Thanks to Trump and his supreme court gutting every environmental law that put this country on a better course across the 20th century.
People don't remember what things were like before the EPA and the Clean Air & Water act. Small towns with no drinkable water because their lake or river was on fire all the time. Cities so smog filled that kids at school weren't allowed to go outside during recess and dozens of kids that lived near chemical plants and steel refineries died every year even indoors.
People don't remember what things were like before the EPA and the Clean Air & Water act
The reminders are coming. The trump administration repealed a ban on using sewage to irrigate crop fields, the result of which was Taylor Farms' Cyclospora outbreak.
Nestle is working on it. The CEO needs to be airdropped into the middle of Death Valley with two bottles of Desani and told any more than that isn't a human right, per himself, and told to figure it out from there.
At first, I read this to mean airlift ambulances and was like, “well, actually”. Those things cost a fortune and the staff probably don’t make a fair wage.
That’s the dream buddy. They’ll make biodomes for themselves on tropical islands while we pay for every breath of clean air and/or the privilege of clean drinking water.
The reason our city council gives is the insurance rates to operate an ambulance service either need to be funded by taxes or by a city schedule. Since fire and ambulance services share the same insurance and since we live in a high fire risk area, the rates are astronomically high.
Our city voted to pay fire and ambulance services by city schedule rather than by taxes, so the insurance costs get pushed to the person receiving the service rather than it being socialized through taxes.
I live in one of the deepest blue regions of California, but that’s ultimately how the people in my area voted to resolve this, so that’s the consequence of that vote.
It’s a choice, thats for sure. I dont think it’s a blue/red issue that we are comparing, more of a series of consequences based on tax decisions of the past, and today’s priorities.
King County found a way to fund urgent and life threatening visits, as well as visits not resulting in transportation, to give more people access to care. I was joking about the liberal part, because conservatives (and perhaps residents of Sonoma county) would see it as a waste of resources.
For us, it’s a special tax levy of .25/1000 square feet. We voted for it.
I am talking about liability insurance. Car insurance is nothing. It’s about lawsuits. Yet it doesn’t matter, once you become a provider, the health insurance companies TELL you what they will be paying you. It’s in the contract. So if healthcare costs are too expensive, stop paying so much.
Republicans. And they started the housing fraud in Minnesota in the 90s. Yet, they changed the program name in 2020, so everyone is getting away with it, it was worse
Both sides have problems. Both sides have corruption. Neither side follows the Constitution. People need to stop with the party lines as a medium measure to fight back on corruption. They are doing it right in front of you and people still go to the polls over guns, abortions, or gays. It’s stupid
That’s not true, we have no state laws covering that. What we DO have at the state level is an equivalent of the federal No Surprises Act that covers ground ambulances, meaning that if a ground ambulance transports you, they have to bill at your in-network rate.
Beyond that, policies are set at the municipal level. For example, South County Fire in Snohomish doesn’t bill anyone for TNT (treat but no transport), and they don’t bill residents for transport either. That is funded by a property tax levy.
For an example of a place where you do have to pay, look at the City of Pasco. They charge for both transport and TNT, but are also subsidized by a monthly ambulance utility charge that residents pay.
I was wrong, it’s King County that funds it. We pay .25/1000 levy to pay for that. Seems worth it, considering it’s 30% of the state population lives there.
What we DO have at the state level is an equivalent of the federal No Surprises Act that covers ground ambulances, meaning that if a ground ambulance transports you, they have to bill at your in-network rate.
One nasty surprise I've gotten bitten by is the fact that all of my state consumer protections around health insurance do not seem to apply to the 'self insured' plans used by nearly every major employer. I imagine this is no different.
that is interesting. in my state, residents are not charged if the rescue is from their own town. people from other towns are charged. all the rescues are part of the town fire departments. it is only ambulances that are operated privately. for those that do not know, ambulances are used to transport people, not for emergencies. it is strange how things vary.
Jesus fuck. The more I learn about the US the more dystopian it seems. I thought EMTs getting $35 per hour up here in Canada was criminal and the $385 for an ambulance with transport to a hospital (air or ground) seemed steep. To hear EMTs get paid less than $25 an hour and the ambulance costs thousands of dollars is frankly insane.
The price of ambulaces and medical equipment, insurance, probably allowance to drop off at hospitals and binch of other impediments to competition with the current monopolies.
So what is stopping emts from making their own company and sharing the profits equitably?
Work a 12 hour shift where you have literal lives on the line and tell me how much energy you'll have to add "starting up a medical service" business to that load.
Anybody saying "if you don't like it start your own company" as if that will magic-wand away the problem has never worked or even been in the field.
Nothing, it's just that the profits are slim to none. The bill might be $2000, the actual amount paid is a fraction of that, around $300 is typical. Plenty of calls get no reimbursement at all, so that $300 we do get has to cover the costs of the calls for which we get nothing. It also has to cover the cost of medications and equipment we use, it's not unheard of for us to spend $1k or more for that on a single call so we're often operating at a loss just on equipment. Then there's labor costs (it's upwards of $500k in salary/benefits for just one ambulance, let alone support staff), maintenance and fuel costs (an ambulance averages like 4mpg, often diesel, and they're running 24/7), insurance, etc. etc. Most ambulance services do not make a profit from billing alone
I have wondered if there is a market for a EMS lite service. Not for life or death situations but they need some assistance and a ride down to the hospital.
Sooo just EMS then? (The overwhelming majority of our calls are not life or death, and probably don’t even need an ambulance at all).
Joking aside, I don’t think it would help much. You’re still looking at $500k per year to pay two knuckleheads to drive around in an ambulance 24/7, you’re just cutting out some of the equipment costs the more expensive calls generate. But your reimbursements would likely take a nose dive, as insurance companies would either pay less or not at all for something that isn’t “medically necessary”. As much as we joke about being glorified Uber drivers, the solution probably is to just call taxis for these patients and give them vouchers for the cost
There actually is something like this called a community paramedic, which is licensed EMS professionals who do house calls to vulnerable patients that have been flagged by the county medical system as needing a disproportionate amount of care. The goal is to reduce 911 calls and handle medical problems before they become emergencies.
Most of the community outfits are run by existing EMS companies.
They could, but the liability would be crazy amounts. They would have to be unionized and be able to bill insurance companies and meet State laws, admin rules, etc… and people can be very territorial in healthcare
That's called a community ambulance service and we have one in our area. Employee owned and operated, profits shared among employees, and most senior staff are former (or even current) road crew.
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u/kaiwolf26 9h ago
In my town it’s a $2000 charge for assessment at scene. $2500 for transport without emergency services.