[streblo]

My daughter had an allergic reaction to food last year, which required us to give an epipen. We were told when this happened that we needed to call 911 and have her taken to the emergency room for observation and potentially for further treatment. We did, the ambulance came and took her to the hospital, which is under a mile away. We then had a similar experience to yours - spent about 2 hours in the hospital being observed, then were dismissed. We eventually got a $2k bill from the ER, which our insurance paid, and a $4k bill from the ambulance company, which our insurance didn't pay.

[munk-a]

That ambulance bill is insane. Up here in Canada ambulance charges are paid out of pocket but my wife had a low blood pressure emergency and got an ambulance called and was only out 300$ for a three mile drive (through dense city streets even).

I'm even of the opinion that that bill was a bit excessive.

[jariel]

$300 seems low.

'The distance' is basically irrelevant.

You're paying for a highly available, rapid response team to be prepared for almost any medical emergency, 24/7, literally almost at the press of a button.

'Preparedness' is expensive. What happened if the Ambulance broke down? Or a medic decided to say f-it and skipped a day. Or the phone didn't work. Or the critical piece of gear didn't work. Or ooops ran out of gas (hey doesn't happen often, but it happens!)

To get all of those things to 99.999% is quite a bit expensive. Constant vehicle checks/repairs/updates. Backups. Process, procedure.

The amount of training required for Medics should be quite a lot, considering the first few minutes of any problem are usually the most critical, and it can be 'anything'.

My unscientific 'instinct' is that $1K per call seems to be more or less in the right ballpark.

There should be some kind of insurance for this, one way to make it more palatable would be to have it subsidized. People who call more often I think can be expected to pay a little more but we can't be breaking the bank on folks.

Given that healthcare is a skyrocketing part of the economy, I wonder if we're going to end up with a kind of triage in Ambulances as well - i.e. ambulances for crazy life-threatening things, and ambulances for more common things which mostly require 'getting to a doctor quite soon, please' i.e. this is important, I need to go to the front-of-the-line'.

Edit: actually, $300 is definitely 'too low', there probably is some kind of subsidy.

Very crudely suppose an average call may last 1 hour. Suppose due to scheduling, that an ambulance may be idle for 1 hour in between calls. So the 'average call' would be 1 driver, 2x medics, for 2 'man-hours' each. Of course, there's other labor overhead: for each ambulance, there might be 0.3 mechanics, 0.3 dispatchers, this before we get into all the other unit an ancillary costs. $100K/year for any kind of professional in the medical field is ballpark reasonable, that's $50/hour - so we're looking at roughly $300 just for the immediate staffing - not including the mechanic, dispatch, op staff, gas, insurance, training, facilities, advanced equipment etc.. So very crudely ... ambulances are expensive.

Edit 2: yes, I'm talking costs here, obviously this is different than what people end up paying as a commenter has indicated.

[pjc50]

As with so many things in healthcare, if it's such a great system, why isn't it used for the military? Medevac helicopters are really expensive, so why not make individual troops decide whether their case merits a few year's pay?

[jariel]

Misplaced sarcasm aside, the military makes very excessive use of basic triage.

Medevac is not called for 'asthma attacks' I can assure you.

[AOsborn]

Different country, but pointing out some reported data on actual costs:

https://www.stjohn.org.nz/news--info/news-articles/st-john-a...

In New Zealand one of the major ambulance services reports costs of around $615 including taxes per callout.

However, the charge passed onto the customer is set at $98 for medical emergencies. This is waived for accidents (covered by the government).

A $4000 ambulance bill is offensive and I don't think justifiable in any way.

[northwest65]

Hell, New Zealand only charge $800 (USD500) for non residents!

In New Zealand if you get tested (free) positive for Coronavirus they'll put you in hospital (free). Assuming you've collapsed and need to be taken there in an ambulance, you'll still have to pay the $98.

[kspacewalk2]

$300 is a user fee, a fraction of the actual cost, which in Canada we do pay for through an insurance scheme called taxes. (Most other medical expenses are covered through our single payer insurance, funded though provincial income taxes, but ambulance service is paid for by property taxes, I think).