4 ms·

I don’t think it is reasonable to expect to have ambulance coverage across the entire United States. There is a lot of land with very few people. Choosing to l

by pclowes 3mo ago

I don’t think it is reasonable to expect to have ambulance coverage across the entire United States. There is a lot of land with very few people. Choosing to live far away from others is also choosing to live far away from help. If a service is highly variable cost dependent and is unaffordable for the average individual to pay out-of-pocket it is unaffordable for the aggregate individual as well. There _should_ be some ambulance deserts.

skinfaxi 3mo ago
Why should there be ambulance deserts but not postal deserts?
- pclowes 3mo ago
  Directionally, I am also fine with postal deserts or at least different delivery expectations for very rural areas. But also because Postal Service is much cheaper than an ambulance service?
cogman10 3mo ago
It's very often not a choice. But also, those rural areas are often the breadbaskets of the united states. Taking care of our farmers is important. Trying to frame it as a choice also misses a lot. It technically is, but you have to recognize there's a huge cost in uprooting your entire life and moving to a new location.
- pclowes 3mo ago
  We give our farmers absolutely insane subsidies already. It is not the government’s job to “take care of” anybody. Everything has a cost, staying has a cost, leaving has a cost. The question is how much should the public be taxed to pay for individuals suboptimal decision-making? Or conversely, why am I subsidizing some billionaires remote horse ranch to have daily Postal Service and an ambulance standing by? Can I move to the wilds of Alaska and then demand the same level of service as New York City? No that would be ludicrous.
  - cogman10 3mo ago
    > It is not the government’s job to “take care of” anybody. That is literally the only job of government. The entire reason we have a government is to serve the citizens in some fashion or another. Even for most libertarians, they'll view the government in having a role resolving disputes. That is "taking care of" citizens by resolving conflicts. Subsidizing farmers so citizens continue to have cheap and consistent access to food is a great thing. Right up there with providing clean drinking water, sewage services, and building roads.
    - pclowes 3mo ago
      I think what I’m saying is being misinterpreted. I should have been more clear. Everybody’s definition of “taken care of” is different. The government needs to balance the interest of the public with the interest of the individual. It is not intended to “take care of “people regardless of their asks. Otherwise, what if I am only “taken care of” if I have a beachside penthouse in Malibu and also a pony? The government is not taking care of people if it allows the average expenditure per person to eclipse the average tax revenue per person. The economics need to be roughly sustainable at the national state and even rural area level.
      - cogman10 3mo ago
        > Otherwise, what if I am only “taken care of” if I have a beachside penthouse in Malibu and also a pony? That's a false equivalence. We aren't talking about giving people penthouses. We are talking about providing EMS. Heck, I can even grant "degraded EMS" maybe we don't ensure an ambulance is stocked with the latest and greatest tech because you are rural. Maybe the ambulance is a hand-me-down from a larger city. But it's not a huge ask to say that rural communities deserve at least some level of emergency health medicine. Less people means less health incidents. That's the primary reason why so many rural locations today are able to get by with volunteer EMS (Something my family participated in. Calls happened roughly once a month at most in my town of 300). > The government is not taking care of people if it allows the average expenditure per person to eclipse the average tax revenue per person. The economics need to be roughly sustainable at the national state and even rural area level. I agree, it's smart to make sure the government isn't over spending on frivolous things. I just don't think "EMS" is frivolous. Everyone might need it, it doesn't ultimately cost that much to provide (especially if it were actually ran by the government and not private entities), and it's services buy a lot of good will with citizens. Additionally, it creates economic output. Someone dying or getting a lifetime disability because EMS wasn't available is someone that's not adding to the economy.
- Der_Einzige 3mo ago
  The farmers can go F themselves. US soybean industry destroyed by trump tariffs, all I see are news stories about the very same soybean farmers talking about voting for trump again despite the pain. Reap what you sow!

by pclowes 3mo ago

skinfaxi 3mo ago

Why should there be ambulance deserts but not postal deserts?

pclowes 3mo ago
Directionally, I am also fine with postal deserts or at least different delivery expectations for very rural areas. But also because Postal Service is much cheaper than an ambulance service?

cogman10 3mo ago

It's very often not a choice. But also, those rural areas are often the breadbaskets of the united states. Taking care of our farmers is important. Trying to frame it as a choice also misses a lot. It technically is, but you have to recognize there's a huge cost in uprooting your entire life and moving to a new location.

pclowes 3mo ago
We give our farmers absolutely insane subsidies already. It is not the government’s job to “take care of” anybody. Everything has a cost, staying has a cost, leaving has a cost. The question is how much should the public be taxed to pay for individuals suboptimal decision-making? Or conversely, why am I subsidizing some billionaires remote horse ranch to have daily Postal Service and an ambulance standing by? Can I move to the wilds of Alaska and then demand the same level of service as New York City? No that would be ludicrous.
- cogman10 3mo ago
  > It is not the government’s job to “take care of” anybody. That is literally the only job of government. The entire reason we have a government is to serve the citizens in some fashion or another. Even for most libertarians, they'll view the government in having a role resolving disputes. That is "taking care of" citizens by resolving conflicts. Subsidizing farmers so citizens continue to have cheap and consistent access to food is a great thing. Right up there with providing clean drinking water, sewage services, and building roads.
  - pclowes 3mo ago
    I think what I’m saying is being misinterpreted. I should have been more clear. Everybody’s definition of “taken care of” is different. The government needs to balance the interest of the public with the interest of the individual. It is not intended to “take care of “people regardless of their asks. Otherwise, what if I am only “taken care of” if I have a beachside penthouse in Malibu and also a pony? The government is not taking care of people if it allows the average expenditure per person to eclipse the average tax revenue per person. The economics need to be roughly sustainable at the national state and even rural area level.
    - cogman10 3mo ago
      > Otherwise, what if I am only “taken care of” if I have a beachside penthouse in Malibu and also a pony? That's a false equivalence. We aren't talking about giving people penthouses. We are talking about providing EMS. Heck, I can even grant "degraded EMS" maybe we don't ensure an ambulance is stocked with the latest and greatest tech because you are rural. Maybe the ambulance is a hand-me-down from a larger city. But it's not a huge ask to say that rural communities deserve at least some level of emergency health medicine. Less people means less health incidents. That's the primary reason why so many rural locations today are able to get by with volunteer EMS (Something my family participated in. Calls happened roughly once a month at most in my town of 300). > The government is not taking care of people if it allows the average expenditure per person to eclipse the average tax revenue per person. The economics need to be roughly sustainable at the national state and even rural area level. I agree, it's smart to make sure the government isn't over spending on frivolous things. I just don't think "EMS" is frivolous. Everyone might need it, it doesn't ultimately cost that much to provide (especially if it were actually ran by the government and not private entities), and it's services buy a lot of good will with citizens. Additionally, it creates economic output. Someone dying or getting a lifetime disability because EMS wasn't available is someone that's not adding to the economy.
Der_Einzige 3mo ago
The farmers can go F themselves. US soybean industry destroyed by trump tariffs, all I see are news stories about the very same soybean farmers talking about voting for trump again despite the pain. Reap what you sow!