
The old volunteer agencies that are still around operate as private entities and have paid staff and bill for services. Some of their staff work shifts and others get paid an incentive pay by the call. I’ve done both in the past, before and for a while after I became a career firefighter. But most of the volunteer agencies can’t make that work and have shut their doors and been taken over by the county’s Office of Public Safety. Which is a shame, because the small town Rescue Squad I used to work/volunteer in used to be able to staff up to 5 ambulances and could cover 5 working calls in our community. Now the county has 1 staffed ambulance there, and when there is more than 1 working call help has to come from 20-40 minutes away.
There are other “for profit” entities around, who mostly do non emergency interfacility transports. That’s where the money is, because for whatever reason medicare and medicaid pay more for those services than they do for responding to 911 calls. But for those agencies to operate they have to answer 911 calls when the system gets overwhelmed. Of the 3 for profit entities I have personal experience with 1 has gone under, one is hemorrhaging money, and one seems to be doing pretty good, but I don’t know any of the people running that outfit so who knows. The outfit that appears to be doing well also pays pretty good.
Pay: I’d be lying if I claimed I didn’t want more money. But I don’t see how that will lower the cost of an ambulance ride.
It’s actually a “Why improve care when some people can’t afford it?” mindset. People going bankrupt from medical care are either better off than they otherwise would have been, or they made a poor choice and used unnecessary services.
I understand that, but I’m only talking about Ambulance rides, why they cost what they do, and why most Americans probably aren’t worried about it.
Here’s another reason people call 911 for an Ambulance ride. Because they think they’ll get seen quicker. And most of the time they’re right. They tie up a vital, and finite public service, because the Urgent Care clinic is too slow, and they don’t want to sit in the ER waiting room.
I’m not talking about a possible stroke, or chest pains. I’m talking about someone with a “fever” of 99.3 degrees, or 83 year old granny has been feeling weak for the last few days. That kind of stuff.
You said you’re Christian? Is Luke the gospel that said “don’t bring me your poor because those dickheads can’t provide me any private jet?”
So most of the articles shared have talked about how people need to negotiate their bills. How are people supposed to refuse things when they aren’t medical professionals and know what they need and they don’t. And then they have to hire a lawyer to figure out they got fucked by people?
Doesn’t happen with Medicare because they know what things should cost.
What a perfect system. You’re 45 and your entire life savings is eliminated and medical profits are through the roof. You sold all your assets and your family is broke. You should be happy!
I understand what you’re saying and that many things go into it of course when you’re talking about it but I believe the bolded part shows that some people have decided having ambulances makes good money. And if it’s no big deal to not pay and has zero consequences why are so many people bankrupt from it? Why would anyone pay?
And no one is more vulnerable to being ripped off than anyone needing medical attention. Laughable for Nick to say you should have refused services. How many of us refuse things when medical professionals tell us we need them? Should the onus be on sick people to have the knowledge of a doctor to keep from getting ripped off?
I can only hope that the people with that mentality are never put in the type of situation where their callousness comes full circle and they stare at the “shouldn’t have had that test done” bill.
If he’s your slave you won’t have to worry about insurance.
Some? More like most, hence insurance.
Where did I say that? Personally, I have no problem doing so; but I don’t recall saying that.