Why American ambulance rides are so expensive

Same from Argentina to Canada? Wow

His mistake was going to an American hospital at all. For what he paid, he could get a round trip ticket to literally anywhere in the world, then just get realistically priced medical care. The entire American medical establishment needs to end. It's cancer. I won't go. Not even if the alternative is my death. I just won't go. I should probably get some kind of dogtag to wear that explicitly states this if I'm ever knocked unconscious. Just leave me in the ditch man, American medical care is a fate worse than death.

My fun ancedotal story about US healthcare:

Kaiser transported me 4hrs in a ambulance to get surgery and I think I just paid the $200 ER fee

But then they would never cover an MRI for an issue with the same leg.

It's like we're almost done with this project guys, come on.

This is the best article of HN ever, so detailed and explaining, and engaging. I have a message for all US readers, this is simply nonsense. Putting blame on the hurt in the moment of need, discussing money over his own health, is something demons do. I hope you will realize someday

This was a fun read, however, I feel that the actual essence is quite thin.

It can be summarized in a short sentence: The cost comes from being always prepared with teams and equipment, and few privately insured riders subsidizes everyone else, getting very high surprise bills - this can and should be a shared community tax which would effectively allow free ambulance rides to almost everybody.

It's an excellently written post though. I suspect people read this author for the experience, more so than actual information. I just wonder if they should just do prose and go wild with their skill instead of coating a few predictable facts with so many layers of color.

Because America healthcare is stuck in the middle - it is semi socialized. You get both the negatives of socialized and free market ones. Either make it full socialized or remove all state money (this includes tax breaks and incentives) and allow competition.

> In 2020, Congress passed the No Surprises Act, which banned surprise balance bills for most parts of emergency care. But by necessity, it exempted ground ambulances from the law: actually restricting the practice would have rendered much of the EMS industry insolvent.

Right, but air ambulances are subject to the No Surprises Act, and we somehow still have those.

Also, ERs are subject to the No Surprises Act, and they do some pretty damned expensive things. Plus, if you're seen by an out-of-network practitioner in an in-network hospital or ER, no you weren't: No Surprises Act forces them to accept QPA and not balance bill. Somehow all of those out-of-network anesthetists and radiologists are still in business.

Here's a PDF about the No Surprises Act:

https://www.cms.gov/files/document/a274577-1a-training-1-bal...

Why? Because fuck you, that's why.

Welcome to America. It's a business. Gimme my money.

I've treated people with panic disorder who, if there were no cost involved, would probably have called an ambulance monthly for suspected heart attacks.

I wonder how countries with universal healthcare coverage deal with the lack of a (dis)incentive here. Maybe they just eat the cost?

its horrible to think when u are caught up in something serious that calling an ambulance could ruin your life later.

better to live in uk where nhs takes care of all this compassionately for free.

i think i read many warnings or jokes about this: when go to usa, dont call an ambulance because it's so fucking expensive..to compare, in china, it usally cost less than 100USD.

This problem just doesn't exist anywhere else in the world. Ambulance is just another truck. There are some fees involved with having priority on the road and some regulations, but it's just another truck. It won't cost (to anyone - i mean OF COURSE it is free for the actual patient) over a hundred euros or so to do a simple across-city ambulance ride anywhere in EU, maybe 2x the price of a cab.

That's corruption and nothing more. End it and imprison everyone who ever had a tangential relationship to this system, for life - to ensure no one will try to pull this sort of "regulatory capture" again.

I had an ambulance ride on Thanksgiving Day last year. And the punchline was that with my ACA insurance, the "ambulance run" co-pay was $1,200. (Of course my total ambulance bill was around $1,310.)

There was a long period of back-and-forth with calls and website visits, where they were insistently billing the wrong insurance, and so forth. But I'm grateful that I used the ambulance at that point in time.

The key advantage to an ambulance ride is bypassing the Triage Nurse. If you're going to an E.D. and you take a ride-share or a friend drives you, then you'll go to the registration desk and then meet the triage nurse. And the Triage window is pretty good at conserving hospital resources, and de-prioritizing you if your issue could be handled by Urgent Care or your PCP on a weekday.

But if the ambulance gets called to your home, it's a foregone conclusion that you really, really want to go to the E.D. and the ambulance crew will Keystone Kops their way to a successful hospital drop-off. They'll take some vitals and ensure that you're stable, because if you're not, they can save lives, and keep you alive during transport. But if you're conscious then they ask that $64,000 question: "do you want to go to the hospital?"

Once a few years ago, a nurse in a clinic had called 9-1-1 on my behalf and it was actually difficult to refuse a hospital transport. The EMS crew put me on the phone with a hospital attending physician and I had to emphatically refuse transport several times, after being advised of all the risks. (My only issue was elevated blood pressure. C'mon, guys.)

One of the troubles with ambulances is that they are really overkill for many calls. If some homeless dude goes unconscious on the curb, they get called. Some neighbor was going to call 9-1-1 because I laid down briefly near the pool. The ambulance and its crew is highly equipped to save lives and respond to the worst trauma cases: multi-GSW, car accidents at 70mph, etc. But I called them because I had a bad headache. And that's why they got to bill so much: they cost a lot! And I bet that a lot of uninsured deadbeats default on their ambulance bills, and the City gets to eat all those costs.

But the times I've transported myself to the hospital, I kinda got blocked by Triage, and it was for my own good. This last time over Thanksgiving, I had a lot of issues, and isn't it always the way that they hit at the beginning of a holiday weekend? So, it was good I went to the hospital.

But I was flabbergasted that my "co-pay" was 92% of the ambulance bill. I don't know why, but that plan has terminated anyway, so there's no arguing about it. At least, my actual hospital bills were well-covered by that plan.

tldr: greed

TLDR: private equity

I 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 allowed for more than a couple kids.

Same thing with houses. I have half an acre. Could easily put 2 affordable tiny homes on it. Good income for me, cheap rent for someone else, but, unfortunately it’s legally blocked