- #1
moonman239
- 282
- 0
Funding? That's what income tax and sales tax is for.
No, ambulance service is locally provided. How much you pay depends on your insurance coverage. If you have no insurance, then you will have to work something out with the ambulance company.moonman239 said:Funding? That's what income tax and sales tax is for.
Are you confusing 911 with ambulance service? They are not the same thing. What you just wrote makes no sense.Alfi said:If I call 911 for me, I don't mind paying.
If you call 911 for me, I may object to paying.
If I call 911 for you and you are charged, I don't care.
If I call 911 for you, I mind being charged.
Evo said:Are you confusing 911 with ambulance service? They are not the same thing. What you just wrote makes no sense.
So is what you are trying to say is if you are seriously injured, you do not want to be saved?
I don't know what country you live in, but in the US, if you call 911 (emergency dispatch), you are not sent a bill just for calling them.Alfi said:my error in not being specific.
911 = emergency response. They are the same here.
First question asked = Fire, police or paramedics?
The question was, Why must people pay for 911 and ambulance service?
I ignored the fire and police aspects of the 911 call.
Evo said:I don't know what country you live in, but in the US, if you call 911 (emergency dispatch), you are not sent a bill just for calling them.
Ambulance service costs will vary from town to town depending on services offered, how much is subsidized by the city/township, etc... and your ability to pay. For very poor people, there are usually services available to them to cover expenses.
Here is an example from Washington D.C..
http://fems.dc.gov/DC/FEMS/About+FEMS/Ambulance+Billing/ci.Ambulance+Billing+Questions.print
mkarger said:I was in a motorcycle accident and attempted to get up once I heard a passerby on the phone with 911 telling them it was serious and that an ambulance was needed.
I knew how much emergency services cost and even with insurance I did not want to foot the bill. I figured I was okay.
Due to my disorientation, I ended up back where I was face down on the asphalt half conscious with people running up telling me to lay still.
Due to the fact that it was a motorcycle accident and in the 911 call the caller felt I was in serious condition, 911 dispatch automatically called in Medivac services to take me to a trauma 1 center.
I told the EMTs that I could not afford Medivac services. Because they feared I had broken my back, they chose to ignore my request (I don't blame them at all by the way. They must always assume the worst when treating a patient). The ambulance took me from the scene to the waiting helicopter that was about 1/4 of a mile away. The helicopter then flew me about 20 miles to the hospital.
It was a 5,000 dollar helicopter ride after insurance (uninsured it would have been roughly 30,000 dollars). And even though the ambulance service drove me only a thousand feet or so, that was another 1000 dollars.
The cost of medical care to the average citizen in this country is absolutely insane. Why we haven't switched to a single payer or socialized system is beyond my understanding. I believed that before my accident and I believe it even more now.
mkarger said:It was a 5,000 dollar helicopter ride after insurance (uninsured it would have been roughly 30,000 dollars). And even though the ambulance service drove me only a thousand feet or so, that was another 1000 dollars.
The cost of medical care to the average citizen in this country is absolutely insane.
As far as I know there's no cost associated with calling 911. As for ambulance services, they're provided either by municipalities or private companies licensed by municipalities, as far as I know. And yes, the prices are ridiculously high. Just another example of wacked out healthcare costs. What can be done about this? I have no idea.moonman239 said:Funding? That's what income tax and sales tax is for.
nanosiborg said:As for ambulance services, they're provided either by municipalities or private companies licensed by municipalities, as far as I know. And yes, the prices are ridiculously high. Just another example of wacked out healthcare costs. What can be done about this? I have no idea.
BobG said:Stuff costs money.
russ_watters said:Ok, so I think most people would agree that it sucks to get socked with a large fee for a helicopter ride or ambulance ride and it would be nice if these things are tax-supported, but:
Several people just proved through their own anecotes that if the costs for these things are hidden from view, people will use them more, whether they need them or not. Heck, if there is no direct cost, why would anyone bother with a primary care physician? If you have a sore throat, just call up your local ambulance (limosine?) service and they'll drive you to the emergency room, saving you the effort and gas money, not to mention a week's wait for an appointment. That's one of my main practical criticisms of socialized medicine, that hiding the cost leads to over-use and abuse. So I ask:
What can/does a socialized medicine system do to reduce abuse of these services if they have no direct cost?
Also, regarding the cost. Cost is not as simple as it may seem and in these discussions, people tend to vastly misunderstand why it costs what it costs.
First, there is an issue of market forces involved in setting the cost and the fact that it might cost $5,000 or $30,000 depending on when and how you pay for it is not necessarily indicative of profitteering. The insurance company provides a known customer base that is useful for planning, guaranteed payment, economy of scale and the ability to negotiate collectively. A similar issue exists with airline tickets, where the same seat may cost $200 or $800 depending on when and how you buy it.
But how much should it cost on average? $5,000 for an entire day's worth of air ambulance service is impossibly low. You can't even support one pilot for $5,000 a day (that's 24 hours of pay, benefits and insurance), much less actually run a helicopter or the mobile emergency room (and its staff) contained in it. Yes, we're all just making guesses, but $5,000 a call seems reasonable to me for an average.
Ambulances are similar. You're not just paying $1,000 for a 1000 foot ride, you're also paying part of the ownership cost of the ambulance and the equipment and you're paying the crew (if it is a professional crew) to nap and watch movies in a ready-room for hours while they wait for your phone call. The gas and salaries of the crew for the time of the ride (whether 1/5 mile or 5 miles) is a tiny fraction of the cost of the ride. So that's the error people are making: they are focusing on the cost of the ride itself and ignoring the cost of the existence of the ambulance (and air ambulance) service.
Heck, if there is no direct cost, why would anyone bother with a primary care physician? If you have a sore throat, just call up your local ambulance (limosine?) service and they'll drive you to the emergency room, saving you the effort and gas money, not to mention a week's wait for an appointment.
You can't even support one pilot for $5,000 a day (that's 24 hours of pay, benefits and insurance)
So that's the error people are making: they are focusing on the cost of the ride itself and ignoring the cost of the existence of the ambulance (and air ambulance) service.
mkarger said:For example, in the US, health insurance has a 30% overhead.
Locrian said:Not mine; it's also less than 10%.
Of course, % overhead is a spectacularly bad measure of efficiency, so we can all stop caring about it right now.
Angry Citizen said:That is exactly what happens in civilized countries where these things are not an issue. Yep, you nailed it. Same thing that happens in those same countries where unemployment benefits are perpetual - everyone loafs about and takes advantage of the government. That's why all those countries have 100% unemployment and massively inflated health care expenses.
Oh wait. That's right, we're the ones with the massively inflated health care expenses, not them. However could that be.
Oh really? So pilots have benefits + pay packages exceeding 1.8 million dollars per year? Well, now we know why the "free market" is ridiculous at these kinds of services.
These things would be significantly cheaper if everyone were paying for them. That's the whole point of society: a collective sharing of resources for the betterment of all. Even if an ambulance does cost a thousand dollars per day, that's infinitesimal if paid for by ten thousand people.
Angry Citizen said:How about per capita health care expenditure in relation to infant mortality and average life expectancy?
I didn't say anyone said "no cost". The wording I used was "hidden from view" and "no direct cost" meaning no cost at the point of sale. This has an impact on who is paying and impacts choices on what services to get.mkarger said:No one here is trying to argue that there is no cost to ambulance and emergency service operation.
There are several different lines of discussion going on, one of which was that it doesn't really cost $5,000 a day much less $30,000 a trip to fly someone helivac someone. $5,000 a day is definitely low, $30,000 a trip is probably high. But some issues:What we are arguing is that the cost is excessive. And, in many cases, prohibitive.
The purpose of insurance is to spread the cost based on the low probability and frequency of using the services. While I agree that the cost is inelastic, it is only mandatory insofar as we have decided it is. But as the anecdotes people have posted in this thread show, if the cost hits you directly, the services become very, very voluntary. Socializing the cost - removing it from the point of sale - allows us to pretend we can pay whatever it costs, but that is only pretend and that is part of the reason why the cost is inelastic. We're lying to ourselves about the cost when we do that, we make it more expensive by doing that and ultimately that is going to come back to bite us, as I'm discussing in another thread. We have chosen, for example, to make health care/insurance more mandatory than police protection in some contexts. And based on Europe's lead, we're going to go further down that road. Eventually we will either go bankrupt or we'll have to start deciding that total healthcare isn't quite as "mandatory" as other government services.Whether or not the market cost of flying me 20 miles was 30,000 dollars, I cannot afford to pay 30,000 dollars. Fortunately, I had insurance. But roughly 50 million Americans do not.
In any other industry, the costs reflect what consumers can bear. Because medical care is not really voluntary (meaning you can't go without it), the costs can be inelastic. And health care providers know that.
This, I strongly disagree with. As the anecdotes show us and the logic tells us, nationalizing the healthcare makes some contributors to the problem worse, in that eliminating the direct cost reduces the incentive to self-triage and encourages abuse. By the same token, making healthcare non-profit will help, but as with many discussions on corporate profits, I think you are overestimating the impact of that. Regardless, if we lower our costs by 20% but don't fix the rising cost trajectory, it will remain too expensive and just be worse again in a couple of years.The only real way to solve such an issue is through nationalizing healthcare so that it is not for profit. Around the world, there are nationalized systems that are not only better at treating the population, they have significantly lower overhead costs. For example, in the US, health insurance has a 30% overhead. In Canada, it's less than 10%.
Please drop the attitude, propaganda techniques and read and respond to the posts as given. What you are doing there bears no relation to what I said and is not acceptable.Angry Citizen said:...
Whatever is causing your attitude is also causing you to not understand this simple issue of math (and one slightly less simple): since people typically work 40 hours a week, but medivac service must be staffed for 168 hours a week, having one pilot available at all times actually requires a staff of about five pilots (assuming these pilots work 40 hours a week and sometimes take vacations). That's the obvious one.Oh really? So pilots have benefits + pay packages exceeding 1.8 million dollars per year? Well, now we know why the "free market" is ridiculous at these kinds of services.
Not my society. The founding point of my society was freedom from government intervention. Collectivist principles are relatively recently conceived, not well established experimentally and not universally agreed-upon.These things would be significantly cheaper if everyone were paying for them. That's the whole point of society: a collective sharing of resources for the betterment of all.
Just for clarity, I was bouncing back and forth in my thought process, but the way I worded it I didn't consider a two-pilot team. This math also allows for zero redundancy which wouldn't be how a real medivac unit would have to operate.Oltz said:Couple things if my simple napkin math is correct to have a helicopter on stand by 24 hours a day 365 days a year you would need 10 pilots on staff (5 teams of pilot/co-pilot) and maybe a 6th not knowing what restrictions there are on time off for pilots.
I'm going to call BS on this. Do you have a reference? $5k/day seems impossible, but I am not in that business.AlephZero said:Their TOTAL operating costs are only about $5000 per day, which pays for flying several missions.
I echo this comment too, the costs are real costs. The fact that someone's life depends on it doesn't make the real costs dissapear. The same is true of any medical cost.Locrian said:This was the one and only response needed to the OP. People must pay for it because the personel won't work for free and the manufacturers of the necessary equipment won't work for free. It's that simple.
Locrian said:Also bad; you're just looking at input without looking at output and value.
It's probably better than the % admin values you see tossed around, though. Those are just awful.
DaleSpam said:I'm going to call BS on this. Do you have a reference? $5k/day seems impossible, but I am not in that business.
russ_watters said:I didn't say anyone said "no cost". The wording I used was "hidden from view" and "no direct cost" meaning no cost at the point of sale. This has an impact on who is paying and impacts choices on what services to get.
There are several different lines of discussion going on, one of which was that it doesn't really cost $5,000 a day much less $30,000 a trip to fly someone helivac someone. $5,000 a day is definitely low, $30,000 a trip is probably high. But some issues: The purpose of insurance is to spread the cost based on the low probability and frequency of using the services. While I agree that the cost is inelastic, it is only mandatory insofar as we have decided it is. But as the anecdotes people have posted in this thread show, if the cost hits you directly, the services become very, very voluntary. Socializing the cost - removing it from the point of sale - allows us to pretend we can pay whatever it costs, but that is only pretend and that is part of the reason why the cost is inelastic. We're lying to ourselves about the cost when we do that, we make it more expensive by doing that and ultimately that is going to come back to bite us, as I'm discussing in another thread. We have chosen, for example, to make health care/insurance more mandatory than police protection in some contexts. And based on Europe's lead, we're going to go further down that road. Eventually we will either go bankrupt or we'll have to start deciding that total healthcare isn't quite as "mandatory" as other government services.
However, much of that is off topic because while I believe that some of the cost of ambulatory services should be borne at the point of use in order to deter abuse, the real cost of the service is so high, use so rare and jurisdiction so broad that most of it should be administered by government via taxes. We had a similar thread about voluntary fire department fees and I am against that concept as well.
That goes against my moral beliefs, but sometimes in politics my pragmatism > my moral beliefs. This, I strongly disagree with. As the anecdotes show us and the logic tells us, nationalizing the healthcare makes some contributors to the problem worse, in that eliminating the direct cost reduces the incentive to self-triage and encourages abuse. By the same token, making healthcare non-profit will help, but as with many discussions on corporate profits, I think you are overestimating the impact of that. Regardless, if we lower our costs by 20% but don't fix the rising cost trajectory, it will remain too expensive and just be worse again in a couple of years.
And "better" is, of course, a matter of what you measure and how. Logically, if nationalization doesn't change the quantity and quality of doctors, ambulances and hospitals, all it can really do is even-out the level of care by rationing it. I don't understand why people overlook this Law of Conservation of Doctors as I will henceforth call it.
For example, one of the primary measures that people have of "better" is, as you noted, fewer people uninsured. But the Law of Conservation of Doctors requires that if you provide a doctor for someone who didn't used to have one, you have to deprive someone who did. This manifests as substantially longer wait times for treatment in many countries with socialized medicine. You increase one person's access to a doctor and reduce another's. That's "better" for one, "worse" for the other.
According to recent statistics gathered by the World Health Organization, the United Nations, and the OECD, the United States ranks 37th in the world for quality of health care behind nations like France, Canada, the UK, Japan and the Netherlands.
The United States ranks 46th in the world for infant mortality; with a death rate nearly twice as high as France and aproximately 1.5 times higher than the UK and Canada.
The United States ranks 36th in the world for life expectancy. The average American citizens lifespan is 2 years lower than a French or Canadian citizen and nearly 5 years lower than the Japanese.
Our mortality rate for children younger than 5 years of age is twice as high in the United States when compared to France and Germany and more than 2 and a half times as high compared to Sweden.
The United States has a maternal mortality rate roughly 5 times higher than Sweden, 3 and a half times higher than Germany, 3 times as high as France and twice as high as the UK.
We have an obesity rate 3 times higher than countries like France, Sweden, Denmark and two times higher than Canada.
Yet, the United States spends approximately 30% more per capita on medical care as a portion of GDP than countries like France, Germany, Sweden and the UK .