13 ms·
Yes, please, Jason if you're here, for the love of God please go see a doctor -- Step-dad is a firefighter; so many times they get to the scenes of accidents,
by sharkweek 13y ago
Yes, please, Jason if you're here, for the love of God please go see a doctor --
Step-dad is a firefighter; so many times they get to the scenes of accidents, and everything looks fine on the outside, patient feels completely fine so refuses ride to the hospital, but then 2-3 hours (sometimes even up to a day later) they end up far worse off and sometimes even dead from internal injuries that EMTs are not qualified to assess.
- nostromo 13y agoAmbulance rides are crazy expensive and insurance companies like to question if you actually needed one. If you don't need the EMT, just take Lyft to the ER.
- flexd 13y agoIt's such a surreal concept to me that having to be picked up by emergency services will cost you money. I feel so incredibly lucky to live in a country where healthcare is free.
- sepeth 13y agoNorway?
- flexd 13y agoYes.
- chc 13y agoMany Americans don't even realize how expensive an ambulance ride is until they go through it. It just seems counterintuitive.
- ryanmolden 13y agoI am not a crazy anti-healthcare nut as this comment will make me appear, but I think you mean "healthcare is paid for by others/collectively", since it isn't free to provide services, unless your doctors are working for no money.
- citricsquid 13y agoI think everyone in the world understands free healthcare to mean free at the point of service.
- ryanmolden 13y agoYou might be surprised, I have talked with people that say 'free' and I say 'you mean paid for collectively' and they say 'no, free' :)
- pyre 13y agoI expect that a conversation with such a person would go like: Person: No, free. You: So how will the doctor get paid? Person: By the government. You: Where does the government get its money? Person: Oh... People usually have the knowledge, they just haven't made the connections.
- LaGrange 13y agoThere are 7 billion people on Earth right now. You are going to find some that don't know what the hell "breathing" means if you just try hard enough. Using this to pick apart at the word "everyone" is just as pedantic as picking at the specific definition of "free" in that question. Even more, in most systems I know the amount paid for health insurance is fairly explicit. Where I live you actually get a bill from a non-state company (some things may be subsidized from other taxes, and if you can't afford it you also get a subsidy, though) so no, people don't think it's "really-really" free. It's "people with more money contribute more".
- enraged_camel 13y agoEveryone except pedants.
- nitrogen 13y agoBut surely there's no reason for a simple ride to an ER to cost $900-$2000, is there? You could hire someone to drive you in a Ferrari for that.
- youngerdryas 13y ago>picked up by emergency services will cost you money It does cost you money. Europe plays a different game than the US but both are games. Thanks to Kennedy no one can be turned away from the ER for lack of insurance and bills are paid off later for cents on the dollar if you have no assets. If you have assets and no insurance too bad.
- justin66 13y ago> Thanks to Kennedy no one can be turned away from the ER Which is funny, since they're only required to "stabilize" you once you're there. I know a guy who was attacked, suffered head injuries, and couldn't remember who he was. He was patched up and discharged in that condition since he didn't have his insurance card on him (and, I assume, since a shirtless and beaten-looking guy with long hair is just assumed to be homeless). I am quite certain that behavior isn't typical of the hospitals in our area, but I bet it's totally legal. And a valuable cost-saving measure! An MBA somewhere is surely proud.
- omarali 13y ago> And a valuable cost-saving measure! Hospitals make a lot of money from unpaid bills http://www.youtube.com/watch?feature=player_detailpage&v=dRn9ySc-RDM#t=464s http://www.youtube.com/watch?feature=player_detailpage&v...
- redthrowaway 13y agoI'm in Vancouver. I got hit by a cab on New Year's and had to pay $80 for the ambulance. The cab's insurance is picking that up, despite the whole ordeal being my fault, so they're sending me a check for $110 then asking me for $1500 back. Go figure.
- elithrar 13y ago> It's such a surreal concept to me that having to be picked up by emergency services will cost you money. I feel so incredibly lucky to live in a country where healthcare is free. We have a (very good) public healthcare system here in Australia; but an ambulance will still cost you.
- NamTaf 13y agoNot for people in Queensland. It used to be rolled in to our electricity bill at $24/quarter but that was abolished a while ago (apparently 2003). We're now just covered simply by living in Queensland for ambulance transport anywhere in Australia (that is, if I need an ambulance in Victoria, I am covered by the State) [1]. [1]: http://www.ambulance.qld.gov.au/about/ http://www.ambulance.qld.gov.au/about/
- rdl 13y agoI'd rather see the direct or marginal costs of the ambulance or paramedics billed to the user (so, if they expend saline, or bandages, or whatever, you pay for it), and the hourly wage and vehicle costs for the trip itself. That would price a routine EMT-B ambulance trip around $100 -- still enough that people who didn't need it would take a taxi or drive themselves to a doctor for a non-incapacitating problem, but cheap enough that it could be paid out of pocket. The costs of keeping ambulances ready, training, etc. could be socialized somehow. I benefit by having 5-10 minute EMS response times even if I never use it for 70 years, so paying for that out of taxes or some other universal subscription fee to users makes sense, rather than putting all the costs on those unlucky enough to need it.
- JshWright 13y agoIn some areas (those with municipal ambulance services), that's exactly what happens. In my case, I volunteer with a combination career/volunteer fire/rescue/EMS agency. Our 'operating costs' are payed by taxes, but if you use the service, you get a bill ranging from ~$100 for a routine BLS transport to ~$500 for a 'significant' ALS call (lots of drugs and advanced interventions). We don't itemize, but we do adjust billing based on what was done.
- pyre 13y agoMy daughter had febrile seizures as an infant. The ride in the ambulance to the hospital was ~$1k, IIRC. I don't think that she was on any sort of IV or anything, but my wife was in the back (I rode up front). (This was in Portland, OR)
- lostlogin 13y agoIf you're prepared to socialise some of it, why not go the whole hog. Is there anyone who thinks that ambulances should e user pays? It simplifies things too, as a fair portion of accidents have a blameless victim, so the cost makes them a victim twice.
- rdl 13y agoThe problem is when it's totally socialized (like medicare), you end up with people abusing the service. If an ambulance ride costs you less than a taxi or even bus, and you're an asshole, you use an ambulance (in some places, provided by paramedics, so the direct costs are high -- in some places they also send a fire truck, so you end up with like 20 highly-trained guys and $500k of equipment) to go to a routine checkup. 3-5 times a week. You could probably waive charging direct costs if you had some other way of deterring abuse, but they essentially always have to respond to 911 calls, so the only way I could think of doing so would be to arrest someone who misuses the service. A policy of informally losing the bill for legitimate calls might work, or doing the standard drug dealer "first one's free" strategy. But I don't think $100-500 for an ambulance would break most people, particularly with insurance; a charity could also cover the bills for some people.
- btilly 13y agoI grew up in a country (Canada) where healthcare was free, but you still paid for emergency services. The two are not the same, and there is a real benefit to discouraging the unnecessary use of ambulances.
- peterpathname 13y agoFYI, where I am, people other than pensioners pay a small annual registration / insurance fee to the ambulance service to avoid large fees upon use of the service
- bdunbar 13y ago"healthcare is free." The money to pay for that ambulance ride is coming from somewhere.
- lostlogin 13y agoSomeone always makes this comment. It's unhelpful as the meaning of free is clear. It's the same kind of free as the bank bailout. It cost you nothing and a hell of a lot at the same time.
- deleted 13y ago[deleted]
- GFischer 13y agoIn my country, ambulances are free for only life-threatening cases, but most everyone pays for an Emergency service (ambulances and walk-in ER), which costs U$ 15/month.
- robterrell 13y agoLyft? Pink-mustachioed cars in Asheville, NC? You have no idea what you're saying.
- cdjk 13y agoI have a hunch that ambulance rides are probably covered by most insurance policies after lightning strikes (ICD-9 code 994.0 for the curious). In any event, a trip to the ER is definitely warranted, even if it's not in an ambulance.
- lostlogin 13y agoWhatever next? So every injury type is specified? This is surreal. How is this cost effective? I thought socialised healthcare was bad as it was inefficient, yet someone writing up the injuries you're covered for doesn't seem very cost friendly.
- kens 13y agoYes, every injury type is specified. You wouldn't believe what is defined in ICD-10. E.g. Stabbed while crocheting: Y93D1 (not to be confused with Activity, computer keyboarding: Y93C1), Hurt at the opera: Y92253. And then there's the famous V9027XA: Drowning and submersion due to falling or jumping from burning water-skis, initial encounter. I should emphasize that these are all real; I am not making this up. http://www.pbs.org/newshour/rundown/2013/03/struck-by-a-turtle-theres-a-code-for-that.html http://www.pbs.org/newshour/rundown/2013/03/struck-by-a-turt... http://www.hipaaspace.com/Medical_Billing/Coding/ICD-10/Diagnosis/V9027XA http://www.hipaaspace.com/Medical_Billing/Coding/ICD-10/Diag...
- cdjk 13y agoYup, and as others have mentioned ICD-10 is worse. There are also CPT codes that specify the procedures and diagnostic techniques that doctors and other healthcare providers do. Insurance is then a mapping from ICD codes to allowed CPT codes. Good luck getting that information from your insurance company, however. Once I had a claim denied because someone transposed two digits in an ICD-9 code, and the treatment obviously didn't make sense. The insurance company couldn't tell me what the codes were - just that it was not an approved treatment for the reported condition. That took a lot of painful debugging to resolve. Oh, and CPT codes are copyrighted by the AMA [1]. If you want to use them you have to pay licensing fees. Too bad it's not usually a case of "want to use" but instead "must use." I'm not sure if ICD codes are copyrighted. [1] http://en.wikipedia.org/wiki/Current_Procedural_Terminology#Copyright http://en.wikipedia.org/wiki/Current_Procedural_Terminology#...
- JshWright 13y agoIf you get struck by lightning, please call an ambulance... There are _many_ people who call ambulances for things a taxi could handle just as well (often those people aren't worried about paying for it... medicaid will cover some small portion of the bill, and they'll ignore the rest), but a lightning strike isn't one of those things.
- chris_wot 13y agoNot to mention, it can stuff the rhythm of your heart. I work for an electricity company, if we get a shock job we tell them to see a doctor.
- chris_wot 13y agoNot to mention, it can stuff the rhythm of your heart. I work for an electricity company, if we get a shock job we tell them to see a doctor.
- JshWright 13y agoIt's not so much that we're not qualified to assess them, it's just that no one has invented portable X-ray (or CT, or MR...) glasses yet (I'm looking at you, Google!).
- rdl 13y agoField portable x-ray (DR, even) and US is pretty widely available. Probably not something you'd put on even a normal ALS truck, but on expedition medicine or if you had to set up a facility in advance, were far from a permanent facility, etc. I've seen DR used for tb screening quite frequently (it avoids exposing the expensive radiologists to the field...); US for midwives for ob/gyn also makes a lot of sense, and I've seen those used with GSM or 3G backhaul of images to a radiologist. Probably the best use would be to have x-ray capability in the truck to verify placement of endotracheal tubes. Shooting an adequate chest film is something you can learn in 5-10 minutes (although, licensure requirements...). (I've seen fairly portable CT, but in the sense of "shipping container with 1-2 day setup"; there are of course the CT and MR imaging trucks too.)
- lostlogin 13y agoAdequate in 5-10. I doubt this. I have trained students for 10ish years. I have seen what very experienced ED nurses (and consultants, anaesthetists etc) do with their 'diagnosis' from films, despite numerous courses and flash qualifications. This is without taking the film. Do it for years, see lots of things, make lots of mistake and then you'll get good. Radiography students are generally competent for unsupervised chest radiography after about 6 months to a year. This is working 2 days a week, study for 3 days. You could probably produce a crap film but good enough to show ET tube in significantly less time, but a good operator has other ways to verify tube placement. Portable x-ray in bigger towns provides a great service to rest homes, prisons etc and is fiddly and laborious. It's a niche market. The same (but less common) with mobile MRI. CT must be done somewhere in a mobile fashion, I haven't seen it. It is easy to get a little twisted with terminology, but mobile x-ray generally means you push it around the hospital, portable meaning you carry it out the van, up the stairs, into the rest home (the 600kg mobile machine is not something you would carry easily).This terminology is widely abused though!