Why American ambulance rides are so expensive
5 hours ago
- #Healthcare Economics
- #Surprise Billing
- #Ambulance Costs
- American ambulance rides are extremely expensive and unpredictable, often leading to surprise bills for patients.
- The high costs are not due to operator greed but rather to a flawed payment structure established by Medicare in 1965, which treats ambulance rides as per-procedure fees instead of funding the readiness infrastructure.
- Ambulance services function as option sellers, requiring constant readiness but being compensated only when rides occur, leading to financial strain.
- Historical evolution from funeral home-based services to professional EMS increased fixed costs, while payment methods remained unchanged.
- Medicare and Medicaid reimburse below cost, forcing providers to recover losses from privately insured patients through out-of-network charges.
- Surprise billing is common, with half of privately insured patients receiving out-of-network bills, causing many to avoid ambulances due to cost fears.
- Proposed solutions like capping charges or banning surprise bills fail to address the underlying issue and could bankrupt the industry.
- Alternative models, such as funding through taxes or memberships (as seen in other countries and some U.S. regions), offer more efficient ways to cover the cost of readiness.