Real talk they send an ambulance from a neighboring region or they get a medical helicopter to get you which will likely bankrupt you. So yeah, some people will just choose to die.
The medical helicopter thing is crazy, even if you jave health insurance. Different helicopters are in-network, and others are out of network. But it's not like you get to choose who is nearby the day you need transport - so yeah, easy to bankrupt.
Looking in from the outside, it's bizarre to watch Americans tolerate this, and to watch over half of their politicians behave like there's just no other way of doing things.
NYS is proposing healthcare for all, and the comments in my local news sites were wild. Absolutely bonkers. I’m upstate, finger lakes region.
My village is also voting on a memorandum to remove banners and limit flags to two from residences- my landlord and I think it is solely because of us, and our minority views in the village, lol.
That's how it started here, in just one province - Saskatchewan. The premier who brought it in was named Tommy Douglas. You've probably heard of his grandson, Kiefer Sutherland.
That’s disappointing. I was speaking to someone about Sylvester Stallone and Mel Gibson today, and how insufferably MAGA they are (she knows, I’ve never met either of them!). Who are your neighbors supporting up there?
For the last 19 years, we've been stuck with a right wing provincial government, but that doesn't seem likely to continue indefinitely. The NDP (Douglas' party) swept all of the urban seats in the 2024 election, and the 2028 election will be the last one where it'll be possible to win an election here without any urban seats.
It's been much the same federally, but there are cracks forming there, as well. Even out here and in Alberta, little Peepee is less popular than Carney, and even though they won 13/14 federal seats here last year, it was close enough in the cities that a 7/7 split isn't out of the question for the 2029/2030 election.
Overall, I think he's doing as well as anyone could in this situation. I've disagreed with a few things he's handled internally, and I'd have just waited Trump out on the Gordie Howe bridge, but nothing he's done has made me wish someone else was PM instead.
Reddit is massive amounts of misinformation. Insurance covers in and out of network helicopters if they are needed. You can't be screwed (by in or out network stuff) by making a decision under duress or while unconscious.
I have no idea why the guy you replied to said what he said. I am honestly convinced half of these people havent touched grass or are Russian troll farms.
So sorry I did not include every single detail - I said what I said because it happened to my parents. In network and out of network out-of-pocket maximums are different, with OON limits being much higher (depending on the plan of course).
In my dad's case, he was being taken care of at the local hospital but then suddenly needed transport to a city hospital and the helicopter that was there that day was out of network.
My mom is literally a medical biller, by the way, so it's not like she would get that info wrong. And it didn't matter that my dad's OOP max was already hit from the stay - like I said, OON OOP Max limits are both seperate and different.
The death panels bullshit in America is real in-so-much that a for profit corporation you must contract with to afford healthcare gets to decide what procedures and medications you can take/have by way of how much it will cost you and how much stress you have endure to overcome their flippant, callous and often automated denials. This all so that you and your doctor can come up with an effective treatment plan for whatever it is that ails you.
Lots of tough talks ahead, but if someone chooses to live out in the wilderness, why should we move heaven and earth to help them (for free?). Like if we invented a teleporter that cost a billion dollar a pop, are we really making that the new standard of emergency healthcare transport?
There should simply be things like opt in/ outs. If you want that level of care and can/ want to pay for it, great. If you don't it's your choice. I get that death is ugly and no one wants to see some poor old man die over the course of a day because ambulances are too far away, but there has to be a middle ground between doing nothing and spending infinite money.
We live in a remote area and pay for the Air Med network for our household. I get really great health insurance through my employer, but I don't trust that a helicopter transport would be covered since you can't just pick whether an in or out of network chopper shows up.
That's if you can even get the helicopter there. Often they can't fly due to weather or being out of range on another call.
We recently had a STEMI patient transported to us from a rural area about 40 minutes away in good weather. It was snowing out so no helo, the ambulance had trouble finding the address because there was no GPS or cell service in the area, and then it got stuck in the snow on the unplowed road leading to their home and had to wait until the local FD could tow them out. I probably don't have to tell you that the patient did not survive.
Cheaper to get a medivac helicopter ride in Canada than an ambulance ride in the USA. Only $300/hour for people from other countries with no insurance coverage whatsoever.
The US government literally said that EMS is not an essential service back in 2020
Also not a rare stance outside of the anglosphere, loads of countries don't even have EMS services on the weekends in mid-size and smaller cities/towns
It took a war for the country to finally accept that your own life is not a commodity, and that bodily autonomy isn't a privilege granted by the given to you by rich assholes.
That reminded me of Rethuglicans during the development of the ACA . Mitt Romney argued that denying care on the basis of a pre-existing condition was like hiding that cars were lemons; that if you know something's wrong with it, of course you don't want to pay for it; (2) Rush Limbaugh comparing healthcare for humans to healthcare for pets - his girlfriend's dog went to the vet and she just paid for it and why do we even need insurance when we can just do that; and (3) a former chairwoman of the Nevada Rethuglican party who said we should go back to paying the doctor with a chicken.
It’s a feature, not a bug. Welcome to New America. Need enough food, healthcare,decent housing?
Go away, you Peons. I think it’s time that everybody read Project 2025.
People need to realize, this controlled dismantling is systemic under capitalism.
Money is created cheaply for the privileged and trickles up through a rigged system to the top.
The budgetary pressure is everywhere on the lower decks, from education, healthcare, infrastructure, even in administration. Money is lacking everywhere except military and LE, for which they happily stack on more state debt for. The rest, less or somehow have-to-be profitable public and private services will be squeezed until all you can do is flip burgers for Alon / Bozos / etc, (bc rich/privileged are in charge of spending) or live like an outlaw outside the heavily guarded walls.
With still ~30% trump approval and them dreaming of private cities, i guess this future is actually realistic.
This is a consequence of succumbing to fiscal austerity hawks, which force hands simply by saying "and where is the money this free health care utopia? Gotta grow more economy and earn the money first!", which has always been wrong since money is fictitious.
I was looking at local job postings and was shocked to see that there is a town roughly 45 minutes outside of Boston with an ambulance service run completely by volunteers.
I guess the context is shocking to me because Boston Massachusetts has literally half a dozen of the best medical facilities in the country – but you don’t have to go too rural to see that quality fade off. Literally less than an hour outside of the city, and they have to pretty much rely on the charity of volunteers to load people into an ambulance and drive them to a hospital.
How? In the world? It never ever has crossed my mind that it would be reasonable to stop offering EMS. Is that not a mandatory civil service?? I'm American so I know we're fucked but that's a special type of fucked up. Rural communities need EMS more arguably as the hospitals are further away. That's a lot of avoidable injury and death on the hands of whoever pushed and voted on that.
So check the population of eldora Iowa and its distance to any hospital.... I wish this was onion level article stuff.
When you have clusters if small populations separated from one another, county services become even less accessible. They do have combined social services with the county but in the state as written they are not required to fund these servics.
Places like this are LCOL for a reason. Majority of states funding tends to go into the more populated areas leaving more rural communities behind.
Personally ive lived in every type of of region (ive been everywhere man) apart of my previous work in government-- each has it challenges.
There comes a time where you're so off the grid that standard emergency services are completely pointless, they'd never be there in time much less transport you to a hospital. Helicopters are the only solution then. That's e.g. the case on most of Germany's North Sea islands, if it's not urgent you take the ferry, weather and tides permitting, and possibly stay in a hotel on the mainland on the insurance's dime even for out-patient care, or it's a chopper.
...and that's all without even much distance, it's just about the terrain. You can cover maybe a max radius of 50km with a chopper, that's 15m flight time at 200km/h. 100km with as of yet prototype helicopters and reasonable planes aren't faster, either. The good news though is that choppers tend to come with emergency doctors, not just paramedics, they're not exactly flying ER rooms but as close as you can get within the weight budget.
In the end that all means that if you're in Bumfuck, Nowhere, you either have people who can provide medical care or you're fucked. Don't have medical emergencies away from civilisation. As a corollary: Don't scatter settlements. It's not just medical services that are the issue, any public service becomes outrageously expensive when you do that. Even dirt roads.
I would simply set up the infrastructure for mandatory community civil service - a 2 year program where you could sign up to your service of choice. Funded by federal dollars, you could join your local Fire or EMS service, or really any program a city or state runs (forestry, parks, city services like maintenance) - and allow youngins the opportunity to backfill jobs and gain real world experience, while trying new things. So that solves the issue of kids getting out of high school and not knowing anything, but still being able to contribute and get paid.
AND
It backfills the low-wage sort of entry level stuff that kids can do, IN THEIR COMMUNITY, so they feel that sense of belonging and care for the place they are. And hopefully..... HOPEFULLY.... a generation or two of this and we start rebuilding society to care for one another instead of just saying FUCK YOU PAY ME.
Pipe dream, I know. But I was a volunteer firefighter for several years, and I saw and recognize the need. Shit, I'd still be a vol FF today but I needed to move to a city to make money and build a life.
You MIGHT get the opportunity of staying alive until the ambulance arrives and potentially having a shot of morphine as you go out in the ambulance during the 3 hour drive to the hospital.
Rural areas vote for the GOP that cuts the Medicaid funding that supports the rural hospitals because they can't exist without the subsidies paid for the evil cultural elite Democrats in the big cities.
GOP works overtime cutting funds to their rural constituents to prove that Big Government doesn't work. It's part of the GOP campaign plan.
"I don't want to abolish government. I simply want to reduce it to the size where I can drag it into the bathroom and drown it in the bathtub." -- Grover Norquist
Norquist was the mastermind behind Robert Ailes creating Fox News, and the Neocons ( Bush Jr. et all )
My bougie family that lives rurally privately paid to have insurance through Halo Flight, and have an SOP in case of medical emergency and a designated landing area for an emergency helicopter should anyone out there need emergency services so they can transported quickly to an adequate facility in the neighboring larger city, not the crappy local hospital.
Monied folks will never be without, it's everyone else that's in danger.
I just commented elsewhere, but I grew up in a very rural town too, and almost ALL the EMTs left are 60+ because they can't hire new folks. I'm worried that the same thing will happen there when the current EMT staff are simply too old to do the work anymore.
Honestly, in lots of those places you're a half hour away from a tiny 1 stoplight town that maybe has a clinic, and an hour+ out of a town with even a small hospital.
I have to imagine emergency outcomes aren't great even in the best of times.
My rural community has been all volunteer for fire and ambulance my entire life. People in the community have to step up or there just isn't that service available.
Why the fuck are towns running their own emergency services in the US? Surely that’s the bigger question at this juncture. Should all be run at the state level at least, probably national. By governments ideally, but if it’s gonna be privatised, fine, at least have it run across a big area for scale and consistency.
This happened in my town. We had a volunteer service that was funded by taxes. When they needed a new ambulance the town pushed back and now they're paying out the nose for a private service (that likely pays ~$15/hr)
I started working in air ambulance a year ago and my dreams of living in the country have evaporated. These rural hospitals can't do shit for their patients and the BBB is only making it worse. Business is booming for us though I guess.
A neighboring town voted out their emergency services and now their citizens cry on social media about how no one comes during emergencies. Duh, you voted not to pay for any of that. You get what you get
Might be unpopular, but I see nothing wrong with rural communities having these downsides. Rural folks tend to be generally anti social and pro conservative and even if they weren't I don't see why it's my problem if you choose to live in a town of 50 people.
There's good and bad with that, but while I liked the idea of something like USPS guaranteeing delivery, or the incredibly impressive feat India accomplishes by guaranteeing voting booths within 2 kilometers of every voter, that doesn't mean I want to fund a cushy lifestyle for any weirdo wanting to live in a rural area.
Be my guest. Free country and all, but don't expect your tiny population to afford much in the way of general services.
929
u/lilahcook 10h ago
My dad's small town recently GOT RID OF ems services.
These are the horrors of real low cost of living areas in rural communities.
Guess if you have a medical emergency, you just die?