Cities with Uber Have Lower Rates of Ambulance Usage

https://www.npr.org/sections/thetwo-way/2017/12/18/571689807/cities-with-uber-have-lower-rates-of-ambulance-usage

by lyk • 9 years ago

298 295 9 years ago

doorty• 9 years ago

They (uber/lyft) work well for my dog emergencies too.

lstyls• 9 years ago

Drivers don't have issues with an uninvited dog passenger? As a dog owner, I find this surprising. But if drivers are OK with it it would be a great option for me because I don't own a car.

smelendez• 9 years ago

It depends on the city, culturally, and it's a good idea to call and ask first.

Obviously if it's a service dog they're required to transport it, but from knowing people with service dogs, it's still worth calling because some drivers are allergic and would rather you call another

cm2012• 9 years ago

Most drivers are okay if it seems like you have your pet neat. I take my cats in carriers all the time, but would never take my parents super sheddy dog.

WhyNotHugo2• 9 years ago

I've taken my cats (in their carriers) to the ER on Uber several times. Generally, they don't have any issues and are quite empathic to the situation.

cardiffspaceman• 9 years ago

We can view this as either a positive for how Uber works or a negative for how taxi cabs work. If the pervasive means of transportation other than ambulances are unresponsive or expensive compared to ambulances, then obviously ambulances are the choice. One might also drive oneself, get a ride from a friend or family member, or hope that a city bus will be fast enough. An Uber ride could be faster than a ride from friend or family and safer than driving oneself.

CydeWeys• 9 years ago

I took a taxi to an urgent care clinic when I broke my ankle in a bike accident. Would've taken an Uber or Lyft if taxis hadn't been around, but there were a lot of them. Whatever was fastest. I really wasn't worried about saving a few bucks on a ride at that point.

an4rchy• 9 years ago

I've been wondering about this for a while but, is there a reason why Uber or an alternative cannot/should not get into the Ambulance space, if it were able to get qualified staff.

I feel like Ambulances/Hospitals charge way too much and using the app/tech at a basic level to connect the ambulances with patients addresses may be a good start for everyone and also the increase in supply may reduce costs.

switch0073• 9 years ago

Are paramedics/ambulances so unregulated in the US that it's /not/ a bat-shit crazy idea to suggest Uber Ambulances?

TylerE2• 9 years ago

Not really. There are plenty of private ambulance services in the US. They generally deal with things like transporting a medically frail person to see a doctor in a different city, things like that. Non emergency, mostly.

http://www.nytimes.com/1987/01/31/style/private-ambulances-w... (yes, over 30 years old, but most of it still holds true)

Spooky233• 9 years ago

Nah, there’s certification and usually contracts with municipalities for response to emergencies.

It’s a real mix though... paid fire dapartments, volunteers, and private operators all respond to emergencies.

adventured• 9 years ago

There are a lot of private ambulance services in the US, they're anything but unregulated though as you'd expect with anything in the US medical field (one of the most regulated industries on earth).

There's no theoretical reason why Uber couldn't get into the driving side of the business, with human drivers. Their future is in autonomous however, which will never be the ambulance business (it will never be autonomous, ambulance drivers frequently have to break standard driving laws in emergencies, drive at high speeds, drive around vehicles, etc).

cik2e• 9 years ago

There are already private services for medical transport, although I do not know if they are allowed to handle emergencies.

chiefalchemist5• 9 years ago

I think the bigger market would be Uber meets "full assisted transportation."

ATM if my father (who had a stroke in early Oct) has to go to the doc there aren't many options - that I've been made aware of - other than me. My mother can't help him enough (without endangering both of them), and anything more traditional would just pull up and wait at the curb.

Long to short, the country - and 1st World - is getting old. It's a big market. The issue is how well technology is a fit, at least for the next couple generations.

p.s. I should know this but does Uber or Lyft deliver groceries? For less than the market?

ballooney• 9 years ago

When people criticize 'Silicon-Valley-Types' for only being able to think of technical solutions to social problems, it's exactly this kind of thing they have in mind.

Just read this thread - the way medical care is paid for in the US is batshit-insane, injured people not wanting to call an ambulance incase they lose their house - and reads like a history book about european medieval history. The solution is not more apps, it's a proper healthcare system like almost every other developed country.

vemv• 9 years ago

An alternative ambulance service wouldn't be just an 'app', but an actual entrerprise with various logistical, legal and medical operations and probably hundreds of employees.

The US would be a better place with that hypothetical startup.

If Obama couldn't successfully reform healthcare long-term (as Trump will repeal it sooner or later), what can regular people do?

Let them make that app.

logfromblammo4• 9 years ago

We fix the largest problems that we are permitted to touch.

We cannot propose a solution to the ultimate cause, because that would require the representative democracy to elect more scientists, technicians, engineers, and mathematicians to the legislature in lieu of the usual professional politicians, lawyers, corporations managers, and educators.

So we work on what we can reach.

We cannot create a proper healthcare system from the top down, but we can issue bugfix patches and hope they get adopted upstream. That keeps the system limping along, but never getting quite bad enough for anyone to demand the complete overhaul that it needs.

It only looks crazy because the biggest problem any motivated individual can solve is limited either by the amount of investment capital they can attract with their solution, or by the amount of campaign funding they can attract with their solution. So any proposals that threaten profit margins cannot be considered.

pixelbill• 9 years ago

I'm curious, this article spins the whole "lower rates of ambulance usage" as a positive thing, but is there enough evidence to say that?

From the article:

_______ With demand for ambulances decreased by available Uber drivers, emergency personnel have been able reach critical patients faster while also applying necessary treatment on the way to the hospital, according to a new economic study from the University of Kansas:

"Given that even a reduction of a few minutes can drastically improve survival rates for serious conditions, this could be associated with a substantial welfare improvement."

The study investigated ambulance rates in 766 U.S. cities from 43 different states. Taking into account the timelines of when Uber entered each city, the researchers found that the app reduced per capita ambulance usage rates by around 7 percent. _______

Okay they claim the study says "emergency personnel have been able reach critical patients faster" but decreased usage does not necessarily equal faster response time. It would have been much more solid if they actually looked at the ambulance response time, not just how many are being used. (My skeptical side leads me to think this is because that data-set didn't match their narrative.)

There is also the question of: Is this actually a good thing? Are those 7% less people using ambulances all not having serious health issues? Especially when something is wrong, you are often not a good judge of your own health.

How many people having chest pain thought it wasn't too bad so they called an Uber instead of an ambulance and died on the way to the hospital? Might not have turned out that way if they just called an ambulance in the first place..

Need more data to decide if this is an Uber propaganda piece.

djsumdog7• 9 years ago

I agree. 7% is a really low number, and people shouldn't be afraid to call an ambulance just to save money. That's fucked up. Especially with comments talking about strokes and heart attacks. In most western countries, this isn't even an issue.

I honestly question of the numbers are even statically significant, but even if they are, this is seriously fucked up and not something Americans should be proud of at all!

jaclaz• 9 years ago

Need more data to decide if this is an Uber propaganda piece.

Well, they could ask Uber for all the rides they made to the ER and see if - roughly - the numbers match with the claimed 7% reduction of ambulance calls.

I mean, a lot of people may have - coincidentally in the same period Uber came to the cities - become aware of the high cost of ambulance, or lost their insurance or whatever other reason and used taxis or some other means.

After all the study takes into account what happened over very roughly 3 years 2012-2015, how many people read (say):

http://articles.latimes.com/2013/aug/23/business/la-fi-healt...

http://www.nytimes.com/2013/12/05/health/think-the-er-was-ex...

If there was a "penetration rate" (which is not the same thing as "establishing the service") and a direct correlation with roughly the same number of UberX rides to the ER and of less ambulance calls then it would IMHO sound much more credible.

bmelton• 9 years ago

If you don't get bogged down in details of the service, I see this as generally net good. For many, ambulance rides are prohibitively expensive, and while I certainly wouldn't be cost-conscious taking an ambulance in the event of a seizure or heart attack, for something like a broken arm, or non-life-threatening ailment, an Uber/Lyft/Cab is a good alternative to trying to drive myself.

Beyond that, I'd like to see statistics on whether people ride-sharing to emergency rooms / urgent care facilities was freeing up ambulances or causing them to sit idle. I suspect it's the former, which would mean ambulances could be more available for more people with more serious conditions, but I could be wrong.

Spooky233• 9 years ago

NYFD has about 220 ALS units (advanced / requiring a paramedic) and 550 BLS (basic transport, no drugs, etc) units per day.

Reducing BLS calls via uber wouldn’t affect availability of ALS units for serious things, but would probably save money.

brokensegue• 9 years ago

well people deciding between an ambulance or an uber aren't really qualified to make that decision so it wouldn't surprise me if a bunch of people who needs an ALS unit decide to take an uber.

jessriedel• 9 years ago

The number of ambulances will adjust to the demand.

donatj• 9 years ago

Six years ago I had something similar to a stoke. I had a relative drive me from work to the ER in outer suburbs because:

a) I would literally rather die than pay for an ambulance. I put my money where my mouth was on that.

b) I knew from previous experience their ER was far cheaper, cleaner and quicker than the one in the cities.

Maybe I am just particularly frugal but I had the presence of mind to consider costs while I could not feel one side of my face.

Another time, I needed surgery and called around to get quotes. The place I ended up was something like a quarter the place my doctor wanted to send me.

yeukhon• 9 years ago

I am glad you are safe. I obviously have no clue into your actual diagnosis, but just some thoughts.

This works if and only if you are in control of the situation. That being said, have you considered if when the worst case happened to you, the kind of stress your relative could experience afterward? Perhaps guilts? What about if you are permanently disabled? You probably won’t be able to keep your current job, and then have to re-adjust to a different life style and re-learning whatever physical skills you have lost. Meanwhile, others would have to take up responsibilities for you, and more money draining down the road. Next thing you know, you regret your decision.

I do share you views in general - I would prefer going to a hospital I know that can provide better service per dollar value, but when it is life threatening situation, I won’t choose money over my life. If it was a minor stroke that probably okay, but still, so much uncertainty. Yes, if ambulance is late, you probably should consider going there on your own (keep 911 operator on the phone - never hang up until an officer has arrived). I am too really frustrated with my ambulance bill, and I wish someone can help me understand why the heck an aumblance can cost $1000.

I am sure you know the risks, but I do want to give my two cents.

thaumasiotes• 9 years ago

I would literally rather die than pay for an ambulance.

I wish more people realized this was an option. You can't even imagine how common it is to see the claim "medical care is a special market, because if someone is dying, they will pay ANY AMOUNT for care no matter how high".

Sure, if that person is dying and rates their own health infinitely higher than the welfare of their family, maybe. That's not many people.

Incidentally, the same stupid argument also proves that scamming a life insurance policy by committing suicide is impossible. Life insurance companies, in general, do not agree.

djsumdog7• 9 years ago

... seriously? What is wrong with you?

If I'm having a stroke, I'm not going to care about anything except getting to the nearest emergency room as fast as possible. Minutes matter in a stroke. The faster you can get basic drugs and a CT scan, the better your chances for preventing serious damage.

I'm still in my 30s and young. Maybe when my body is older and falling apart I'd have a different opinion, but your statement feels really ludicrous and dangerous advice to me.

collyw• 9 years ago

"For many, ambulance rides are prohibitively expensive"

Third world health care.

DanBC4• 9 years ago

Beyond that, I'd like to see statistics on whether people ride-sharing to emergency rooms / urgent care facilities was freeing up ambulances or causing them to sit idle. I suspect it's the former, which would mean ambulances could be more available for more people with more serious conditions, but I could be wrong.

I'd also like to see whether ride-sharing increases the number of people who attend ED.

"I can't justify getting an ambo, so I won't attend" vs "I'm not wasting an ambo, so it's okay if I attend".

Spooky233• 9 years ago

I’d be more interested to see the reduction in medicab or medivan usage.

My father had the misfortune of having a stroke, and transporting him via van is outrageous — you’re talking >$250 for a 15 mile drive, in what amounts to a cargo van with zero service beyond driving.

It’s one of those weird markets where the pricing is driven by the Medicaid reimbursement, which is a price floor.

chiefalchemist5• 9 years ago

Same situation for me, and I've seen the same with regards to price.

That said, I also suspect the med transport niche is heavily regulated (a la taxi service). Special training for drivers, insurance, etc. I don't think that covers the full $250; just saying they're not identical to a Uber.

kelnos11• 9 years ago

Right. If the Uber driver fails to get you to the hospital in time to save your life for any reason, they have no liability or consequences whatsoever, because they're not intended to be a life-saving or emergency service.

If the ambulance driver screws up in some way, they're in for a world of trouble and legal liability.

dajohnson89• 9 years ago

it's perverse that I find $250 to be a reasonable price, compared to other medical expenses.

aquadrop3• 9 years ago

That's probably if you're actually insured. If not, it will be in thousands.

bsder• 9 years ago

Last time I talked to someone who ran one of these and got out of it, the price is driven primarily by liability insurance.

Uber and Lyft can get away with this because they self-insure and amortize over a much larger customer base.

walshemj5• 9 years ago

An ambulance is a van and actually not very comfortable to travel in speaking from experience

jrlocke• 9 years ago

I've personally found this to work great, the only exception being the moment of surprise and confusion when I asked the driver to pull around to the emergency entrance.

chiefalchemist5• 9 years ago

Good stat but there's nothing about outcomes. Uber might save money for transportation but how does the lack of a proper ambulance effect outcomes?

xor1• 9 years ago

I imagine most of the cases involving people opting for an Uber instead of an ambulance aren't in obvious risk of dying if they don't make it to the hospital in time. The first things that come to mind are broken bones, lacerations, and severed digits. Then again, there are plenty of things that can be fatal without being readily apparent, especially if the only person making that judgment call is the patient.

chiefalchemist5• 9 years ago

I don't disagree. But let's see the data and not assume. One or two extreme cases could make any savings moot.

m333t• 9 years ago

Would be nice to have a service like Uber where you have a virtual doctor's visit by phone in the car on the way to the pharmacy or to the hospital if it turns out to be more serious.

Johnny555• 9 years ago

What are you going to do if it turns more serious during the ride? The Uber driver (probably) has no medical training and certainly has no advanced medical equipment, the best he can do is pull over and hope that a real ambulance can meet you at his car before you die.

If you have a condition that is so serious that you feel you have to keep in contact with a doctor while you're transported to the hospital in case it gets worse, call an ambulance since they can actually treat you in-route.

joshvm2• 9 years ago

Coming from a country where ambulance usage is free for citizens, it would be interesting to see the stats in Uber cities. The only reason not to call an ambulance here is if you feel it would be unethical (e.g. if you broke your arm and your partner could drive you).

EDIT: That is, I imagine you might be able to see whether Uber provides a better alternative than the local cabs. This still holds in US cities though, why is Uber specifically good? Why don't people consider calling their local cab company, which will still be much cheaper than a $250 ride.

jMyles2• 9 years ago

The only reason not to call an ambulance here is if you feel it would be unethical

I dunno, maybe you just want to avoid the psychological feeling of urgency and gravity that comes with an ambulance. I think there's something to be said for staying calm and keeping self-control and dignity when facing an emergency situation.

If you're bleeding profusely or are in-and-out of consciousness or have a deadly virus, obviously that's different. But what about a broken bone? Or a laceration or burn for which you've already successfully applied first aid?

Might you not prefer to stay out of an ambulance in those situations, even if it's free?

ComputerGuru• 9 years ago

There’s also the question of control. No matter how badly injured, if I’m driving myself or taking a cab, I am still “the boss.” But as soon as EMTs and doctors become involved, that control is lost.

In an increasingly authoritarian country/world, where we are expected to give up all rights upon first interaction with persons in a position of power or authority, be it the policeman that graduated yesterday but has the full might of “the boys in blue,” the TSA agent at the check in line, the EMT responding to the call, or the nurse checking you in, it is easy to understand why some people have an aversion to willfully surrendering themselves and their free will so long as an alternative is present.

I prefer to not cede what little control I have until I have to. If I want the driver to take the highway and not the local roads, it’s my call. If I want to text while I’m being driven through traffic, it’s my call. If I change my mind and want to go back home to die, well, it’s my call.

endless1234• 9 years ago

Might you not prefer to stay out of an ambulance in those situations, even if it's free?

Ambulance ride here in Finland has a symbolic fee (10 eur if it's deemed necessary), but still, for a non life threatening issue it feels much more sensible to get a taxi. Since the situation is not life threatening you'd be put in a pretty low priority for the ambulance and have to wait for an hour or so. Taking a taxi is even incentivized - taxi to the hospital is going to cost the same 10 euros even if it's from further away, but even without that system I'd probably still use a taxi for broken bones etc.

lfam• 9 years ago

In most places in the US, the local cab companies are terrible. They might answer the phone, they might show up, and they might try to scam you.

Imagine you call a taxicab for a medical emergency, and they never show up, or only after an hour.

Uber and Lyft are extremely popular because the apps always tell you if a driver will come, the drivers almost always arrive very quickly, and the price is set in advance.

I'd bet that most people younger than 25 years have never used a traditional taxi, and they never will. They don't even see them as an option.

kelnos11• 9 years ago

Not to mention that there are consequences if an Uber/Lyft driver blows off a confirmed ride, and even if they do, you can request another one immediately.

In the case of taxi dispatch, a car may never show up, and you won't know until you get tired of waiting, and there are no consequences for the taxi company or driver if they do this. Pre-Uber, in SF, the normal quoted wait from a taxi dispatcher was on the order of 20 minutes, which if anything was usually understated. If you're in a lot of pain you probably don't want to wait that long.

I would probably still call an ambulance for something I thought might be life-threatening, but for anything else I'd take a Lyft.

dazc3• 9 years ago

I also come from a country where ambulance usage is free but I can tell you from experience that getting one of these ambulances isn't as simple as one might think.

I imagine, maybe, there are keywords or phrases that result in instant dispatch but the default behaviour seems to be to frustrate you as much as possible to the point where you just hang up and drive yourself to the nearest hospital accident and emergency department.

This is, I suppose, a result of the service being costed and allocated to different departments who are all under pressure to manage their own budgets?

Accident and emergency departments obviously get the brunt of all this because they don't have anyone to pass the buck to.

So, yeah, maybe utilising a service such as Uber is actually going to be a way around this problem?

jopsen2• 9 years ago

Free ambulances are always going to come with the problem of abuse, followed by a reluctance to send an ambulance.

Resulting in news stories of how some people call of help and don't get any. But these stories are rare, it's seem better than letting poor people die.

This said, we probably should add a tiny ambulance fee ($50), and apply a fine for inappropriate use.

GordonS2• 9 years ago

What country is this?

will42742• 9 years ago

A relevant personal anecdote - I hit my head earlier this year and gave myself a concussion, but did not realize it at the time. The next day, I began experiencing severe headaches, sensitivity to noise, sensitivity to light, etc. and decided to go to a hospital. I called an Uber.

I'm not sure what I would have done without Uber. I guess I could call a cab, but I don't know that I would have wanted my ride to the hospital to be 30 minutes late, to refuse to turn the music down, and to tell me the credit card reader is broken when I get to my destination and then insist on taking me to an ATM. So I might well have called an ambulance.

mysterypie• 9 years ago

my ride to the hospital to be 30 minutes late, to refuse to turn the music down, and to tell me the credit card reader is broken

As much as I'd like to stick it to taxis because of their decades of price gouging due to being granted a monopoly, I have not had many bad experiences riding a taxi. If I had to put a number on it, I'd say that less than 5% of my taxi rides were in any way unpleasant other than for the cost. What city or country are you in if I might ask? Are taxi experiences really that bad for most people?

jowiar• 9 years ago

Taxis in cities with decent taxi systems, in a neighborhood with decent taxi coverage, hailed by waving your hand on the side of the road are fine, and getting better by way of competition. I have no qualms with taxis in, ie NYC or DC. Taxi dispatchers, though? Especially in smaller cities? I lost count of the number of times I had a cab no-show when I lived in Pittsburgh.

will42742• 9 years ago

Taxis are good in NYC.

In Binghamton NY, they all tell you the credit card readers are broken at all times of day and insist on driving you to an ATM so they can get paid in cash. In Washington DC, if they think you're drunk, they overcharge you / don't start the meter and the dispatchers always tell you 15 minutes, but then the cabbies just grab other people and you end up needing to call the dispatcher repeatedly to actually get a cab and it usually takes closer to 45 minutes or an hour. And in Ithaca NY, they tell you the credit card reader doesn't work until you say you don't have any cash, and then it's suddenly working.

WhyNotHugo2• 9 years ago

This really depends on where you live. Harassing and other similar situations are very common in Taxis where I live, while Uber drivers seem to be well-behaved.

None of my female friends dare get into a Taxi due to, well, harassment, (some have stories of groping, attempted rapes, etc.). Generally, they'd only take a taxi in groups, or walk. Uber seems to be working well in that regard (at least for now).

kelnos11• 9 years ago

In SF, pre-Uber, taxi dispatchers would universally quote "20 minutes" for expected arrival, when the reality was usually 40 minutes to never (where "never" was equally likely as a finite number). I called to complain about this (and other things) so often that one of the cab companies blacklisted me and stopped answering my calls.

rconti3• 9 years ago

Right, but 5% is quite terrible when you're sitting around wondering if the car will ever show up, and if they quoted 20 mins, should you call again after 15 or 20 or 25 or 60?

s_esser• 9 years ago

Correlation != causation

djsumdog7• 9 years ago

Yea, the percentage stated is super low. It might be true, but the data isn't enough to reflect the statement.

bckygldstn• 9 years ago

The title of the NPR article would be more accurate as "Cities See a Reduction in Ambulance Usage After Uber is Introduced".

The paper looks at 700 different cities, each with a different Uber market entry time over a two year period. The researchers also control for some seasonality effects.

Perhaps more covariates could have been considered, but this seems like a pretty decent design to measure a before/after causal effect.

throwaway02552• 9 years ago

I injured myself and needed to go to the ER. The injury wasn't life threatening, but I definitely needed to go to the hospital immediately.

I called an Uber.

I don't have the time or expertise to do the months of legalese and calculus it would take me to understand my insurance policy, so I have no idea how much an ambulance ride would have cost me. $0? $400? $15000? None of those numbers would surprise me. As best I can tell, insurance companies throw a dart to decide whether you're covered or not, and then the healthcare provider makes up some insane number if you aren't.

The Uber got me to the hospital faster than an ambulance would have, for less than $10, and I knew it would cost less than $10.

The injury, though extremely gruesome and painful, only warranted an x-ray, some tylenol, and an ace bandage.

I'm insured. They sent me a bill for over $900. For taking a picture, and giving me tylenol and an ace bandage.

I view insurance as a tax my employers pay to the American healthcare system to be compliant. When I have my end-of-life event, whatever that is, I fully expect a choice between death, and living a little longer in bankruptcy. I'll probably get treated outside the US or choose death.

The system works if your net worth is somewhere above $5 million. For everyone else it's just the mechanism that sends everything you earned back to rich people right before you die.

Or maybe I'm wrong! I hope I'm wrong. The stack of papers is 4 inches high so I'll never know, but I sure hope so.

nvahalik• 9 years ago

The system works fairly well if you are poor too. I know several people who have walked into and out of the hospital without paying a dime.

It really seems like the middle class gets the raw end of the deal.

taxicabjesus2• 9 years ago

It really seems like the middle class gets the raw end of the deal.

My hairdresser figured she has to spend $5,000 before she can get any benefit from "health insurance". She & her husband decided it'd be better to pay the penalties, spend that first $5000 on herself, and "hope" that she won't need more.

She's from Cuba, originally - left in 1987, iirc.

caresource_ta2• 9 years ago

Can confirm it works fairly well for the poor. I have been registered for Medicaid the past three years of school and have not had to used it until this year. Every single time I use my insurance (CareSource) I am absolutely blown away by how painless it is. Other than presenting proof of coverage twice in a series of multiple hospital and doctor's visits I have not had to worry about insurance for a single moment. At one point my physician was ordering lab work and kept asking if I wanted any additional lab work of my choosing and this just seemed absurd because on private insurance I would never consider lab work to be discretionary.

djsumdog7• 9 years ago

Well, not if you need treatment. If you're poor, yes you won't pay anything because the hospital won't bother to bill anyone. But if you need surgery and have no insurance or medicade, there are cases of doctors sending you home, waiting for sepsis and then amputating, because it's cheaper and takes less resources.

Extremely poor people may not pay for care, but be assured that in America, they get no where near the same level of care.

And if you're poor and have cancer? Most other western countries will give you a chance.

There is a much deeper problem relating directly to this topic. Transportation. Access to real transpiration is THE BIGGEST FACTOR in escaping poverty.

Uber isn't public transportation. A train is about $2 ~ $3 in most cities. In an Uber that would be a $10 ~ $20 ride. Multiply that by 7 days a week to and from work, and there simply is no comparison. Many cities have discounted fare cards for the poor as well. The structure of American cities hurts the poor.

lazulicurio• 9 years ago

This to me is the biggest issue with health insurance in the US right now---it's effectively trying to cover two issues at once: 1) non-payment to health care providers 2) unexpected ailments to health care consumers. We have insurance companies as the middlemen, trying to make money from both ends. It's like having the same lawyer as prosecutor and defense attorney; no matter how much you trust any individual to do a good job, you're asking for trouble in the long run.

I feel like the best solution would be to change the arrangement from consumer<-->insurance<-->provider to insurance<-->consumer<-->provider<-->insurance. Have providers charge consumers directly (so prices are more transparent), consumers buy actual "health insurance", and providers buy non-payment insurance. If the government needs to subsidize non-payment insurance rates for certain providers, it can do so without as much risk for inflating prices and screwing over people who can pay the bills.

eugeniub• 9 years ago

"taking a picture" is not the same thing as "an x-ray"

aisofteng• 9 years ago

It's called dramatic effect.

oakridge• 9 years ago

It is, but with wavelengths that aren't in the visible range.

gonyea• 9 years ago

It’s incredibly old tech and costs you maybe $5 in most countries.

jMyles2• 9 years ago

The point is sound though - x-ray is a very good example of a procedure that is absurdly expensive compared to its actual cost - and compared to any other country on earth.

api_or_ipa2• 9 years ago

Crazy. Very recently I saw a guy get knocked out cold on his rollerblades and we called an ambulance. The question of cost never crossed my mind and I'm not sure I would ever want to make the utilitarian calculus: Am I helping this man or am I bankrupting him?

IIRC it's $82 or something like that in Vancouver BC Canada.

deepsun2• 9 years ago

Could he just said "I didn't call for ambulance, charge the guy who did"?

smnrchrds2• 9 years ago

Wow! It is almost $400 here in Alberta [1]. But we don't have MSP premiums, so I guess it is not much different from BC when you consider all the factors.

[1] http://www.health.alberta.ca/services/EHS-who-pays.html

FussyZeus2• 9 years ago

This is all coming from a hardcore capitalist, so know that going in:

Health Insurance, as a concept, is disgusting.

You "Insure" property. You "Insure" specifically against loss of that property, and the cost of insurance is determined (forgetting an awful lot of math, but the basics are) by: The value of the property in question, the amount of payout required to replace said property in the case of full loss, put up against the security of said property and the odds of loss occurring.

For cars, this presents as the value of the car, factoring in where you live and work (the two places the car is most likely to be), the costs to repair or replace the car, the security devices the cars have, and obviously your driving record.

To insure a life, you need to first establish the value of a human life, specifically your life. Your life (probably) is infinitely valuable to you. The cost to repair you in our current system could also be infinite, given the numerous and terrible things that can happen to a person with literally no fault of their own. By the same token, the odds of you needing that payout are also damn near incalculable; every place you go, every activity you engage in from skydiving to eating turtle soup in Mexico all have a probability of killing you. By the same token you can trip and crack your skull open in Harlem, NY or in the center of the Pentagon, it makes no difference.

Therefore, you have an asset with incalculable worth, incalculable cost to repair or replace, that is exposed to hundreds of things per day that could result in a full-policy payout, with barely a hint of predictability.

Even if the industry behind it weren't legendarily corrupt and full of fraud and nonsense from every player in it, this would be completely insane to attempt. The solution (the first part anyway) is to outlaw health insurance, completely, full stop. Then hospitals must be instructed to destroy their chargemasters and go back to charging for services at reasonable rates. After that, everything else should more or less be solved.

throwaway02552• 9 years ago

I completely agree, but I don't think it's a winnable fight. I think it's so big and so entangled with everything that the only thing that could ever pry it loose is some kind of fundamentally transformative event that results in the complete dissolution of our entire economy and/or nation.

Trying to make any progress through typical political avenues is hopeless. You're casting your vote into an ocean of voters that don't even see health insurance as a financial product, they see it as healthcare itself.

kelnos11• 9 years ago

I've always had this same objection. I prefer to think of it as a "health plan" rather than "insurance". You can't "insure" someone's health (well, ok, you can, but it's a case of "I don't think this word means what you think it means"). You can merely create a structure where people pool their money on a large enough scale such that it's affordable to fix a person when they break in most (if not all) of the myriad ways they can break.

That's similar to insurance in some ways, but isn't in one crucial way: you generally don't know the "repair" cost up-front; the repair is done, and then you get the bill. If you insure your car against damage up to $50k, you get an estimate when it gets damaged, and ask the insurance company for approval for that amount before the work is done. If the insurance company disagrees on cost, you can find another auto shop that agrees with the insurance company's cost, choose to bear the difference in cost yourself, or decide to forego the repair entirely. You can't do any of that when it comes to healthcare.

The cost to repair you in our current system could also be infinite, given the numerous and terrible things that can happen to a person with literally no fault of their own. By the same token, the odds of you needing that payout are also damn near incalculable; every place you go, every activity you engage in from skydiving to eating turtle soup in Mexico all have a probability of killing you.

This isn't entirely true though, or, rather, it doesn't matter. Health "insurance" companies have a ton of data that allows them to predict pretty well how much it will cost to fix people when they break, in the ways that they usually break. They collect premiums based on that data and are doing a pretty decent job of not going bankrupt while actually fixing people, even outliers who fall outside of the "usually break" range. (Yes, I know, that's certainly debatable; they're dicks and deny coverage for things they should absolutely cover, and that helps with their bottom line; in principle, however they can afford to cover everything that medical science can perform and still stay afloat.)

Then hospitals must be instructed to destroy their chargemasters and go back to charging for services at reasonable rates. After that, everything else should more or less be solved.

The problem here is that "reasonable" means different things to different people, and for some procedures, even if the price were dropped down to "at cost" (if that's even a calculable thing), you'd still have people who couldn't afford it. Health care itself isn't free. It costs money to develop medicines. It costs money to train doctors. Those doctors, once trained, need to make a living. It costs money to run hospitals and private practices. Someone needs to bear this cost.

So you still have the same problem of inherently deciding that the life of a rich person is worth more than the life of a poor person; in some cases the rich person can afford to get healed, while the poor person can't and dies (or lives, but goes into crippling debt or bankruptcy to do so). I agree that healthcare costs in the US are out of control, but even if you fix that problem, you still need some system in place to ensure everyone gets the care they need, regardless of their financial situation. (That is, of course, if you believe health care should be a basic right. If you don't, then we're not going to have a productive discussion.)

I think the concept of a pooled health plan is fine; just payments into it need to be dependent on means, and payments of $0 don't disqualify you from coverage. The person who can't afford to pay into it gets the same treatment that everyone else gets. I don't care how we achieve that, whether it's government-single-payer, or something similar to what we have now, just with price controls and government subsidies/credits for those who are unable to pay.

Absolutely agree that the current corrupt health "insurance" industry needs to go, though.

adamnemecek2• 9 years ago

How does your solution solve the problem?

barrkel2• 9 years ago

The reason you must get car insurance isn't to cover the cost of the car, it's to cover the very high variance in potential payouts to third parties should you cause an accident.

Health insurance in principle works on a similar basis: it's a cost smoothing mechanism for unexpected large costs that not everyone is expected to incur.

It breaks down if everyone incurs the big costs (old age) or not everyone insures (only at risk people insure, which increases costs, which pushes out people who aren't as risky, which pushes up the price further, in a cycle.) It also doesn't make much sense for regular care that doesn't directly prevent major payouts.

So it seems to me that health insurance is only workable if it is mandatory, old age spending is rationed, and checkups that find things that can become very expensive are covered, but other bits and bobs aren't. Obviously gold plated coverage could cover more, but that's all the mandatory insurance should cover.

It's all far too politically charged for any kind of rationality to prevail though. I think single payer state care can work, but it has high overhead and suits high tax countries better, not the US, where there is less acceptance of the social contract of taxation.

caresource_ta2• 9 years ago

Insurance does not replace value, insurance is fundamentally and always a value transfer vehicle. Although in some implementations insurance can act as a value replacement mechanism this is the result of the implementation and not a fundamental property of insurance. You seem to base your understanding of insurance on some common implementations that do replace value but these are not the rule for all insurance.

peteretep• 9 years ago

you have an asset with incalculable worth

Actuaries, national health providers, governments -- generally they all have hard cash valuations for human life.

blhack• 9 years ago

There is pretty much nothing that infuriates me more than the health insurance system. Here is just one example (other than your ambulance example, which is like some trolley-car problem come real):

We use "insurance" for routine medical examinations which are supposedly to be done regardless of health. We use "insurance" for YEARLY checkups.

The absurdity of this is on par with insuring yourself against getting hungry, or buying gasoline insurance to fill up your car.

Gas in $8000/gallon. But pay $900/month and we will cover the cost!

It is absolutely embarrassing that this is the system we have allowed to exist. I consider myself a pretty staunch capitalist in most regards. Health insurance is definitely not one of them.

domenzain• 9 years ago

It makes good financial sense for insurers to push the insured to take preventative measures.

An insurer should provide incentive to bring a building up to code to avoid a costly fire. The option to simply raise prices accounting for the fire leaves out the business of those who cannot afford it: the people leaving in a building that's not up to code.

karmelapple• 9 years ago

You described a big example in the book “Catastrophic Care: How American Health Care Killed My Father--and How We Can Fix It.”

Highly recommend it. It’s got some great ideas.

briandear4• 9 years ago

Insurance should be used for what it is — an financial instrument to protect against unforeseen and catastrophic financial loss.

Car insurance doesn’t pay for tires or oil while it could be argued that bad tires increase the risk of accident. However tires and oil are an inextricable requirements to owning a car.

This idea that health care should be paid for by someone else has always puzzled me. It’s the equivalent of food being “free.”

For the legitimately poor, there is definitely a role for government just as governments don’t let people starve to death, but for everyone else — its just wacky that the government ought to be involved at all beyond safety regulation. We went wrong when some groups started claiming health care as a right — nobody has a “right” to the labor of other people. In other words — I don’t have a right to make you produce something for me.

Health care costs have spiraled out of control because of the detachment of who is paying from who is receiving the service — much like higher education.

kalleboo• 9 years ago

It's more like your car warranty paying for an oil change, so they won't have to pay for a seized engine years later.

dantheman• 9 years ago

The health insurance system in the US is about as far away as you can get from capitalism. It's heavily regulated, a cartel, the prices are not transparent, and there is no competition (existing hospitals have to approve new hospitals, etc).

Xylakant• 9 years ago

It absolutely makes sense to insure routine medical examinations. If they’re not covered, people don’t do them. Many routine examinations uncover conditions that are not critical yet and easy to treat before they turn into a costly nightmare. (e.g. routine skin checks uncover potential cancer before it spreads, tooth checks uncover problems before they require expensive replacement) It’s an investment, not only health-wise, but also financially for the health insurance.

shados2• 9 years ago

To be fair, a lot of stuff work that way. Take an HVAC maintenance plan for example. For some fee (based on the model and age of your HVAC and the condition it's in), you get routine maintenance covered. They do what they can to prevent major hiccups, but if it breaks down, they'll repair it (after trying to weasel their way out of it).

It's pretty darn common across a lot of industries.

rectangletangle• 9 years ago

Similar story; dislocated my shoulder, and needed to visit the ER. Came to the same conclusion at the time, that Uber would be the cheaper/easier option. The driver got me safely to the ER, likely faster than an ambulance would have. The driver was even courteous enough to help me with the door. I don't remember the exact price, but it was reasonable, I'm sure it probably saved me hundreds relative to an ambulance ride.

It was probably the more socially responsible option all things considered. I didn't require urgent medical care, so taking Uber helped ensure those resources where free to those whom might have (though this thought didn't cross my mind at the time).

lostlogin• 9 years ago

If it’s anything like the taxi drivers here in Auckland, you have a fair chance of getting a driver with some sort of medical qualification too.

thewhitetulip• 9 years ago

If you have something life threatening and you know it in advance, please have a look at Indian healthcare system. It will not be that costly and there are a few mind blowing hospitals who are really very damn good.

vostok• 9 years ago

The system works if your net worth is somewhere above $5 million. For everyone else it's just the mechanism that sends everything you earned back to rich people right before you die.

Must be above my net worth! Sure I can afford to pay out of pocket for everyday medical expenses, but cancer or a heart attack would probably destroy my finances.

rconti3• 9 years ago

My wife was in a car accident, and surprisingly, the ambulance bill (perhaps 5 miles, "night" surcharge (7pm), private ambulance in the bay area) was "only" ~$3400. I seem to recall an ambulance ride when I was a kid (20 years ago) costing something like $5k plus when I crashed my bicycle.

Funny thing, though, the ambulance bill was the only thing NOT covered 100% initially. The hospital and surgeons bill your insurance, and we didn't pay a dime (other than a comical $200k+ explanation of benefits telling us our claim was denied when they initially submitted to the wrong insurance). The ambulance company billed us, and I spent ~6 months working it out, and I think it's finally sorted. The upshot is because it was a "car accident", the health insurance doesn't want to pay it; car insurance is primary. In theory the car insurance is the primary on her entire hospital stay, but because the medical payments on our car insurance is only $10k it's basically pointless to involve them. They don't even know there was a hospital visit. So I had to go back and forth a bunch of times to even (re-)open the car insurance claim, get it submitted, send more and more documents, fend off the ambulance company always threatening to send us to collections because I had better things to do than deal with their crap, and so on.

Current status is I've paid maybe $600 on a payment plan, my insurance says they paid in full, the payment wasn't yet reflected on the ambulance co billing site, but in theory once that payment posts they issue me a refund on my payments to date.

We're so incredibly lucky to have insurance; actually she was double-covered at the time of the accident (hence the billing confusion initially), we have money, we have family in the area to help with doctor visits, and there was really only one provider. I can only imagine what a nightmare sorting the bills would have been if we had to manually submit to insurance from multiple providers and stay on top of many many claims. It would be a full time job for sure.

StreamBright3• 9 years ago

These sort of stories I usually use to explain to non-US people how is to live there.

sitepodmatt3• 9 years ago

3.4k and 5k. I would expect the keys to ambulance after the ride for that price. How can that cost be justified, did you get any treatment in the ambulance other than oxygen and maybe some morphine?

pvinis2• 9 years ago

Why did you need a throwaway for this comment?

pvinis2• 9 years ago

I'm honestly asking. It's a very good and valid comment and I didn't see any obvious reasons why they might decide to use a throwaway account.

skrause3• 9 years ago

Here in Germany the copayment for an ambulance is 10 €, everything else is covered by the health-insurance.

So the choice is easy: If it's urgent call an ambulance, if it's not urgent and/or there are other ways too get to the hospital quickly and easily use those instead.

nofilter4• 9 years ago

Yeah, never moving to America. Never. I value my life more than that. In Estonia (and I'd imagine most of Europe), the ambulance ride is free (unless you prank call them, then you get a fine). The healthcare is free (paid by your employer), doesn't matter how badly you're injured. The only thing that's not free is dental care, but you can insure that, so you pay a monthly fee and they cover the actual cost if something happens. And no, it's not a made-up number.

dbancajas• 9 years ago

Is it a good place to live? What about racism etc?

dullgiulio• 9 years ago

In Estonia you have to pay for non-serious visits to the ER. How much was it, 5 euro?

vijayr• 9 years ago

They sent me a bill for over $900. For taking a picture, and giving me tylenol and an ace bandage.

That is awful :(

Imagine someone making minimum wage. 900$ is huge for most people.

Honest question - outside of politics, is there anything a person on the road do to help make this situation better (other than not falling sick)? Any company/org working on solutions?

logfromblammo4• 9 years ago

Generally speaking, most of the people "working on the problem" are actually working out ways to profit enough from the existing mess that it doesn't affect them personally.

If you intend to visit the US, you absolutely need to buy traveler's insurance, with medical coverage, before you enter. If you can't afford the premium, cancel your trip, and go spend money in a country with a better paradigm for emergency medicine.

Dove3• 9 years ago

If it's not life-threatening, don't go to the ER. Go to urgent care. They'll charge you $100-$200 for the visit, plus cost of materials. $27 X-Ray kind of cost of materials in my experience.

https://www.howmuchisit.org/how-much-does-urgent-care-cost/

Better yet, get direct primary care. It's ideal for tylenol and ace bandage situations.

I am completely convinced that even if you have insurance, you are much better off acting as a self-pay patient. Your options are better, and you have a much better idea of how much things cost. People say you can't shop for a hospital in an emergency, and that's true -- but I already know how much the hospitals around here cost and how good they are because I have to for routine medical care.

zappo2938• 9 years ago

Between the hours of 10 to 10.

bastawhiz• 9 years ago

Many places don't have urgent care facilities. And you'd still need to use an ambulance (or Uber) to get there otherwise if you aren't well enough to drive.

chapium• 9 years ago

“I'm insured. They sent me a bill for over $900. For taking a picture, and giving me tylenol and an ace bandage.”

What also happened: You received care at an ER. The time of professionals was used on you and not other patients at that time. You also received a diagnosis and verification that the injury was easily treatable and didnt require much else. What if they came to a different conclusion?

$900 is expensive but you are grossly mischaracterizinf the services you received.

taxicabjesus2• 9 years ago

Various insurance companies had contracts with the taxi company I drove for. Part of our usual fares were taking people to and from emergency rooms. If a person with Medicaid had a problem they'd call their insurance company, whose representative decided whether to send an ambulance or a taxi.

The hospitals also had contracts to send their patients home. One pre-obamacare passenger comes to mind: she didn't have a problem that wasn't related to being poor/homeless/childhood abuse, but the E.R. couldn't address her actual problems, and gave her a prescription for "something". She waved the prescription and said, "I can't afford these pills..." The hospital sent her to her sister's apartment. I called twice to check up. She was doing okay the first time. The second time the passenger's sister said she was at the State's psychiatric hospital.

A non-insurance passenger with a non-life-threatening injury asked to go to an emergency room. I suggested going to the full-service emergency room at the heart hospital. They got in & out in a fraction of the time that people usually spent at the big hospitals.

I knew of that emergency room because the Fire Department had a contract with the taxi company too. They sent people who didn't need an ambulance via taxi to the nearest emergency room. That guy was homeless, iirc.

BrainInAJar• 9 years ago

Notably, in the US.

this speaks more to a failure of the healthcare system than it does to the success of ridesharing

Slippery_John• 9 years ago

Well yeah. I had a kidney stone earlier this year. Pain so bad I couldn't move or think. Went to the hospital in an ambulance and ended up paying nearly $3k for the ride. First round they thought it was muscle spasms, so when I inevitably had to go back again I got an uber. The only reason I wouldn't take that option again is if I was bleeding / puking / doing something that would make a mess in the car.

ajasmin• 9 years ago

How is Uber any different than taking a taxi to the hospital?

Malician• 9 years ago

If Uber says 5 minutes, it might be 7, or even possibly 15 if things go very, very wrong. Heck, if it's gonna be 15 you know this ahead of time because you can see the driver making wrong turns.

If you call a taxi service, and they say "15 minutes," it could be 30, 45, or 60. Maybe they're mussing with the truth, maybe they're outright lying. You don't know, and without the map showing the driver, you have no way of knowing.

djsumdog7• 9 years ago

A lot of modern taxi services have apps (often written by just a few big shops and contracted/branded out, but still). So you can start to get some of the same assurances from Taxis that you could get from Uber.

Also even before Uber/apps, I never had a problem with calling a Taxi and it not showing up within a few min, and I've lived a lot of places.

philmcc• 9 years ago

Also, I could imagine a series of accidents where explaining to a Taxi where you were and where you needed to be might be physically difficult.

You can call an uber (or lyft) for your destination, with a few finger taps.

(*And the driver will know who they are looking for visually, as well.)

averagewall• 9 years ago

It may be an overall improvement in efficiency, but it's not going to help patients long term. Whoever pays for the ambulances is going to eventually reduce their funding because they're being under used and revert them to the same state they were in before. If that wasn't the case, then they would have already been paying for more ambulances before Uber came along.

Robotbeat3• 9 years ago

This is simplistic and probably wrong. Part of the reason ambulances are expensive is not because of the intrinsic /cost/ of the service but because the consumers have no choice but to choose the ambulance. They are, in effect, a monopoly and therefore can charge monopoly rents. And Uber (or whatever) is helping to break that monopoly.

(It doesn't have to be that way. Other countries have managed to keep ambulance services affordable.)

StreamBright3• 9 years ago

Article should have "in the US" qualifier.

k__• 9 years ago

Medical stories from the US always sound like from third world countries to me...

saas_co_de4• 9 years ago

Yeah, most people don't tell the stories about how they go to luxuriously built hospitals that make most corporate offices and hotels seem cheap by comparison, with parking lots full of BMW's, Mercedes, and other 6-figure foreign cars, and are treated by teams of highly paid people using millions of dollars of the best equipment in the world ...

As long as you have money the US is great.

qaq2• 9 years ago

"As long as you have money the US is great" even if you have money you will still have to go to the local hospital for emergency and will have to wait for specialist appointment some stupid amount of time unless you actively spend time and money donating to the hospital some serious $ so you have direct numbers of people in charge etc.

scott_karana• 9 years ago

"Best equipment in the world"? This is capitalism. They're going to use the cheapest "good enough" equipment they can get away with. And considering the domain experience a patient would need to tell a new MRI from an eight year old one... I'm sure they get away with lots.

I guarantee the hospital administration isn't going to pay the upcharges for the fanciest new MRI if they can spend it on themselves.

jdietrich2• 9 years ago

Here in the UK, there has been a major campaign to try and reduce the usage of ambulances and emergency departments. Many of our ambulances literally have "this is not a taxi" written on them.

https://i.pinimg.com/originals/5c/ff/1e/5cff1eac4bef3b52f76d...

Because it's free to use, a lot of people call ambulances when they really don't need them. Women in the early stages of an uncomplicated labour. Young people with minor injuries. Elderly people who want a repeat prescription. Discouraging these people from abusing the service without putting off people who are genuinely in need of an ambulance is a complex and delicate task.

The US healthcare system is clearly an unmitigated disaster, but our single-payer utopia has a different set of problems.

orcdork• 9 years ago

Your example is the result of years of government failure to provide adequate funding and support to the health system, not some kind of fantastical moocher, using ambulances for no reason.

DanBC4• 9 years ago

Not sure why you got downvoted, what you say is true.

People sat similar things as GP about A&E - "the problem is all the people who use it who shouldn't". No. Those people are easily triaged and sent away. The problems with A&E are all the people who need a hospital bed who spend hours on a trolley in a corridor.

jacquesm3• 9 years ago

Women in the early stages of an uncomplicated labour.

That's taking a bit of a shortcut there. You don't know if a labor is uncomplicated until it is done and it can go from 'uncomplicated' to 'life threatening' in the space of a heartbeat.

jdietrich2• 9 years ago

London Ambulance Service policy states that ambulances should not to be dispatched to women in the early stages of labour unless there are known risk factors. It's a massive waste of resources to send two trained personnel and a fully equipped ambulance to act as a taxi, just in case something goes wrong en route.

http://www.londonambulance.nhs.uk/talking_with_us/freedom_of...

Childbirth is not a medical emergency.

assafmo• 9 years ago

Can't you pay directly for private insurance in the US?

I pay directly to the insurance company. It costs me about 145 usd/month and includes health insurance (with urgent care), long term care insurance, life insurance (about 500k usd) and some more.

I could have done it through my employer, but when I leave for another place I'll have to renegotiate the price with the insurance company, and also this option has less good of coverage IMO. It is cheaper by 70% tough.

hak8or• 9 years ago

What's the name of the insurance company? Oscar? Thay seems incredibly cheap.

vincnetas• 9 years ago

I'm happy that in Lithuania (northern Europe) you can call ambulance even if you have fever and it's free (paid by you with taxes). Of course it's not perfect, medical personal don't earn much, and yes, it could take longer than Uber (except might be rush hours when ambulances can skip the congestions).

gaius• 9 years ago

Here in the UK ambulances are paid for by the NHS, to which Uber steadfastly evades contributing to. Now that their drivers have been legally classified as employees, there’s a shed load of back NI they owe us.

t3rmi• 9 years ago

I'm currently a student in the Bay Area. One of the first thing that my seniors told me here was if you are ever injured or in an accident do not call 911 unless its life threatening as the ambulance bill can bankrupt you. We do have insurance but the system is too complicated and the consequences are the too scary if we don't get reimbursed.

froindt• 9 years ago

Are you from the Bay Area? Is there anything in particular that would cause it to be extra expensive?

During undergrad in the Midwest, I heard a freshman who was way too drunk fall off his lofted bed around 4 in the morning during the last couple days of the year. I heard his roommates discussing whether or not to call the ambulance because last time this guy got super wasted and hit his head drunk, the ambulance ride was a couple thousand dollars.

It was so messed up to hear them talking. He could have a brain bleed going on and they were discussing how handle the situation. Ultimately they did call 911 and he was fine the next morning.

Improvotter• 9 years ago

Never ever have I thought this would be a side effect of not having any proper health care. I've never had to take an ambulance, but it's a second nature where I live in Europe to just call the equivalent of 911 and they'll send out the best unit depending on the injury. It can be a plain ambulance or a faster car with doctors that definitely is very expensive if you weren't covered.

What a shame.

jacquesm3• 9 years ago

Cities with Taxis have lower rates of ambulance usage too.

In fact, any kind of public transportation will result in lower ambulance usage. Because when there are alternatives some %age of ambulance rides will be replaced by some %age of public transportation rides.

trts• 9 years ago

Had a bad bicycle accident about five years ago. No taxi would stop for me as it probably looked like I'd been in a drunken brawl. Uber or Lyft would have been nice, as I could have probably texted the driver not to be alarmed but that I needed a lift to the ER (at that point I still had not gotten a smartphone). I ended up walking 2.5 miles to the nearest hospital.

saas_co_de4• 9 years ago

Does nobody else wonder how an un-peer-reviewed paper from Kalamazoo College is being reported by a tech blogger from NPR?

Why would anyone take this seriously?

nmca• 9 years ago

Healthcare in the US sounds nightmarish. I'm a UK citizen and broke my leg badly in France; ambulance etc. Whole thing was <75 GBP. That was for the cost of crutches and medicine in France, X-ray+ER visit was free. Then after I got my train back to the UK I had complex reconstructive surgery for free on the NHS.

heisenbit• 9 years ago

Researchers often cite costly transportation as a significant barrier to receiving quality healthcare. A study by Samina T. Syed and Lisa K. Sharp, doctors at the Kalamazoo College, suggests that cost-efficient access to a vehicle is consistently associated with increased access to health care.

Uber is using venture capital to subsidize rides. Drivers are often providing the services by going underpaid and putting up their own capital without getting the appropriate rent.

This is not a sustainable model. If there is a real need that is currently not met it has to be provided through other means in the long run.

formerchamp• 9 years ago

Good, former EMT and Paramedic for busy metropolitan city here. Your exorbitant costs are subsidizing the homeless, system abusers, and illegals who can't be billed. 90% of the calls we were dispatched to were not acute emergencies. And 90% of those calls were people of the lower socioeconomic demographic systematically abusing medicaid.

arximboldi• 9 years ago

Many potential emergency room patients are too sick to drive themselves to a hospital. But an ambulance can cost hundreds or thousands of dollars without insurance. This is where a popular ride-sharing app can step in, while also freeing up the ambulances for those who need them most.

The rich?

Cities with Uber Have Lower Rates of Ambulance Usage

Related Stories