SubJeff on 9/10/2009 at 10:21
Quote Posted by the_grip
one way to increase supply is to loosen the restrictions that you posted (long schooling and residency, very expensive, large opportunity costs lost, etc.).
Then you get substandard doctors. The training is that long because it needs to be.
Cutting doctors pay and/or increasing the supply of docs is not the answer for affordable healthcare. The NHS works just fine for the most part. It could do with less meddling managers (who ARE a waste of money) but otherwise this system is fine. The USA should really take a good look at it.
CCCToad on 9/10/2009 at 17:00
Even though you complain about "meddling managers", I suspect that you still have much fewer than in the US. Don't quote me on it though, I don't know that for a fact. Its just a hunch.
What I would love to hear from somebody, or ANYBODY is a clear explanation of why ambulance rides(not counting any other treatment) cost from hundreds to thousands of dolllars.
scarykitties on 9/10/2009 at 17:10
Quote Posted by CCCToad
What I would love to hear from somebody, or ANYBODY is a clear explanation of why ambulance rides(not counting any other treatment) cost from hundreds to thousands of dolllars.
Because you often aren't in a condition to decide whether or not to take the ride, hence being an easy way for the hospital to extort money.
the_grip on 9/10/2009 at 17:11
Quote Posted by Subjective Effect
Then you get substandard doctors. The training is that long because it needs to be.
Cutting doctors pay and/or increasing the supply of docs is not the answer for affordable healthcare. The NHS works just fine for the most part. It could do with less meddling managers (who ARE a waste of money) but otherwise this system is fine. The USA should really take a good look at it.
I don't really want to argue on this point b/c I'm just speculating, but NHS presumably would reduce pay in the US for doctors. Just to be clear, too, I don't think an increase in doctors is *the* solution, just perhaps part of it.
DDL on 9/10/2009 at 17:15
Probably discourages people from using them as a LOL I R TO DURNK TO GET HOEM taxi service, too. Or calling them out for no real good reason (there have been cases in the UK where people have called ambulances out for a stubbed toe or a grazed knee).
More seriously though, even if you're simply being taken from A to B (er..A to A&E, really), and require nothing other than a ride, you're still being transported by a state of the art ambulance staffed with highly-trained paramedics. All of which cost money...
EDIT: Re. Moar Doctors!!, is there actually any evidence that number of doctors is 'artificially' kept low, for profit? You know, as opposed to it simply being a ludicrously demanding job that not many have the skills and stamina for? The few doctors I know over here generally seem in favour of more doctors purely because they're being worked to death.
CCCToad on 9/10/2009 at 17:18
but it sure as hell doesn't cost the twelve hundred dollars described elsewhere on these forums. Even assuming a crew of four, being paid 50 dolllars an hour, the actual operating costs for an individual trip are only 200 + gas and maintenance. Unless an ambulance trip takes longer than an hour, which in my experience is rare.
heywood on 9/10/2009 at 17:46
I think scarykitties has got it. It's not how much it costs, it's how much they can charge. And that probably varies based on who the ambulance company is contracted to.
june gloom on 10/10/2009 at 09:23
Billing people for their ambulance rides has got to be the most soulsucking job ever, if Something*Positive is at all accurate.
Rug Burn Junky on 10/10/2009 at 10:32
Quote Posted by CCCToad
but it sure as hell doesn't cost the twelve hundred dollars described elsewhere on these forums. Even assuming a crew of four, being paid 50 dolllars an hour, the actual operating costs for an individual trip are only 200 + gas and maintenance. Unless an ambulance trip takes longer than an hour, which in my experience is rare.
If you're going to bother using a hypothetical and throw out numbers, at least think it through and quantify the entire hypothetical. Your little attempt is pretty sorry.
In addition to what you've mentioned, you have:
(1) the initial purchase cost of the ambulance, amortized over the life of its use. This can be quite a bit. Even supposing conservatively that the entire ambulance costs only $150,000 and is used about 5 years, that is going to cost almost $100 a day with financing costs. I wouldn't doubt that a modern ambulance costs multiples of that (A good friend of mine is NYPD. He was just telling me that their cars cost over $200k all-in. That's a cop car, ambulances are bigger with even more sophisticated equipment.)
(2) maintenance costs will be nontrivial, For a large fleet that means mechanics on payroll and a garage. But even if this is contracted out, there are oil changes, tires, and general breakdowns, inter alia. For high use vehicles, this adds up.
(3) in addition to the vehicle maintenance itself there is the medical equipment maintenance. Again, nontrivial.
(4) On top of the medical equipment, there are medical supplies, used and diminished on each ride.
(5) salary and maintenance costs don't cover simply the time being used. A vehicle and crew on call 24 hours will be paid for the entire time. If they only make X calls during that time, those rides have to earn enough in fees to pay for the down time as well.
(6) in addition to the crew of the ambulance, there are dispatchers, back-office support staff, and and other overhead to pay for.
That's all just off the top of my head. Come up with reasonable number for each, bump it up for a profit margin, and you're well in excess of $200.
SD on 10/10/2009 at 14:53
Quote Posted by dethtoll
Billing people for their ambulance rides has got to be the most soulsucking job ever, if Something*Positive is at all accurate.
Oh, I think some people quite enjoy it. My limited experience is that the profit motive of US healthcare turns every health worker into an asshole. This is a little tale from someone on the Dawkins forum:
Quote:
Not two weeks ago my brother was experiencing severe pains and thought he was having a heart attack, yet begged me not to call an ambulance because he could not afford a hospital visit. I did anyway, and he was right; for the ride in the ambulance alone, he was charged more than $1000 by the for-profit ambulance company that was dispatched after the 911 call. Hours later, he had to leave the hospital with only the bare minimum of care, without even any tests done, because it was too expensive and being self-employed, he lacked insurance. This despite the fact that he was still telling me that he was in the worst pain of his life. We were sitting in the lobby, the only people there at 2AM, and a nurse in scrubs walked over and said to us, "You're either a patient, or you're out," meaning she was about to call security and have us thrown out on the street because he wasn't paying for anything. My brother looked up pitifully and said, "As soon as I can walk, I'll be out." She said, "I'll inform the security guard."
His bill was in his mailbox the same day: $2500, including the ambulance fee.
