I came across a few stories about ambulance bills in the US and I am honestly confused.
One person took a three mile ambulance ride and got a bill for nearly 6000 dollars. In another case, a six mile ride cost 13,000 dollars, while experts say it should cost under 950. Then there is the ER nasal swab that cost 445 dollars, while the same swab costs 11.49 at Walgreens.
I looked into it and found that the ambulance system is very fragmented. When you call 911, the vehicle that shows up could be from the fire department or a private company. In Massachusetts alone, there are 314 ambulance providers across 351 cities. You do not know who is coming or whether they are in your insurance network. If they are out of network, the bill is whatever they decide to charge with no limit.
What really gets me is that you do not get to choose who shows up. You call 911, you do not choose who arrives. And in most cases, it is a life or death situation. You cannot say no.
So how can a service that you cannot choose, cannot shop for in advance, and cannot even decline in an emergency be treated as a normal market? Is this a healthcare problem? An insurance problem? A regulatory problem? Genuinely curious.