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as a European it blows my mind that this is not the norm is many parts of the world :(
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I am not going to defend the US Healthcare industry, but EMS is often? usually? a service of your local government in the US.
Here in Maryland, our ambulance are stored in the firehouses next to the fire engines and staffed by the firemen… Paid for by the county.
When I went to Austin for a bachelorette party, one of the girls passed out and hit her head and the ambulance that came to check her out was also free of charge paid for by the city. Now, their dismissive paternalism was also free of charge because it was Texas, but my point is: emergency services are frequently not part of the predatory American healthcare industry.
Like many services in the US, it is highly dependent on the region. In the places I’ve lived (in California and Washington state), each county generally contracted with a private ambulance company (or sometimes several, just to be confusing) to provide transport services. Even if an individual city’s fire department staffs their own ambulances, they may still attempt to bill insurance (since they’d be leaving money on the table at the expense of their taxpayers otherwise). Some of them may cover city residents free of charge but bill people from out of town. It just all really depends.
I would definitely dispute your last sentence — in many places, ambulances are absolutely part of the predatory American healthcare industry. Plenty of people will try to avoid calling an ambulance or try to find an alternate ride to the hospital, since they know an ambulance ride may end up costing them thousands of dollars.
Yeah, I’m in Washington state right now, and my county has a mix of public and private ambulance services. I got t-boned by a SUV once, a private ambulance company picked me up, and I found out later that they didn’t take my insurance and wanted $1500.
Only $1500? Was the hospital across the street?
Across all provider and payer types, the mean reimbursement per ambulance transport is $1,147.
So $1500 doesn’t seem unusal.
The Centers for Medicare & Medicaid Services report they reference has a lot of information about how much ambulance service in the US costs to provide and how much they end up getting reimbursed: https://www.cms.gov/files/document/medicare-ground-ambulance-data-collection-system-gadcs-report-year-1-and-year-2-cohort-analysis.pdf
t EMS is often? usually? a service of your local government in the US.
wow awesome. no one cares what level of beurocracy they are getting fucked by.
This is basically
Weed is legal in the united states
Yeah no. Not fucking federally. Not everywhere. Until that service is done the way the civilised world does it, you guys need to shut the fuck up
It’s not that I disagree that our system is shit, it’s more that it seems puritanical to require the US to be totally standardized across all 50 states. We’re 50 different states because we don’t like each other, and the animosity is growing. It’s enough to maintain the union with crazy red states trying to role back rights and illegally imprison people.
I don’t see Europeans standardizing social programs across all the different countries within the EU. Germany was loathe to even lend money to Greece following the 2008 recession.
it’s more that it seems puritanical to require the US to be totally standardized across all 50 states
no it isn’t. We expect the same from other countries like brazil or indonesia, india, china or russia.
I don’t see Europeans standardizing social programs across all the different countries within the EU.
The EU is very much not a country.
Lol tell that to the $1500 ambulance bill I got from when they drove me 3 miles in Baltimore to a hospital
Oh and the dude I knew in Baltimore that ran his own private ambulance service. Yea, they’re not all funded through local gov and run by firefighters
Your comment made me look up the way Maryland does it, and yes, it varies a lot by county.
Have you received care from EMS without being taken to the hospital? The case posted by OP did not involve going to the hospital, and so I used an example that did not involve going to the hospital. I had a vague impression that if you require transport to a hospital, you are more likely to be billed for it.
I’m going to chime in with how it’s done in BC, Canada. It’s a very large ambulance service relative anyway considering it covers the entire province.
These are about decade old figures, but you get the idea.
Healthcare here is free except for little bits that aren’t. An ambulance trip to the hospital isn’t free, but it’s heavily subsidized and usually I believe able to be waived based on a sane argument of need or via benefits plans etc.
An ambulance ride to the hospital is/was $850 for a non-resident. Say a visitor from Antarctica or Washington. Flat, there’s so difference or accounting for if the ambulance gets torn apart throwing everything at you or you just slept.
This is way less if you don’t go to the hospital. I don’t remember exactly but I think between $150, $350, and the paperwork was missing your details. Somewhere in there.
For residents the trip to the hospital is heavily subsidized, but lacking any benefits or whatever it’s $80. I don’t know about the non-transport, but yeah.
Just to avoid any false impressions: healthcare is not free in Germany. You should always get travel health insurance. Having said that, it’s pretty affordable. I pay about €80 a year for me and my wife for worldwide coverage.
Same in Ireland but a trip to the emergency room (including ambulance if you need it) sets you back €100 euro which is about $110 USD.
2nd last time I was in one there was an American couple across from us whose daughter had gone into a seizure in their hotel. We ended up chatting a good bit and I honestly was very glad for them that they weren’t paying American pricing.
Last time I was in one we had a referral from our doctor so it was free (there’s a filtering process to stop people with a cold coming to emergency) Included an MRI for my daughter and we’ve a follow up coming. Again all free.
So when you say it’s not free, it’s strictly true but holy moly the difference in potentially life destroying cost and not having to weigh that up. It saves lives.
In Germany you would need to pay a copay for the ambulance between 5-10€, the emergency room would be fully covered. Only if you get admitted you would be charged a copay of 10€/day up to 30 days a year. For prescription medications there is also a copay between 5-10€ for each of them.
All Co-Pays are capped at 2% of your yearly income, or 1% if you suffer from chronic diseases
The American system for me.
Halfway through the year cost so far:
Relatively inexpensive union insurance for the family $2310. Out of pocket expenses so far $3,700. Total $6010 so far…
Estimated total by the end of the year - $2310 in insurance premiums, 3,000 out of pocket.
Yearly estimated total $11,320.
2 years ago we had the corporate America special. Premium was $16,200, out of pocket was 8,000. $24,200 was the total cost. It was 26.8% of my gross income that year.
Well 2310$ per year isn’t that much.
In Germany the statutory Health insurance is 14,6% of your salary, capped at a maximum of 942€/month (half paid by you, half paid by your employer ), this also covers your children and your wife if she’s not working.
But on the other hand, there won’t be any significant out of pocket expenses here
My son was in the hospital for 4 days and the charge was $20,000.
The ER visit before admitting was a separate $2,000 charge.We have insurance, so we only had to pay around $8,000 out of pocket. It would have been less, but some of the people in the hospital didn’t take our insurance, and our insurance also said that some procedures were overpriced so they only paid the amount they thought was fair.
We didn’t get to pick any of the people who provided care, and we were not presented with the ability to negotiate on prices to make sure our insurance wasn’t being taken advantage of while they were doing respiratory therapy on our baby.
Our entire system needs to be torn the fuck down and be replaced with something entirely free. I don’t even give a fuck about people abusing the system at this point. Fuck it, let it cover elective cosmetic surgery. Never say no to anyone unless the doctor says it first.
My taxes will go up, but I can fucking promise they won’t go up by as much as I’d be saving in premium.
Because of right, I pay hundreds of dollars a month for the insurance that then only pays once I get fucked hard enough, and then still doesn’t pay for all of it.
Fuck the entire industry, fire them all and seize their assets.And I’m well off compared to a lot of people.
Better yet, have Mario pay them a visit. They have more than earned it! 👹
Tourists pay for healthcare in Britain, and pay a charge as part of the visa costs, as well as expenses if they use it. except for emergency care, which is always free for everyone.
I pay $250 in copay if I drive too close to a hospital in the US.
But after $5,500 out of pocket, the insurance will start paying.
It’s literally robbery. They’re legal thieves. They collect until you’re dead, and they sure as hell aren’t lifting a finger to keep you alive.
United Healthcare got caught forging DNRs. So they will definitely lift a finger, to kill you!
That’s literal, actual murder. No hyperbole.
Faking documentation to make people die
“When injustice becomes law, resistance becomes duty.”
Where do you get travel health insurance from?
From commercial providers. It’s not necessary for EU Citizens travelling inside the EU/EEA as they are treated like people in the national systems for emergencies.
But it simplifies a lot because you can go to any doctor and sometimes they play dumb and pretend they don’t know about the rules and want to force you to pay out of pocket (Happened to me in Austria, I’ve just reported them to the Austrian Health Insurance, he wanted 200€ which is outrageous overpriced and was a contracted doctor of ÖGK). Especially in Eastern Europe. But that applies only to GPs, Hospitals usually play by the rules.
And it’s also useful for travelling outside of the EU
Especially in Eastern Europe.
In post-Soviet countries, it was sadly normal that doctors would demand bribes on top of state insurance. The most outrageous shit I heard was and ob/gyn charging a months salary for a birth, half a month if it turned out to be a girl.
Thanks. I should have been more specific on my question, thats on me. Like, would I get it through my current health insurance in the US, like an addon to my plan? Or would I get it through a provider in the country/EU where I would travel too?
Squaremouth (weird name) is like a kayak.com site for travel insurance. Just put in your details and it’ll give you a big list to pick from based on price, coverage, etc.
I don’t know much about the US health plans, you might check if they have some special offers, or if they are valid worldwide. I’ve bought mine through Allianz, a big German insurance company.
They seem to offer travel insurance in the US too. But it’s much more expensive and they have pretty low coverage limits in the US. (Here I pay 30€ a year and don’t have any coverage limits for medical costs, there I was quoted 400$ a year for much shittier coverage). But you can compare yourself
https://www.allianztravelinsurance.com/
https://www.allianz.de/gesundheit/reisekrankenversicherung/rechner/#/angebot
Not necessary but some countries have a deductible. Like in the Netherlands hospitals will charge you up to €380 and only claim the costs above that amount from your insurer. So cheaper to get travel insurance.
If that’s all you’re worried about then paying a insurance 20-80€ a year to insure a risk of 380€ would be a pretty stupid idea, and on average certainly not cheaper
You don’t have to pay every year if you are not going on holiday every year. Also not everything will be covered by your normal health insurance, like if you need to get air lifted back home.
That’s basically free to Americans. We pay that per visit if we are lucky. Health insurance here exists to make a profit, not to help people out when they need it.
More death = More profit
I pay $80 twice a week for coverage for my wife and myself in only a very limited fraction of US facilities.
To be clear, that’s 100× as much money for far less coverage.
Same in the Netherlands. If you are uninsured and not an EU citizen an ambulance can cost you €400 to €700. And even if you have European health insurance you still need to pay the €380 deductible if you need to visit the hospital. And if you are not an EU citizen but have travel insurance you probably need to pay the hospital bill upfront.
The Netherlands has a privatized health insurance system. So yeah don’t expect free healthcare if you visit.
I guess he had some form of Health Insurance as it’s mandatory to carry in Germany for almost everyone.
Also there is a copay of 5-10€ with public health insurance, but the insurance will send a separate bill for it. You won’t usually get charged at point of service
I once collapsed and lost consciousness in the streets in Russia. Someone must have called an ambulance. I woke up in a hospital with a woman yelling at me for my insurance number. (I am a Russian citizen but I have never lived there, I tried explaining I had a traveller’s insurance, but she didn’t understand what I meant.) Anyway, after I got treated they released me basically as Jane Doe, I never got billed anything.
Over the course of the years I had to go to a hospital in Russia two more times. Each time they would rather not bother with figuring out how international insurance works (basically, I would pay a bill and then send it in to the insurance company and they would reimburse me - I explained that over and over) and just let me go free of charge.
The treatment was good and professional and stereotypically unkind. I’m still amazed by how they’d rather not bill you because they aren’t sure what you’re talking about than try to get the money and let you figure out how to pay it. Too much of a hassle I guess.
Here in the U.S., we let billionaires tell us which of two candidates are “electable”, and we then argue over which one is “better”.
A vote for the lesser of two evils is still a vote for evil.
I live in America. But I’m originally from Ukraine. Therefore I have many friends and family from there and because of the current situation I’ve known many people that came and are still coming over from there and they keep asking the same question: you really have to pay for the ambulance?
Then I tell them ambulances are privet for profit companies. And you can see them loosing all faith in America.
Personal anecdote: my father died of cancer 4 years ago. When they were transferring him from the hospital to hospice the paramedics asked him if he was ready and Dad said yes, he was ready for the last car ride of his life… They sent us a 5000 dollar bill for a 15 minute drive.
We didn’t pay it.
I would say this is normal in a society where people trust each other.
First time in America? Everything is going to be like the new black mirror ep1. Everything subscription
Americans can’t fathom paying for something they may not need to make use of. They can’t extend their sense of compassion beyond what they can touch.
It’s hilarious and ironic considering they have to pay insane rates for insurance anyway
I thought there was going to be some punchline and I was quite confused at the end, what else would paramedics do if some kid was sick? Then I read the comments and remembered about America… I genuinely don’t know how people can live in a country that is so antagonistic to its own citizens.
It’s all we know and most of us don’t have any other choice. It’s wild the stuff humans can normalize when you grow up with it and are surrounded by it.
They’d do the same thing but you’d have a five-figure bill.
I used to get so angry seeing stories like this…
At this point it just increases my sadness. America (my country) is completely fucked and there is no way out of it until we completely hit bottom, like an addict. It will be decades before America hits bottom, long after I am dead and it will take generations to build something better, no guarantee that will happen.
I feel tremendous sadness for my children and all of the rest of our younger citizens that will live through all of this to never see or experience anything better.
title sounds like a line from an Aesop Rock song
It’s probably a trap
I had a relative who once had a serious emergent heart problem (not a heart attack) in Italy. Ambulance to the ER, admitted to hospital for several days, ran a gazillion tests and procedures; huge workup. Was billed because no national insurance.
Grand total: €200. Not even worth trying to claim on American insurance.
It’s what you get in civilized societies. Really the US is so far behind it gets overmaken by a bunch of what they consider 3rd world countries, while those countries have a war going on.
It does seem to be a bit of a toss-up between countries whether or not you will actually get charged. Supposedly international visitors to the UK are supposed to get charged but no one seems to know how to actually bill anyone, so it never happens. Weirdly the government doesn’t seem all that interested in fixing it either, so it kind of just exists as a pseudo international free healthcare service.
I would think that giving people care doesn’t actually cost much, it’s having the capability that’s expensive. And the administrative work required to deal with the edge case of charging foreigners might not be worth the minor sums involved.
An ambulance for food poisoning? Really?
Yeah, imagine being a parent and your kid is in a foreign land has a medical emergency but you don’t know what it is and whether your kid is going to live or what.
I certainly can imagine myself calling an ambulance. But maybe it’s my “socialist” mind thinking here…
I recently had severe food poisoning in Cambodia, like, really really bad, followed by a severe stomach infection. I just went to a doctor. Ambulance is for when you’re not able to go to a doctor/hospital yourself and/or you need immediate care. I don’t consider food poisoning in that category, but I wasn’t there so I don’t know what the condition of the kid was.
You obviously know better than the German paramedics.
In civilized countries, if you feel sick enough that you don’t think you can make it to a doctor or emergency room on your own, you call an ambulance
