[jimbob45]

IMHO, you're mis-stating the problem. One should take an uber/friend to the hospital if the ailment is not time-sensitive or in need of ongoing treatment so that the ambulances are freed up for more critical patients. Ambulances should have some level of cost associated with them to dissuade using them for minor ailments. Should that level of cost be thousands and thousands of dollars? Probably not.

[tialaramex]

For example, some years ago on holiday to Edinburgh I had terrible diarrhoea. Probably norovirus infection. Fine, holiday spoiled but I can sit in a hotel room, stay hydrated and watch Netflix in the calmer moments. Then I began shitting blood. OK, that definitely might /not/ be fine, need somebody to check.

So I call NHS Direct, they agree that unexpected blood is potentially urgent and I arrange a taxi in the middle of the night to go to the closest Urgent Care clinic. Taxi driver did completely fail to find the right entrance to the hospital, but I was just sick not stupid so I followed the signs he'd ignored and went to Urgent Care. I was the only adult, every other patient was a sick child whose parents were probably worrying too much. A doctor takes a look, goes yup, just what you'd expect, not serious but thanks for checking, disapproves of my "Crisps and full fat Coke = Salt + Sugar + Water = acceptable rehydration" approach and hands me nasty tasting rehydration powder. Boo but since I'm the one who just dyed a toilet bowl red with their own blood I vow to follow their instructions. Taxi back to the hotel. All better in time for the trip home. Still have the last sachet of rehydration powder somewhere actually, it's probably expired but can't taste worse now than it did then.

NHS Direct is really handy, because it's often tricky to judge the correct amount of urgency or know how best to access the service you need, especially when far from home. But I don't see how you could build a trustworthy service like that under the US system.

[jopsen]

Don't need to be a cost... We could just have 911 send a taxi instead.

I know in other countries ambulances are not always dispatched, because 911 operators decide it's not critical.

Mostly this decision is correct, but from time to time a heart patient dies. (Maybe the alternative should be to send a taxi)

[jimbob45]

Is that a thing in other countries? Sounds like an excellent idea for a bill here.

[jopsen]

In Denmark we have cases where ambulances are not dispatched because operators don't think it necessary..

But I don't think the dispatch taxis instead -- besides our taxi availability is highly limited and extremely expensive (Uber being prohibited). To be fair taxi drivers are certified, and service is IMO high quality.

[jacobush]

Shouldn’t dispatch triage if you need an ambulance or not?

[jopsen]

In other countries they do that so aggressively that we have stroke victims dying, which an ambulance being dispatched.

On the other hand, given that triage failures are rare -- cost/benfit wise it's probably better.

[jacobush]

In countries where you can call an ambulance like a taxi, won't that lead to ambulances not being available to people who actually need them?

[jopsen]

GP was making the argument that high costs of an ambulance is necessary.