• InevitableSwing [none/use name]@hexbear.net
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    29 days ago

    In two words: private equity.

    -–

    Ninja edit

    The writer doesn’t agree.

    The standard answer is greed: rapacious ambulance operators, owned by villainous private equity firms, exploit patients at their most helpless. But I don’t think that’s actually what’s going on. Ambulance providers are chronically unprofitable businesses; margins are thin, crews are underpaid, and operators exit the industry every year. Whatever is being extracted from patients like Whitten, it isn’t padding anyone’s pockets.

    The real problem is much more specific and much more interesting. American ambulance bills are enormous and unpredictable because of how American law forces ambulance services to work…

    • InevitableSwing [none/use name]@hexbear.net
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      29 days ago

      xp84 2 hours ago

      I tell this story every time ambulance costs come up because it might be helpful to anyone. I once lived in San Francisco in the mid-2010s. In SF, the SFFD operates the vast majority of ambulances in the city. As in, 80%+. I once had the need to go to the hospital urgently and called 911. The ambulance that showed up was SFFD. They transported me and I recovered safely.

      I then got a bill from them saying that my insurance had refused to pay for it - apparently that insurance company (they’re lucky I’ve forgotten which one, as naming and shaming health insurance people is one of my favorite hobbies) had refused to contract with SFFD, making them “out of network.” Yes, an out of network ambulance.

      And remember, there’s at least an 80% chance that an SFFD ambulance will show up, and I’ve never heard of them offering a menu of ambulance companies to the caller who’s likely having a heart attack, bleeding, etc! So of course, my insurance would only pay some small pittance, if anything, and I was sent a ~$1000 bill.

      I immediately filed a complaint with the insurance company’s California regulator (at the time it was the Dept of Insurance for this one, but it seems most or all now are under the Department of Managed Health Care) since insurance companies are by law obligated to pay at the in-network rate in the case of an emergency (which presumably is why you call an ambulance in the first place).

      Within 2 weeks I received a letter from the insurance company that all was completely fine and that they’d corrected the situation and paid the bill. So we have an insurance company which surely knows that law, surely knows what an ambulance is for, but has discovered the “life hack” of having an extremely inadequate network, simply refusing nearly every ambulance claim made in the City, and then only paying the small percentage who know the law and know how to file a complaint.

      And of course, there’s no punishment, the punishment is just having to pay the few times they’re caught. And insurance companies wonder where all that anger (Delay, Deny, Depose, was it?) comes from. Anyway, practical moral of the story: don’t let them get away with doing that if it happens to you or someone you know!

      Note: My story is obviously kind of tangential to the actual article which explains why the cost is so high due to everyone who’s being subsidized by what they’re charging privately-insured patients. However, I have but the world’s tiniest violin for those extremely profitable insurance companies who would obviously really like one of their costs of doing business to just go away. Yeah, I’d also like it if I could be paid my full salary, even though I refuse any work I find annoying.

      I edited it so the paragraphs were sane.

      • Maeve@kbin.earth
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        29 days ago

        That’s the one. The blogger does backflips to worship capitalism, which, I guess to be fair, if you’re never exposed to different ways of thinking is normal (alternately, their income depends on if, maybe both?), but the comments get what the blogger denies: greed.

        • InevitableSwing [none/use name]@hexbear.net
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          29 days ago

          Your comment made me think of a four panel lib cartoon poking fun at MAGA.

          I made a one panel version of us making fun of American normies.

          I’m not sure what’s in his right hand. A half-eaten hotdog? God Bless America

  • free_casc [comrade/them]@hexbear.net
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    29 days ago

    PSA that in my area you dont get charged for calling an ambulance, only for the ride if it takes you soemwherey. Not sure how ubiquitous that is, but I thiiink that is standard practice. Do not hesitate to call 911 if you might need it.

    If you call, maybe paramedics can help you onsite, maybe they can advise if someone else should drive you to the hospital, or maybe they can at least be there a little bit before you truly need the ride in case it escalates that far.

  • Aradino [they/them, comrade/them]@hexbear.net
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    29 days ago

    I recently had to take an ambulance to the hospital in Australia. The full bill was $1,500.

    I didn’t have to pay(like I could pay anyway) because I have a concession card, but it isnt solely an American thing. Any for-profit ambulance service will have this problem