Ambulance Costs and the Hidden Financial Burden

When an unexpected injury or illness strikes, the first call often is to an ambulance. But the cost of these services can be profound, with some 15-minute rides in the U.S. ringing up to $2000. This raises the question: are the ambulance vehicles themselves that expensive to maintain, or are there other factors leading to such high costs?

The Unseen Costs and Their Impact

Such ambulance charges not only affect the patient but have a wider impact on the community. It is said that these charges may harm rather than help society. One alternative, supported by some communities, is to establish a system based on volunteer crews and minimal staffing, which at a cost of practically zero, ensures a service is provided to the residents without the need for insurance premiums.

The Economics of Ambulances

A brand new, custom-built ambulance, fully equipped, can cost around $250,000. However, these vehicles typically last only 10 years, a period often defined by the cycle of the ambulance's depreciation in value rather than the number of miles driven. The cost of maintaining these ambulances is a significant factor in the overall cost of ambulance services, yet it is just one part of the larger puzzle.

The Payroll Challenge

Paramedics in some areas are paid approximately $36.50 per hour. However, this payment is per diem (day's rate) with no benefits. To minimize expenses, many districts ensure that no employee accrues enough hours to qualify for full-time benefits. Moreover, due to the high cost of maintaining sufficient staffing levels, patients might encounter irregular coverage times.

Insurance and Billing Practices

Some ambulance districts, especially those that charge $2000 for rides, often attribute these costs to personal insurance deductibles. For instance, if the ambulance picks up a patient from their home, the charge is usually billed to the patient’s health insurance, which will likely be denied. If the patient is at home when injured, the ambulance may bill their homeowner’s policy, and if the accident occurs on the road, they may bill the auto insurance policy. Many of these policies, however, have deductibles, leaving patients to pay out of pocket.

In some cases, ambulance companies agree to allow hospitals to bill for their services, leading to additional costs. For patients who end up in the hospital for an extended period, such bills can be daunting, potentially leading to financial difficulties and negative credit scores. The patient might end up in collections, further impacting their ability to secure credit or rent an apartment due to poor credit history.

A Re-evaluation of Emergency Services

While most health insurance companies consider ambulance transport to be non-emergency unless the patient is treated in the emergency room and subsequently admitted, there is often a strong argument against this procedure. If a patient is treated in the ER and then released, the claim might be denied, as it was argued that a taxi or a friend’s car could have been used. This leaves the patient to fight the claim, which can be a daunting and costly process.

The high cost of ambulance services not only affects individual patients but has a broader impact on society. It is crucial for policymakers, healthcare providers, and the general public to understand the true cost structure and potential financial consequences of these services. Establishment of effective volunteer-based programs, while ensuring adequate care, might offer a viable solution to mitigate these costs.

Conclusion

The issue of ambulance costs is multifaceted, involving the high cost of vehicle maintenance, low-paid staffing, insurance billing practices, and the financial impact on patients and communities. Understanding these costs can help us find more equitable and sustainable ways to ensure access to necessary emergency medical services.