Why must people pay for 911 and ambulance service?

[mkarger]

Here's another thing to consider. Nobody ever has to pay for ambulance service. As far as I know, there's no penalty for nonpayment -- other than possibly ruining your credit rating.

But if you owe, say, $10k for prior ambulance rides they'll still respond to your 911 calls and take you to the nearest hospital if you're in urgent need of medical assistance.

It's really a pretty good system, albeit somewhat overpriced, imo.

You realize that your assets can be seized if you fail to pay your debts, right? It doesn't just disappear because you're broke. You can negotiate the price down during bankruptcy or directly with the ambulance service. But you cannot just make it go away.

The number one cause of bankruptcy in the United States is debt from healthcare.

If the standard of service rendered is "well at least they don't let you die," then I think we need to seriously reevaluate our standards.

 

[nanosiborg]

You realize that your assets can be seized if you fail to pay your debts, right? It doesn't just disappear because you're broke. You can negotiate the price down during bankruptcy or directly with the ambulance service. But you cannot just make it go away.

The number one cause of bankruptcy in the United States is debt from healthcare.

If the standard of service rendered is "well at least they don't let you die," then I think we need to seriously reevaluate our standards.

I think that not letting people die is about as good as it's ever going to get. Fortunately I haven't yet had to call an ambulance, so have not had to deal with the exorbitant prices.

I agree that a serious reevaluation of standards and values is in order, but I doubt that that will ever happen. We're locked into a greed based system. One must learn how to manipulate it to one's advantage or simply be one of the disadvantaged.

 

[russ_watters]

I'll let the facts do the talking...

A ranking by the OECD is not a useful "fact", it is a collection of individual facts, with a weighting attached to them by the OECD. The OECD has its own politics and measures "quality" based on its opinion on what matters. Based on previous investigation of the OECD's poverty measurement, I suspect that this largely reflects the OECD confusing equality with quality. But I'd love to see how the OECD comes to that conclusion.

And an anecdote on cost:
My father buys his Zocor from Canada because it is much cheaper there. This fact has nothing to do with socialized medicine and everything to do with patent law and lobbying and
1. It wouldn't necessarily change if healthcare was nationalized and
2. It could be changed without nationalizing healthcare.

In addition, profit may be a dirty word that equals exploitation and waste to people who prefer socialism to capitalism in certain areas, but profit is also a motivator for fiscal responsibility. Lacking it, I fear our government would just do more of what it is doing already; funding its promises with borrowed money and pyramid schemes.

 

[Oltz]

I'll let the facts do the talking...




The general population receives better treatment at a lower cost per capita. And emergency services are rendered just as quickly. Non-emergency services are doled out according to who's first in line. Which makes sense.

See my previous comment about statistics and base line definitions this conversation has been had before about those very OECD stats they are using the data collected by each government without any adjustment for different definitions.


If you dig nearly every one of these "Independent third party" evaluations have similar flaws.

 

[D H]

London Air Ambulance costs roughly 2000 dollars a patient on average. It flies about 5 missions a day on average.

That's 10,000 dollars a day.

London Air Ambulance doesn't operate its helicopter service 24/7/365. It only flies during daylight hours, and weather permitting. Around the clock operations (weather permitting) would require more pilots and at least one more helicopter.

 

[Locrian]

As a side note, I've done a bit of research, and it's actually really hard to show that air ambulance services really do benefit the patient over ground ambulance service. There are some studies that show they do, and some studies that show they don't.

Suprisingly (shockingly! amazingly!) studies that show they do tend to be done by universities with air ambulance programs, and studies that show they don't. . . well, the opposite.

 

[AlephZero]

London Air Ambulance costs roughly 2000 dollars a patient on average. It flies about 5 missions a day on average.

That's 10,000 dollars a day.

The $5000 per day I quoted was based on the air ambulance charity website's statement of the funds they need to raise (not for the London area, but a factor of 2 isn't important compared with the US figures that were quoted).

 

[AlephZero]

London Air Ambulance doesn't operate its helicopter service 24/7/365. It only flies during daylight hours, and weather permitting. Around the clock operations (weather permitting) would require more pilots and at least one more helicopter.

Those factors don't necessarily affect the cost per flight, which is what the US figures quoted. There is no point in providing a 24 hour cover unless it is actually going to be used 24 hours per day. (The UK service already operate 365 days/year).

The basic restriction to daylight operations is the JAR regulation that night time takeoffs and landings are only permitted at "class 1" landing sites, which would exclude most emergency locations, and (at least in the UK geography) transfers by a combination of land and air transport don't have much advantage over land-only.

 

[russ_watters]

Those factors don't necessarily affect the cost per flight, which is what the US figures quoted. There is no point in providing a 24 hour cover unless it is actually going to be used 24 hours per day. (The UK service already operate 365 days/year).

That's fine, but it is misleading to say it costs a certain amount of money per day if it isn't available all day while other services we are comparing it to are. In fact, I completely lack comprehension as to how it can be that useful if it doesn't operate 24 hours a day. Night-time service is probably just as important as daytime service, as people drive drunk more often at night than during the day. It seems like a pretty severe limitation in service to me.

Also, the fact that it requires a certain amount of money in donations doesn't necessarily indicate that the donations are the only source of funding. Could you (and mkarger) please cite the source of the information so we can look at it ourselves? For example, this link says "relies heavily on public donations" which means it also relies on other sources. But it doesn't say how much:
http://www.londonsairambulance.co.uk/donate

However, that website also says the service runs 24/7 so I'm not sure if we're talking about the same service.

In any case, the "staff" page lists 5 doctors, 5 pilots and 5 paramedics, which together make up about 2/3 of the staff of the company, for this particular service.

[edit] Oh, it does have a wiki page which says (after exchange) that it costs $3.6 million a year to run, or about $10,000 a day... which is less than I would have expected for a service with a full-time doctor onboard.

 

[D H]

At night they use "Rapid Response Cars" in lieu of their helicopters.

 

[russ_watters]

At night they use "Rapid Response Cars" in lieu of their helicopters.

Who, London Air Ambulance? That's misleading! [goes back to the wiki site] I see. Ok, so $10k a day gets you 8 hours of helicopter service and 16 hours of a car service.

Er...its late and I should go to bed. I apparently stopped reading halfway through this sentence:

ased at the Royal London Hospital and founded in 1989, the service is unique in that it operates 24/7, with the helicopter running in daylight hours and rapid response cars taking over at night.