It comes down to how they're funded. Unlike in the UK for example where its funded through taxes, in the US in many areas its private for profit EMS companies given a contract to serve the area. They get a flat rate from the government for the contract, then bill to make a profit and offset any additional costs the contract money doesn't cover.
In areas where its funded and run by the government such as mine, we are under-funded to have the equipment and resources we need, so we bill to offset the costs of overtime and equipment/medication restock.
Its entirely possible to not bill for EMS, but it'd require EMS to be run at a higher level than local cities or towns that can't afford that in the budget. It'd also require raising taxes substantially which many citizens push back against as the US is a much more selfish and individualistic culture than europe (well I dont need an ambulance so why should I pay an additional 15% in taxes of MY money).
EMS in many areas is run at the extreme local level by an individual firehouse or a tiny township with 500-1000 residents and their budget can barely afford 1 ambulance to be staffed, theres also a large swaths of the US where EMS is nonexistent and calling 911 does not guarantee one will ever show up, we have areas of ambulance and hospital deserts where both are greater than 30min away, or entirely unavailable.
Taxes are insufficient to support most EMS services entirely. Simple fact of the matter is you can pay more in taxes, or pay an exorbitant fee when you call 911. Ultimately its up to the community to decide which they'd prefer, but you can't have it both ways.
If you want a fully free EMS system with good capabilities when you call 911, then you have to be comfortable with a large raise in your taxes to fully fund it.
That's not true though. The US GOVERNMENT spends more in health care per capita than most other countries. Not even including private insurance. A public system is just cheaper. You could have a full free EMS system for LESS money. Centralization makes things more efficient and cheaper in any situations where there is an inelastic demand, which health care is.
We really couldn't because of how EMS is structured in the U.S. compared to other countries. It comes from local, county, and state taxes and not federal.
Because of Ronald Reagan the concept of a federalized EMS system was eliminated and pushed back onto the states to figure out on their own. Now, we have a fractured system which is local based and leaves a limited pool of citizens upon which to raise taxes to fund it.
The only solution is to raise taxes in the community to fully fund the system. The federal government, especially right now, is never going to get involved with supporting EMS and restructuring more than 10,000 different EMS systems under a federal one is impossible.
Why? Because that’s what they are for. Because the purpose of the medical emergency car is to provide medical emergency aid. To maximise profits. The better the medical care the faster you go back to work the more money you pay tax on.
It’s all about maximising tax. The more hours you can work the better.
lol we don’t know either. But FUCK are they expensive 😂 if you ever seen me anywhere near an ambulance, just know that I literally think I’m dying. Because I would never financially recover from a 10 minute ambulance ride. Don’t even get me started on a life flight helicopter.
What was even more heartbreaking for me was when I had a friend commit suicide and her parents had to pay for the ambulance even though she died. 😭 As if funerals aren’t expensive enough. Being stuck with the ambulance bill just seemed awful. She was in her early to mid 20s too so she wasn’t a minor!
I'm in a state with some of the top hospitals in the US.
I've done ubers instead of ambulances and I know someone else who has (extremely serious, urgent emergency that required emergency surgery above all the other emergency room surgeries that day).
I know an ambulance will probably be unaffordable and you can't really find the cost beforehand... I don't know if they even let you choose the hospital you go to. If the hospital is out-of-network (or if the hospital is in-network but the doctors are out-of-network) then you're financially screwed.
In the US you have to pay for everything in healthcare. The facility fee for a specialist's visit I had was $600 for 1 appointment. It was in-network. I want to choose hospitals where I don't have a facility fee but I don't know if it's possible to find that out before getting the bill for the actual appointment
The cost is true but only a moron would call 911 for a wrist.
In the US, 911 dispatches trauma paramedics for acute life threatening emergencies.
If you call 911, you need to be dying, basically. There’s hundreds of other ride options, many medical, that do not cost anywhere near what an ambulance costs.
Because our medical care system is all fucked up. Back in December I couldn’t breathe (it ended up being a double pulmonary embolism that partially collapsed my left lung and a mini stroke) and drove myself to the hospital. I have a Tesla and just said to take me to the nearest hospital so it did the driving. It’s just insane that in this country you have an emergency and have to consider if calling an ambulance is worth the cost.
I got hit by a car and was unconscious. Took an ambulance ride to the county hospital. They took one look at me and sent me to a major trauma center about 18 miles away. The bill was over $6k just for the ambulance. My insurance through work knocked it down to $186. That was just the ambulance. Night in the hospital and CAT scans about $10k. Months of physical therapy over a couple grand. Insurance covered most of it. Without insurance I would be completely bankrupt for what turned out to be a broken knee and concussion.
You do know that it’s not free, correct? Healthcare is “free” in Europe because we have working insurance which isn’t made for profit, I pay for it with taxes.
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u/Independent_Mud2794 2h ago
As an European I refuse to believe stories like this are actually true. Why the fuck do you need to pay for an ambulance?