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Coles_Law
July 4, 2009 12:16 PM
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I only weigh 130. Can I get a discount?

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2 replies
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icantreplyright
July 4, 2009 1:47 PM
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@Coles_Law: at 125, I totally agree.

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factotum
July 4, 2009 12:22 PM
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I'm confused. Is the new fee $543 or $1172? I need to know . . . cuz I'm fat.

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Andrew Farris
July 4, 2009 5:29 PM
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@factotum: Is the difference going to effect whether you call the ambulance? I sure hope not. You'll find out what they take you for when they send the bill.

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mmmsoap
July 4, 2009 6:28 PM
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@Andrew Farris: Unfortunately, we're not just talking critical care (emergency) patients here. AMR transports bariatric patients routinely all the time. For example, a 400+ person who may be immobile enough that they can't drive themselves to (or, more likely, home from) a procedure at the hospital.

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itsnotbecca
July 4, 2009 12:26 PM
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@factotum:
If a normal ride costs $629, and they want to charge overweight people an extra $543, the total of those two numbers is $1172. They have to pay the basic cost of the ride, plus the extra bariatric charge.

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Skin Art Squared
July 4, 2009 12:27 PM
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What do I think?

I think the ambulance services and hospitals in general WAAAAAAAY overcharge for what they provide. So now they're charging more? Not surprised. One trip to the hospital in an ambulance, a couple of Tylenols, a few hours in the building, and no insurance can very easily run you upwards of $10,000. I know this because they did it to me. The healthcare system in the U.S. is severely broken, and I don't see it getting fixed during my lifetime. The next time I visit a hospital or ride in an ambulance, it will be when I'm dead.

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Freeloader
July 5, 2009 9:12 PM
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@BZMedia: Reading the comments in here is like a testament to the complete lack of knowledge of the general public in the way EMS works.


First of all, there is no ambulance in the world that would cost you \"upwards of $10,000\", and I doubt highly that the total ambulance bill was 1/10th of that, unless you were taken by aeromedical, and that's a different beast in and of itself. I like the last bit you posted. THAT'S THE REASON IT'S CALLED EMERGENCY MEDICAL SERVICES. We don't exist to take you to the hospital because you have a cold, and if we do, expect a bill.


@@chatterboxwriting: So let's see, you had a syncopal episode that could have many different etiologies, you were treated appropriately, a differential diagnosis was determined and you were taken to a facility capable of rendering you definitive care? I'm sure they did more than check your sugar and put you on oxygen, and if not then that's one lazy medic.


@katstermonster: It's already been addressed here, but let's just say that your friend lacerated her liver. Fairly easy to do, actually, depending on the mechanism of injury. It would be negligent of that crew to take that person to a local, non-trauma center, who would not be capable of rendering the right care, than to take them to a trauma center where they can get the surgery needed to recitfy any serious injury. Ambulances don't have X-Rays. Mechanism of injury is sometimes more important than presenting symptoms - better safe than dead, IMO.


@Matthew Berkhan: That wouldn't work. IANAL, but how was she supposed to know she wasn't injured? Paramedics are not doctors, and cannot make that determination, when presented with a serious mechanism of injury. It would have been much worse for them legally to have just dropped her off at the local hospital.


Now that I'm done replying, I can get to the meat of my coment here. Yes ambulances are expensive. So is the training to be an \"attendant\" (EMT Basic or Paramedic). So is the insurance, for the liability and the vehicle. Ambulances are in excess of $100,000 and most only have a 5 year lifespan. Equipment can add another $50-100,000. Employees are expensive, health insurance for those employees is expensive. If you want to make a real change, and solve the problem, make it a mandatory service, like fire suppression. Force municipalities to provide EMS coverage and then they can recieve the proper state and federal funding like the fire departments do, and then you will see per-person costs start to lower because there is more funding available. EMS is a new concept, relatively speaking, and there's a learning curve when it comes to where the money is found. Or we can all just complain about how our lives aren't as important as our flaming belongings. When was the last time you heard of a bill, exhorbitant or not, for putting a fire out?

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shfd739
July 6, 2009 1:02 PM
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FWIW my service sends 2 units on patients over 300lbs. There is an extra charge for that but Im not sure what it is. One crew cant safely move someone over that size.


This is no different than having to buy 2 plane tickets if you are a large person

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RedwoodFlyer
July 5, 2009 2:00 AM
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@BZMedia: If it were so profitable... don't you think that by now, someone would have opened up a cheaper service that would still clear a healthy margin? I'm sure some insurance companies would have started their own service in areas where they have many customers if it meant they could save $400 on each patient.

Is it expensive? Yes... Is it a ripoff? Probably not...

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btrotta
July 5, 2009 2:55 AM
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@RedwoodFlyer:
The reality is that it's tough to make a profit in the ambulance business -- particularly on the 9-1-1 side of the business. First off, a new ambulance is about $100,000 -- average lifespan of a city-based ambulance 3.5 years. Then you have to fill it with another $50,000 worth of equipment. Next, you have to staff it 24x7x365. Then you have to pay to insure the vehicle, pay your malpractice, maintain the truck, fuel the truck, resupply the truck each time it goes on a call -- starting to get the picture? It's expensive.

Now, you take that ambulance, park it on a corner and wait for someone to get sick or injured. In a big city, on a busy day, that rig might do 12 calls. Sounds promising, doesn't it? It is, right up until you realize that you'll never collect a dime on 1/3 of those calls. That means the other 8 people will have to cover all the costs.

And when there's only 6 calls in a day, that's even fewer people to spread the costs around.

Do ambulance services make a profit? Yep. But it's not nearly as much as you would suspect from looking at your bill.

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Hobz
July 6, 2009 12:59 PM
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@btrotta: LOL your numbers don't jive.

$500 x 6 calls per day x 365 days = $1,095,000 a year (note I'm using low estimates for cost and calls)

at 3.5 years is about $3,832,500

with a total investment of $150,000 in equipment

and $280,000 for a two man crew at $40,000 a year for 3.5 years

Throw in another $400,000 for gas, repairs and supplies?

That's a profit of $3,002,500?

So the ambulance owner can look forward to making 1 million dollars a year on one ambulance? Sign me up!

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Torabo
July 7, 2009 11:30 AM
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@Hobz:
And your numbers don't add up either.
So you have a two men crew @40k a year for 3.5 years...
congratulations, you now have an ambulance that's not 24/7/365... or were you planning on paying them outrageous overtime which you did not mention or calculate?

So let's start fresh again
150k for the vehicle and equipment
2 man crew 24/7 would result in a bit more than 4 sets assuming 40~ hour work weeks. but taking into account holidays and such you probably need 5 sets, so @ 40k per year for 3.5 years that'd be 1,400,000 ... which is QUITE a difference from your 280,000 estimate.
You'll probably need at least one support personnel of some sort for paperwork and such, so let's add another 40k for 3.5 years = 140k
Then you consider insurance costs for the vehicle, equipment and personnel
Insurance for an ambulance vehicle is about 10k/year (At least that's what i saw on a random article somewhere... you're free to dispute this if you have a source you can quote since I don't) I
So that's another 35k
I have no idea what the insurance on the equipment would be so let's assume its included in the vehicle insurance
Now for the personnel, according to this link I got from google [stillwater.org]
Its about 14.5k per year for each ambulance personnel, so for 3.5 years that's about 507.5k
For the support staff it's prob around the 1k for avg adults so let's just round that to 510k
so now its 150k+1400k+140k+35k+510k = 2235k
Now I'll just use your 400k for gas repairs and supplies and we're already at 2635k

Now let's look at the 3832.5 revenue you estimated, you'll probably get about 2/3 of that due to 1/3 of it being unrecoverable. So that puts it at 2555k
Gee.... lots of profits we have here... a whole 2555-2635=-80k!
Maybe I overestimated the loss due to the unrecoverable calls... but I'm going off of what someone else mentioned, you're free to debate this number with whoever mentioned it. Though this doesn't include other costs like legal costs due to the lawsuit happy nature of America :P

Yup, sure profitable.

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Tolgak
July 4, 2009 6:33 PM
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@BZMedia: As far as I know, it's a rare occurrence that an ambulance company makes a profit in any given year. Many of them are supported by donations.

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Scubastevie00
July 4, 2009 5:22 PM
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@BZMedia: LOL... Are you serious? Maybe a bit excessive, but after reading your post earlier you think everything should be free. To hell with all those people that paid hundreds of thousands of dollars to go to medical school and nursing school ect. God forbid they do their job as they should and check you out to make sure your okay. I'm sorry the system is \"severely broken\" and they shouldn't charge you just to make sure your fine. Next time your in a serious accident or who knows what else and can't answer I'll make sure they ask you if its okay to billed for the treatment your about to receive. When you can't I'll make sure to let them know that you don't want any treatment that may be precautionary. You idiot.

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chatterboxwriting
July 4, 2009 1:12 PM
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@BZMedia: I agree. In March, I had to call the ambulance because I blacked out after being ill for several hours. They charged me $953 for a 1-mile ride to the hospital. They took my BP and blood sugar and put me on oxygen. That's it.


It turned out that I was only dehydrated and just needed IV fluids, but because I have severe hypertension and chronic kidney failure, I couldn't chance staying home and seeing if I felt okay after blacking out. The hospital bill was \"only\" $2,953 - why should a one-mile ride cost 1/3 of a 5-hour hospital stay, x-rays, lab work, medication, and nursing care?

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RonDiaz
July 4, 2009 10:33 PM
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@chatterboxwriting: I had to take a late night ambulance ride once after taking a spill. $893 to go 1.2 miles. The ER bill was only $475 for 5 stitches in the face and a tetanus shot.

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rpm773
July 4, 2009 1:38 PM
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@chatterboxwriting: They're not charging you by the mile. If, god forbid, your issue turned out to be much more serious (resulting in much higher hospital costs), the ambulance ride would have been a lower percentage of the entire cost.

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MisteriosaNYC
July 6, 2009 3:37 PM
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@rpm773:


other have said it, but i'll say it too.


the ambulance charges by the mile.


i was in a car accident back in late march of this year, and the ambulance drove me (and my sister) to the hospital. it was 10 miles away. my sister and i both got the bill and they even laid out a fuel surcharge of about $9/mile to each of us. we shared the damned ride, and they charged us twice for the same gas and vehicle.

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btrotta
July 5, 2009 2:39 AM
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@rpm773: Actually, ambulance calls ARE billed by the mile. That's in addition to a flat rate for an ALS or BLS call, plus charges for a few specific procedures.

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padams89
July 4, 2009 2:49 PM
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@rpm773: As an EMT, I can verify that we do charge by the mile for transport. As for people alleging that we pick hospitals by furthest distance: false. State laws dictate what qualifies as a significant accident or a trauma case. These state laws also require that ambulance take those patients to the closest Level 1 trauma center in such circumstances. If an ambulance fails to go to a trauma center, they are given significant fines by the state. The state find out very quickly because almost all patient charting is electronic and is automatically exported to the state.

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katstermonster
July 4, 2009 3:31 PM
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@padams89: I'd be curious to hear what qualifies as \"significant accident\"...is it based on damage to the vehicles, or perceived injuries, or...? I can understand the reasoning behind these requirements, but in my friend's case (see above), it wasn't as if the ER she was taken to even did anything significant. I would have understood if they'd taken X-rays, CAT scans, etc. to see if there was hidden internal damage but...they didn't. It seems a little overboard, considering the patient is the one who ends up getting nailed for the longer ride. Just wondering, really.

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padams89
July 4, 2009 8:20 PM
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@katstermonster: It is baed off of a combination of perceived injuries and damage to vehicle/machanism of injury. As an example, in my state a fall from height greater than 3 times the persons height requires a trip to a level one trauma center. Additionally when multiple criteria such as \"spidering\" of a windshield, airbag deployment or significant (>6\") intrusion of a body panel into the passenger compartment are criteria for a trip to a trauma center. If a patient presents with significant injuries, a EMT or Paramedic can also elect to go to a trauma center.

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EqualOpportunityCrasher
July 5, 2009 7:55 PM
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@padams89: Are you sure about that? I was involved in a rollover accident on the freeway where the windshield was broken, the front corner of the roof was collapsed, and the car ended up on its side. When the ambulance came, we were able to refuse treatment even though the car was totaled and my dad had a cut in his hand. We went to the doctor's office that same day just to check us out.

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padams89
July 5, 2009 8:44 PM
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@EqualOpportunityCrasher: Well you can only be mandated to go to the hospital if you are legally incapable of making a decision for yourself (such as if you are intoxicated, have a head injury, etc.) The criteria I listed are for when a trauma center would be utilized in a car accident with injuries.

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Skin Art Squared
July 4, 2009 1:36 PM
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@chatterboxwriting: I know, it's ridiculous. I remember reading the breakdown of my bill. It's been a long time now, but I think the Tylenol was billed at something like $653 per pill.

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PunditGuy
July 4, 2009 1:05 PM
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@BZMedia: You had to go to the hospital to take a couple of Tylenols? And you needed a ride? I'm guessing there's more to the story.

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katstermonster
July 4, 2009 1:30 PM
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@PunditGuy: Nope, happened to my best friend. She got in a car accident...her car was severely smashed up, but she only had bumps and bruises. They made her go to the hospital...understandable, they need to cover their asses.

But oh wait! They can't take her to the hospital 5 minutes down the road! This is a \"serious accident\"! Note: her car got the worst of it, and she was up, walking, talking, perfectly fine. Nope, they had to take her to the bigger hospital, 30 miles away. And -- you guessed it -- she got charged for every mile.

She arrived at the larger hospital. They told her to move her limbs. They told her to go home. No joke. No Tylenols, no checking for whatever hidden problems the medics were convinced could have been caused by the \"serious accident.\" She got charged over $1000 for the ambulance ride ALONE. She hasn't even gotten the ER bill yet.

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btrotta
July 5, 2009 2:37 AM
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@katstermonster:

The crew probably took her to the trauma center, rather than the community hospital based on what they perceived to be the mechanism of injury ie the car was \"severly smashed up.\"

Just because someone is up and walking around doesn't mean they're fine. I've had plenty of people walking and talking to me one minute and then crump on me the next.

The ambulance crew did what was in your friend's best interest. If they had taken her to the local facility, which isn't equipped to handle major trauma, and she then crumped, you, her family, and her friends all would have been calling for the ambulance crew's heads.

Instead of bitching, you and your friend should be thanking the crew for looking out for her best interest.

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PsykoDemun
July 4, 2009 3:38 PM
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@katstermonster: Are you sure they made her go? I was in a severe accident and my car was quite totalled. While on the scene walking around I was approached by the paramedics. They asked me if I felt fine, I told them yes. They asked if I felt that I needed to go to the hospital, I said no. They made me sign a waiver and that was about it. Had a vicious bruise from the seatbelt that I didn't notice till a friend pointed it out to me a week later but that was about it. My poor car was ruined though RIP.

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katstermonster
July 4, 2009 3:49 PM
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@PsykoDemun: She was not given the option to sign a waiver, and I believe the hospital situation was presented to her in such a way that she did not believe she had any other option. Yes, she probably could have legally opted out altogether, but she was pretty shaken up and it was probably beyond her capability as a 21-year-old girl to stand up to the police officers, firefighters, and medics who responded to the scene and were insisting that she go to the hospital. My point: her options were not completely presented to her, and I'd say she probably believed that she had no choice but to take the ambulance ride.

On another note, I remember now why she was forced to go to the Level 1 trauma...her door was smashed up and her seatbelt was stuck, so they had to cut her out of the car. Makes some more sense...but still, the price is obscene.

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Matthew Berkhan
July 4, 2009 6:06 PM
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@katstermonster: If your friend wasn't given the choice then I say she doesn't owe the ambulance anything. Get a cheap lawyer or file a lawsuit in small claims court (if the amount is small enough). All she really has to do is file a sworn statement that she was alert, she didn't feel she was injured, and she refused treatment, but that the police and paramedics on scene told her she was required to go and she was afraid to disobey them. Her hospital records will support that she wasn't actually injured. The only defense the ambulance company can really offer is that they were just being cautious by advising her to go to the hospital, but she can just turn that around and claim that in there attempt to be cautious they mistakenly told her she couldn't refuse treatment.

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Skin Art Squared
July 4, 2009 1:07 PM
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@PunditGuy: There is, but that's what it boiled down to in the end.

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Steve Pan
July 4, 2009 12:43 PM
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Can you imagine how much Marxist healthcare would cost Americans if we let all overweight people get treatment on our dime?

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varro
July 5, 2009 1:04 AM
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@Steve Pan: Less than the amount small businesspeople like me pay insurance companies for their Taj Majospitals and ivory backscratchers for executives.

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razremytuxbuddy
July 4, 2009 2:36 PM
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@Steve Pan: You've just hit on my biggest fear with health care reform. Obese people alone need to pay the expenses of being obese. Obesity is a lifestyle choice of such exploding popularity that it will undermine this country's health, economy, and even its ability to defend itself. As the obesity trend grows, there are fewer healthy people to help shoulder the cost.

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floraposte
July 4, 2009 4:34 PM
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@razremytuxbuddy: But so are a sedentary lifestyle, smoking, and consuming unhealthy food, whether you're obese or not. Obesity tends to be where people concentrate their fears about the price of unhealthiness because it's visible, but it ends up being a scapegoat for a range of contributory behaviors.

How about a massive health tax on internet connections, videogames, alcohol, snack foods, and fast foods?

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the_wiggle
July 6, 2009 2:00 AM
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@floraposte: tax away. it'd be no more than a fart in a hurricane as far as effect.

what needs to change FIRST is the corporate dominance of every aspect of life. That is what destroys the ability of most folks to attempt, never mind succeed, the necessary balance of work & life to be healthy.

only so many hours in the day - if most are at work or traveling to/from - not a whole lot left for healthy lifestyles.

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Robert Synnott
July 4, 2009 8:01 PM
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@floraposte: Also sports. Those people have a lot of expensive injuries. And people who have the cheek to live near coal power plants, because they're more likely to have respiratory problems. And people who drive, cycle or motorcycle. And people who work in dangerous industries.

VERY slippery slope, this taxing of voluntary health risks.

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razremytuxbuddy
July 4, 2009 4:55 PM
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@floraposte: Wow, you may have hit on a sound way to fund health care reform, IMHO. Taxing internet connections could be problematic, but the other items you listed are so directly tied to the root of unhealthy living, that it makes sense. There are healthy snack foods and fast foods if you make the effort to seek them out, and it would defeat the purpose to tax those, but I get your general drift, and I like it.

And I agree--obesity is a visible effect of an unhealthy lifestyle. But then it also becomes the cause of further health problems.

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Jaynor
July 5, 2009 3:19 PM
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@razremytuxbuddy: But it's not the only one.


Would you add cost for people who chose to eat meat, because of the added risk of colon cancer?


What about people who live on more than 1200 calories a day? There are proven health benefits to living on an extremely calorie restricted diet... you're cold all the time and you look like a skeleton (literally... google this) but it's a much healthier lifestyle. Perhaps we should add cost for anyone who chooses not to limit caloric intake in this fashion.


There are countless decisions that individuals make that impact their health... Obesity is the \"Largest\" (sorry for the pun) issue right now (smoking would have been 20 years ago) but it's only one of many. You can start with extra costs for the fatties but I suspect you're more comfortable with this because you're not overweight. Were the crosshairs focused on a habit/choice that you engage in you might not be so quick to pipe up in favor of variable charges.

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razremytuxbuddy
July 5, 2009 5:53 PM
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@Jaynor: I'm not sure which comment you are referring to, because this thread has gotten so long. The tax comments, maybe? But no, I would not add cost for meat or any food that has dietary benefits, and is ACTUALLY ONE OF THE ESSENTIAL FOOD GROUPS. That's why they call junk food what it is. It is filler and empty calories, and if not eaten in moderation, will make you fat very quickly. I eat junk food myself occasionally, so I'd be one of those paying the higher cost whenever I wanted to indulge. Cheetos taste great after running a marathon. ;)

I also think there should be tax breaks or other incentives for fitness programs. You can what-if that notion to death too, but a regular fitness routine is cost effective and a proven preventative measure.

It's incongruous to say that someone who works at maintaining a healthy lifestyle is trying to make it easier on him/herself. It takes effort and discipline to live a healthy lifestyle, and it's a self-worth thing; you have to think you're worth it. The rewards are cheaper grocery bills, fewer medical bills, more energy, and generally feeling good all the time. It's not a matter of being \"comfortable\" with the fact I'm not obese. It's that I work at not being obese, and it's unfair that the growing obese population expects me to subsidize their unhealthy lifestyle while they don't take responsibility for their own health.

Are there days when you give more than 100% at work? I'm sure there are, and I'm sure you resent picking up the slack for anyone who sits there and only gives 50%, or who calls in sick all the time. It's the same with healthy living. I'm not willing to pay premiums or taxes to cover those who don't do their part.

The reason I'm so passionate about it is that the cost of the obesity trend is going to hurt us all, beyond comprehension. Our state is now 27% obese, and we aren't the worst state in that regard. I remember in grade school when there used to be one \"fat kid\" in class. Now 1 out of 3 kids are obese. The growing obese population is passing that lifestyle on to their children. I don't know how these 1 out of 3 children who've never known any different lifestyle, will ever find their way out of obesity, or even understand why they should try. And so the trend will continue--until it becomes unaffordable.

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zibby
July 6, 2009 12:33 PM
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@razremytuxbuddy: Good points, but you need to be fair - fat people are already soending more money on Chee-tos and Ding Dongs, and now people want them to spend more for an ambulance ride too? Where does it end?

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razremytuxbuddy
July 6, 2009 1:45 PM
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zibby wrote at 8:33 AM: @razremytuxbuddy: Good points, but you need to be fair - fat people are already soending more money on Chee-tos and Ding Dongs, and now people want them to spend more for an ambulance ride too? Where does it end?

@zibby: Lol! Hopefully it ends when the person can no longer afford the lifestyle and resulting medical costs, if not before. That is, unless the rest of the population is forced to subsidize it, and then it ends when we all are out of money.

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TCama
July 4, 2009 3:24 PM
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@razremytuxbuddy: Good thing we have these folks in Kansas to put a damper on this fad.

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Julius Seizure
July 4, 2009 2:15 PM
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@Steve Pan: Ok, let's talk about \"Marxist\" Healthcare. As a proud Canuck mine is a mix of provincially supplied and private (my employer's plan fills in gaps not in the provincial one - ie drug plan, dental.) In the last six months, I've:
- visited the dentist for a cleaning/exam ($15 out of pocket)
- refilled 2 asthma meds (Flovent/Salbutamol) ($20)
- visited my family doctor ($0)
- visited a GI specialist on referral ($0)
- went to the hospital for an upper GI Scope ($0)
- have another scheduled to complete biopsy samples ($0 - in two weeks)
- got a 3mo supply of proton pump inhibitors ($10)

Pharm costs are my co-pay - the plan absorbs the rest and, oh, yeah, meds supplied in the hospital for the procedures are paid by the province.

So, that leaves me out of pocket $45 plus the cab ride back from the hospital.

Canucks pay both federal and provincial tax (calc'd separately on the same form, my blended tax rates about about 16% federal and about 13% provincial)

My employer's plan is funded by them. I don't pay any extra premiums.

Granted, if I lost my job, I'd have to pay retail for drugs and dental - but the doctor, specialists visits and the hospital procedures would continue to be free as they would if I weighed 500lbs.

Now, explain to me why this is bad??

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JulesNoctambule
July 4, 2009 5:35 PM
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@Julius Seizure. (Mourning Mollie Sugden): You know, in the past six months you've spent $10 more on combined health care than I do for one medication alone in one month. And I also pay federal and state taxes. One of us is certainly getting the better deal!

(and bless Mrs Slocombe -- the halo will ride up with wear.)

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Julius Seizure
July 4, 2009 10:35 PM
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@JulesNoctambule: That's one of the big bonuses from having employee \"extras\" (primarily dental, drug, physio, etc) benefits.

If I'd been unemployed for that same period, the hospital/doctors items would be covered but I'd have been out about $300 (2 puffers, 3 months of pills and the dentist visit.)

And I have to point out my employer pays for that extra coverage so one could say I'd be paid more if they didn't - if you wanted to look at it that way.

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TCama
July 4, 2009 3:21 PM
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@Julius Seizure. (Mourning Mollie Sugden): Healthcare is provincial? I thought it was federal ...

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Julius Seizure
July 4, 2009 10:22 PM
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@TCama: As I understand it, the feds supply the dollars and the province manages it. It's essentially invisible to the user - even province to province. (With your non-expired provincial health card, other provinces will treat you without much fuss.)

We're not limited to a single hospital but, of course, it helps if you do as all your records would be in one spot. When I first moved to this small, fictional city, I used to go to the French hospital out of convenience. When I found a new family doctor, she works out of the English one so now I go there.

It's not a perfect system, I'll give you that, but it's pretty darn close.

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verdegrrl
July 4, 2009 6:43 PM
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@TCama: Healthcare is provincial? I thought it was federal ...

Funding and some standards are passed down federally, but each province administers it's own health care system. Some do it better than others. For example, despite hefty oil revenues, more often than not, the province of Alberta (acknowledged within Canada as being the most like the US with regards to it's Reaganesque policies) is known for shutting down facilities, limited specialist services, and long waits, while British Columbia next door fares better. BC has had to enact a number requirements to prevent Albertans from coming over to get care in that province.

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Segador
July 4, 2009 2:34 PM
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@Julius Seizure. (Mourning Mollie Sugden): From the New York Times:

\"In 2006, 1 in 9 Canadian-educated physicians practiced in the United States. Collectively, this is equivalent to having 2 average-sized Canadian medical schools dedicated to producing physicians for the United States.\"

Also,

\"The results of the study highlight the lure of larger physician salaries in the private market-based U.S. medical climate, versus the government-run Canadian system, where physician salaries are limited to what the government will pay in compensation.\"

That seems problematic to both physicians and patients in Canada, if you ask me.

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negitoro
July 4, 2009 5:38 PM
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@Segador: Even though some Canada-trained doctors move to the US, Canada still has nearly the same number of doctors per capita.

Canada's doctors, while limited in compensation, are still very highly paid and respected.

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Julius Seizure
July 4, 2009 3:00 PM
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@Segador: Ah yes, I wondered how long it would take for someone to bring that up.

So, you're happy with a system that allows \"I'm the best kidney person in Miami. I'm doing HIS operation first because he'll pay 20 grand and, if I have time before my tennis game, I'll deign to look at that welfare schmuck dying in the basement somewhere. Lucky they put him near the morgue, eh?\"

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Segador
July 4, 2009 6:01 PM
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@Julius Seizure. (Mourning Mollie Sugden): I'm not saying I'm happy or not with it. I'm just pointing out reality. High-quality physicians will continue to seek work where it pays the highest, like any trained worker.

Also, the vast majority of US doctors, even extremely expensive ones that cater mostly to the \"outpatient elective\" crowd, take medicare patients. It simply makes economic sense - only a small minority of their patients are able to pay out-of-pocket, and in some cases, seeing a % of medicare is a stipulation in their contracts.

However, my disagreement with you is that you seem to have the opinion that medical care is a right, not a service. If that's the case, let the government pay the massive cost of physicians' education, certifications, licensing, and insurance. In many cases, the cost of malpractice insurance alone is 40% of what a doctor makes. (The ridiculousness of our litigious US society is another argument for another time)

I just spoke to a friend of mine who's a physician in Michigan. He informed me that his base cost to perform a certain procedure is around $2500, and when he performs that surgery for medicare, he's reimbursed less than $1900. Now, he could be lying through his tennis-playing, sports-car driving teeth, but that situation doesn't seem \"fair\" to me either.

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Robert Synnott
July 4, 2009 8:07 PM
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@Segador: \"If that's the case, let the government pay the massive cost of physicians' education, certifications, licensing, and insurance. In many cases, the cost of malpractice insurance alone is 40% of what a doctor makes. (The ridiculousness of our litigious US society is another argument for another time)\"

That's more or less what happens in most countries. Third level education is either free or heavily subsidised in European countries (I paid 600 euro a year; if I'd been from a disadvantaged background I'd have been paid to go to college). Doctors who work exclusively in the public system don't require insurance, because if something goes wrong, the state pays (the doctor may still be struck off by the Medical Council after a trial, of course). Those who work in both systems (the most common case in Ireland, which has a peculiar medical setup) have their insurance somewhat subsidised by the state. Those who work exclusively in the private sector get to pay their own insurance (to a non-profit semi-state), which goes some way towards explaining why few doctors work exclusively in private hospitals.

And strangely, even with all of this, all European companies spend a lower percentage of GDP on healthcare (and in many cases, that's a smaller GDP per capita than the US), and all rank better in most international rankings of medical treatment (in large part because preventative care is far more commonly taken advantage of, because it is free or cheap). Go figure, eh?

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Radi0logy
July 4, 2009 2:23 PM
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@Julius Seizure. (Mourning Mollie Sugden): And yet when rich Canadians need advanced medical procedures, they still come to America to do them.. Huh. Go figure...

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Jaynor
July 5, 2009 3:12 PM
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@Radi0logy: I'd like to see some statistics on that that didn't come off of the side of your frosted flakes box.

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mmmsoap
July 4, 2009 6:31 PM
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@Radi0logy:

And yet when rich Canadians need advanced non-critical medical procedures, they still come to America to do them immediately, rather than wait.. Huh. Go figure...

There, I fixed it for you.

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Trai_Dep
July 4, 2009 3:56 PM
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@Radi0logy: Yup. Canadian doctors must make due with rusty harpoons as scalpels and partially used fishnet castoffs as stitches. And Canadian (duh) whiskey as anesthesia. But the cool part is how - by Socialist law - the cardiac surgeons have to shout, \"Ahoy\", \"Ehh?\" or \"Quelle chance!\" before starting any quad-bypass operation.
Uhh, to rephrase: what are you smoking, and can you cite something not paid for by the real pirates: our insurers?

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WarOperationPlanResponse_GitEmSteveDave
July 4, 2009 4:09 PM
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@Trai_Dep: Do they have to wear surgical tooks as part of their scrubs?

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Skin Art Squared
July 4, 2009 2:24 PM
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@Radi0logy: \"And yet when RICH Canadians....\"

You don't see a problem with that statement at all?

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GC
July 4, 2009 2:05 PM
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@Steve Pan: Haha, yeah man, totally. What if we had to treat overweight people as real human beings? That'd be a real hoot.

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WarOperationPlanResponse_GitEmSteveDave
July 4, 2009 1:09 PM
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@Steve Pan: No, but after that comment using an appeal to ignorance, a non-sequitur/straw-man argument, and a little poisoning of the well thrown in for good measure, please, tell us. Do try to keep yourself under two logical fallacies in your response.

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zibby
July 6, 2009 12:27 PM
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@BuyingPowerTools_GitEmSteveDave: Damn. Someone just wrapped their high-school logic course. Glad you resisted the temptation to throw a red herring in there - everybody loves that one.

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DerangedRoleModel
July 4, 2009 1:02 PM
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@Steve Pan: Why is it that every other first world country can have UHC and also have better care and less spending per capita?

Why are we still subservient to corporations that don't give a crap about anything besides the almighty dollar? At least the government is somewhat more accountable than some corporation.

So step back from your shrine to Ronald Reagan and please stop trying to derail anything decent.

(Also, screw most of the Democrats for capitulating to special interests and the Republicans. We need more Kucinichs, Feingolds and Sanders and less Baucuses and Dodds)

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Andrew Farris
July 4, 2009 5:31 PM
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@DerangedRoleModel: Canadians routinely come to the US to get treatment they are being denied. Keep your rosy glasses on about 'every other first world country' friend, you're going to need them if the US ever loses our healthcare system to the gutters like the rest of the world.

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LibraryGeek
July 5, 2009 4:28 PM
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@Andrew Farris:
You do realize that the Canadian system is not the only model right? I think that the province based system is a problem b/c if you live in a poor province your medical care is affected. I heard nightmares from a family that live way up in a northern mining province. They had a child with special needs and the province didn't really have the means to provide the best medical care for her. The town raised funds and they brought her to a specialist in the US. However, we can look at other systems and learn from them rather than doing the old \"see it doesn't work\" maneuver.

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mythago
July 5, 2009 1:04 AM
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@Andrew Farris: No, they routinely don't. But you keep telling yourself that, and wondering why all these imaginary healthcare-denied Canadians aren't fighting to have a wonderful system just like America's.

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Kogenta
July 4, 2009 6:31 PM
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@Andrew Farris: You mean the same way Americans routinely go to Mexico? No healthcare system in the world is perfect. If the US healthcare system crashed, the biggest loss would undoubtly be the ability to do procedures that other countries simply do not have the facilities and/or specialists required to preform them.

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WarOperationPlanResponse_GitEmSteveDave
July 4, 2009 1:58 PM
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@DerangedRoleModel: The government is more accountable? WHAT?! The current administration has made executive orders allowing bonus payouts under the bailout and also pardoned anyone who may have committed torture. And you also suggest that we put our eggs in the basket of a entity that shouldn't care about being viable? So when this entity starts losing money, where will it come from?

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bohemian
July 4, 2009 1:12 PM
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@DerangedRoleModel: You just said everything that was in my head. As someone with a chronic medical condition I am totally fed up not just with the state of health care but the blatant BS spewed by people who are doing nothing but protecting corporate profits at the expense of everyone and their health.

Maybe I am just cranky because I spent 4 hours last month sorting through one of our kids medical bills. I found multiple errors and a fraudlent claim to our insurance.

What really burns me is that drugs are insanely expensive. Drug company profits are coming before theraputic benefit at the clinic level in the way doctors prescribe. Our health insurance is the second most expensive monthly bill only smaller than our mortgage. Yet we still get sunk for a huge chunk of money for out of pocket and medications. The system is a total failure. We don't need reform. We need a new system.

I know it is mean to wish someone has something bad happens to them. But I wish all these idiots spreading disinformation about the current system would fall ill and get to experience it for themselves. It is about the only thing that would wake them up to reality.

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Skin Art Squared
July 4, 2009 1:02 PM
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@Steve Pan: Probably less than the outrageous extortion going on now. Currently, you either pay through the nose to the insurance companies for their \"protection\" (hmmm, the Mob comes to mind here), IF you're lucky enough to be accepted, what with all of your 'prior conditions' and all, (like being born), or you pray nothing ever happens to you because you're facing bankruptcy if you need help.

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prag
July 4, 2009 12:44 PM
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Charge 'em.

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morlo
July 4, 2009 1:05 PM
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Ambulances should really be publicly operated, since government first-responders feed them their patients, government insurance generates most of their revenue, and government subsidized hospitals take the patients off their hands.

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bohemian
July 4, 2009 1:06 PM
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I know a few guys who push that 350 limit because they are really tall and bulky, not fat. Sounds a bit unfair.

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veronykah
July 4, 2009 5:32 PM
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@bohemian: I love the arguments people use...I know someone 8' tall who weighs more than that!
I'm 5'8\" and weigh 360 but its not because I'm fat, I have a lot of muscle and big bones, swear!

GENERALLY speaking if you weigh more than 350 pounds, you are fat. Sorry to break it to you.
I have 2 friends one is 6'7\" one is 6'8\", neither of them weigh over 350, not even close.
I'm 5'11\" and you could DOUBLE my weight and I wouldn't weigh over 350, by a long shot.

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Jaynor
July 5, 2009 3:22 PM
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@veronykah: You sound like someone desperately in need of a Baconator.

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Eyebrows McGee (now with more baby!)
July 4, 2009 2:51 PM
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@bohemian: But they're not being penalized for being fat ... I think you're making the same error the first poster is in wanting a discount for being 130. They're being charged more for requiring extra equipment. If they had a ambulance specially equipped for other particular types of calls, I'd expect those to cost more as well.

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grumpygirl
July 5, 2009 5:16 PM
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@Eyebrows McGee (now with more baby!): Exactly. People are asking where to draw the line? I would say when special equipment has to be purchased.

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mmmsoap
July 4, 2009 6:36 PM
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@Eyebrows McGee (now with more baby!): I'm with you there, but I'm totally against this \"discretion\" policy. I understand there's going to be variability in people's mobility, but if the policy is really about their equipment and stress/damages, then how exactly is it fair to say she doesn't get charged the extra $500, while he might...

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floraposte
July 4, 2009 4:44 PM
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@Eyebrows McGee (now with more baby!): The articles are somewhat unclear, unfortunately, because they make it sound a little like it's an offset for equipment that's always there. I did find one article that suggests they're equipping a special bariatric ambulance and that if you use that (or the special critical care, which is also getting an additional charge, unrelated to weight) the charge will be greater.

I foresee some problems in the classification, but it also seems reasonable to me that different equipment costs different amounts.

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Segador
July 4, 2009 2:47 PM
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@bohemian: The government-mandated attempts to make every aspect of life \"fair\" scares the hell out of me.

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the_wiggle
July 6, 2009 2:13 AM
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@Segador: as they should.

[instruct.westvalley.edu]

Harrison Bergeron by Kurt Vonnegut (1961)

read it.

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bravo369
July 4, 2009 2:20 PM
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@bohemian: i don't have a problem with charging people over 350 lbs. there really is no reason to be that heavy regardless of height or bulk. to compare, i looked up shaq who is 7-1 and 325 lbs. if he is not over the 350 lb mark then there really is no reason for anyone else to be

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katstermonster
July 4, 2009 1:33 PM
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@bohemian: I think that's what they meant by \"use their discretion\" and \"look at length and width.\" There are definitely going to be people who weigh 350 but don't require any special sort of equipment, and they might not be charged. Could all depend on the day and the mood of the paramedics, though...who knows.

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frank64
July 4, 2009 1:27 PM
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@bohemian: The article does say they will take that into account and us discretion when making a decision.

But whatever the reason IF it costs more it is \"fair\" to charge it.

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veg-o-matic
July 4, 2009 1:21 PM
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@Steve Pan: Well, I laughed, anyway.

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Anonymous
July 4, 2009 1:27 PM
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Our daughter cut her hand on a rusty something or other, and we took her to the doctor, who told us to go to the emergency room because she needed a special shot (sorry can't remember exactly what it was called) because her DTaP series wasn't complete. Long story short, we had a three hour wait, she got hurt a couple times by the other little kids who were waiting in the ER, all they did was put a crappy bandage on it, after taking off the beautiful bandage job our doctor had done, and they wouldn't even give her the special shot, because she was too young. Just gave her the DTaP booster. Then they misbilled us for a head injury and SUTURES! Besides feeling utterly stupid after that experience, it only reinforced my belief that 9 times out of ten, the doctor can't do anything more than I can (the only reason they gave us the booster is because she was due for it, not because it would actually help a whole lot. They even said that.) I will never again go to the emergency room unless I absolutely have to. BTW, she was perfectly fine.

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ToddMusket
July 4, 2009 1:47 PM
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As a volunteer firefighter/EMT, I can understand why a private provider would do something like this. There are times when we need to call for manpower assist from an engine crew because of the weight of some patients. We don't charge extra for it, but we're utilizing all volunteer labor in that case.

We've also had to, in one instance, bring our truck to an EMS call(100' platform), cut out the person's 2nd story wall, and use the platform to bring them down to ground level because they no longer fit through their doorways.

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Kesov
July 4, 2009 2:43 PM
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I know I've had issues getting larger folks onto stretchers. To the point where I had one of our old spinal boards make a disturbing 'creaking' noise.

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SpruceStreetPhil - in a new Pine flavor
July 4, 2009 2:27 PM
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@ToddMusket: I hope that person ended up footing their own house repair bills. It's ok to be fat, but when it's a personal choice, their should be consequences to be paid for.

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WarOperationPlanResponse_GitEmSteveDave
July 4, 2009 2:01 PM
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@ToddMusket: I've always wondered how people can get that large. And what I mean by that is that once you cease to be able to leave your house, you should, in theory, be forced to lose weight to a point that you can then leave the house for more food.

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TechnoDestructo
July 4, 2009 9:06 PM
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@BuyingPowerTools_GitEmSteveDave:

While you're pondering that, consider this classic tale of real-life sadness and horror:

[sprott.physics.wisc.edu]

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pyramus
July 4, 2009 2:52 PM
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@WarOperationPlanResponse_GitEmSteveDave: If you get big enough, Kevin Spacey will break in and feed you all you can eat. Of course, then he'll also kick you to death, so there's a downside.

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Skin Art Squared
July 4, 2009 1:53 PM
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@ToddMusket: See, now for unusual circumstances, I don't have a problem with some extra fees being attached to compensate. But I do have a problem with the typical, average, perfectly normal ambulance ride costing thousands of dollars. For what it costs to take the average person to the hospital, they could drive across the entire country, stop for food every hour, stay in a few hotels, and still enjoy a week's vacation.

BTW, thanks for volunteering. You guys don't get enough credit.

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btrotta
July 5, 2009 3:01 AM
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@BZMedia: See my earlier post for an explanation of why that ride is so expensive.

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icantreplyright
July 4, 2009 1:49 PM
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I think this is more than fair. You want to be fat, you pay for it.

I would like to know why fat people think it is okay to make \"Thin\" comments to me (being 125 lbs). Fat people telling me \"you need to eat more\" is deemed to be fair game. But if I say \"Stop eating that, lard ass\" people get angry. I am healthy. They are not. Why the double standard?

HAPPY 4th!

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farmerjeanh
July 5, 2009 8:23 PM
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@icantreplyright:


Given your very,very high risk of osteo as a thin runner, what about heavy folks paying extra for the hip fracture you're almost certainly going to get in your 60's? Your spinal compression fractures? That joint replacement surgery in your 50's because you've blown your knees? The long term effects of the kidney, intestinal and pancreatic damage you sustain during a marathon?
many lifestyle choices come with downsides.

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Mari Walker
July 4, 2009 6:59 PM
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@icantreplyright: I am fat. I do not want to be fat. It's not as simple as \"I don't want to wear this shirt.\"

As for the comments people make about your weight (also, thin and healthy are not the same thing. McDonald's is bad for everyone)? Maybe you need to examine the way you treat other people. Karma's a bitch.

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XBL: Legend xKWx (Kyle)
July 5, 2009 4:15 AM
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@Mari Walker: However it is as simple as, Hey I'm fat and this is really unhealthy and could very well haunt me later in life, maybe, just maybe I should go speak to a doctor or nutritionist and maybe work out a plan for me to be able to lose some of this weight. And yes Karma is a bitch, what icantreplyright was saying is that larger people shouldn't make jokes about someone being skinny(healthy) just because they aren't. If some 400 lb person told me to eat more, I would tell them I am quite happy being 6 feet tall and 150 lbs and that maybe they should be watching what they're doing and not worrying about other people. And I would call 125 a healthy weight for a lot of people

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LostTurntable
July 4, 2009 3:47 PM
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@icantreplyright: I'm 6'6'' 330 pounds. When I was born I weighed over 12 pounds, I work out 5 days a week and lift weights. I got a gut on me but I'm probably more muscular than you. It is very hard for me to loose fat, while my friend who is the same height as me weighs 160 and can eat Ho-Hos all day and not gain weight.

Shut up.

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negitoro
July 4, 2009 5:18 PM
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@LostTurntable: To be fair, you and your friend are extreme examples. And you probably weigh more simply because of the muscles.

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Anonymous
July 4, 2009 2:45 PM
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@icantreplyright:


Why don't YOU gain some weight? Clearly, you are making a conscious decision to be that skinny. It probably isn't healthy to be that skinny- some fat is necessary for the body. So I really think that you should gain some weight and stop being so skinny. Eat some more! Clearly, the only reason you are skinny is because it is a personal choice.

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GC
July 4, 2009 2:07 PM
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@icantreplyright: What the hell do you mean 'want to be fat'? Being fat is not a conscious decision.

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razremytuxbuddy
July 4, 2009 2:43 PM
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@GC: Except for extremely rare cases, it certainly is a conscious decision to eat more and not take care of yourself. Worse, it's a conscious decision, and an inexcusable one, to raise children in that lifestyle.

As another person considered small by today's standards, I'm shocked when someone puts me down for that, and scoffs at the fact that I'm a runner. Somehow those good habits have gone from being admired to being resented as making obese people feel bad about themselves.

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floraposte
July 4, 2009 4:46 PM
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@razremytuxbuddy: Thing is, the scientists who work in overeating and hunger don't actually see it the way you do. And I think they're likely to know more about it than anonymous internet posters.

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razremytuxbuddy
July 4, 2009 5:11 PM
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@floraposte: Unless the anonymous internet poster has a background in nutrition and food science, maybe? As a nutrition student, I once listened to a scientist from Frito-Lay describe how he \"determined\" that bag of potato chips is healthier for you than an apple.

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DesignerToast
July 4, 2009 4:17 PM
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@razremytuxbuddy:

I was resented by some previous overweight roommates for this. Always scoffing when I got up early to run or didn't go on the late night McDonald's runs. Even more fun was when people complemented me on my figure they'd say \"Oh she's so lucky, she doesn't have to do anything to be thin\". Excuse me?!

But on the subject of this article, I think it's completely fair. If you need extra services because of your large size you should have to pay for it.

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Charlotte Rae's Web
July 4, 2009 3:16 PM
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@razremytuxbuddy: So because I\"m fat, I'm automatically a bad parent? Ridiculous.

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Englishee Teacher
July 5, 2009 4:29 AM
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@Charlotte Rae's Web: Nice paraphrasing.

Raz said that it's inexcusable to raise a child in that \"eat more and not take care of yourself\" lifestyle. Not that fat people are bad parents.

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Skin Art Squared
July 4, 2009 2:58 PM
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@razremytuxbuddy: \"As another person considered small by today's standards, I'm shocked when someone puts me down for that, and scoffs at the fact that I'm a runner. Somehow those good habits have gone from being admired to being resented as making obese people feel bad about themselves.\"

You know, there was a long period of time when being obese was in fashion and admired, because it meant you had money. I'm sure there were people then that resented the fat people.

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razremytuxbuddy
July 4, 2009 3:12 PM
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@BZMedia: I'm not THAT thin. And the \"attractive\" fat people of 200 years ago were not obese by today's standards. Ironically, whenever I put on a few extra pounds I'm probably closer in size to the attractive person of 200 years ago. That is how much our perspective has been skewed by today's obesity explosion.

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Segador
July 4, 2009 2:41 PM
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@GC: You'd be hard-pressed to argue your opinion logically. I'm a tad big for my height, and do you know why that is? (Hint- I'm not \"big-boned\", nor do I have \"bad genes\".)

It's because I eat too much and don't work out enough! Ding Ding Ding!

Both of those are conscious decisions I've made.

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mmmsoap
July 4, 2009 6:42 PM
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@Segador:

It's because I eat too much and don't work out enough! Ding Ding Ding!

Both of those are conscious decisions I've made.

Really? You look at a plate of food, and you're all \"Gee, I guess I'm going to have to force it down, to make sure I keep my spare tire!\"

I think it's a lot more accurate to say that eating too much is an unconscious decision. Yes, it's one that people need to take ownership of, which is hard. It's like an addiction, I think. The same way smokers unconsciously reach for another cigarette, overeaters unconsciously keep reaching for more food.

And I think you'll find that the vast majority of people hate themselves for it.

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Kevin Wolf
July 4, 2009 6:49 PM
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@mmmsoap: Put down the fork. I'm fat, but I'm fat and happy. If you hate yourself, do something about it instead of self pity!

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I Love New Jersey
July 4, 2009 1:53 PM
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Why not just use a flatbed pickup.

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I Love New Jersey
July 4, 2009 2:00 PM
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@BZMedia: Well that is because the any hospital that takes one cent of any sort of federal funds has to treat people who can't pay. So who is to blame, you guessed it - the fools in Washington who want to solve the problem they created by making an even worse one.

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Skin Art Squared
July 4, 2009 2:01 PM
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@I Love New Jersey: So then I should just refuse to pay the next time I go. The gov will pick it up.

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the_wiggle
July 6, 2009 1:52 AM
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@BuyingPowerTools_GitEmSteveDave: and don't mind having your credit destroyed for the rest of your life.

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Skin Art Squared
July 4, 2009 2:21 PM
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@WarOperationPlanResponse_GitEmSteveDave: \"As long as you can't afford it, yes.\"

Yeah, I tried that. Because I didn't exactly have $10k in my budget for unplanned trip to the hospital. They don't care. You get billed, rebilled, and sent to collections. Just like anything else. At no point did anyone ask me \"can you afford this?\"

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Skin Art Squared
July 4, 2009 2:08 PM
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Another misconception is that you can't be forced to take an ambulance. Completely untrue. You can, you will, and you'll be billed for it.

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padams89
July 4, 2009 2:53 PM
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@BZMedia: You can be forced to take an ambulance but only under certain, very specific circumstances:

1: You are clearly under the influence of drugs or alcohol. This generally requires a consult with a ER Physician before we are permitted to compel a patient.

2:You are a threat to yourself or others as determined by the ambulance crew, police officers, or ER physician based upon a call made by the ambulance crew.

3: You have a significant head injury, are not completely alert and oriented (person, place, time, event).

In the ambulance I volunteer for we are required to contact online medical command (ER physician by phone) before compelling a patient.

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Skin Art Squared
July 4, 2009 3:18 PM
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@padams89: Even if all three of those applied at the same time, if you decline medical attention, it should be honored. And if you are still forced to comply after declining, you should not be billed for it.

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mmmsoap
July 4, 2009 6:46 PM
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@BZMedia: If you decline medical attention, but you are in an \"altered state\" of some sort (either substance or injury related) where you could be considered to be not making rational decisions, then the EMTs are required to make the decision based on what a rational persion would decide (ie -- give care.)

You have the right to give (or withhold) consent, until you are unable to do so, and then the default goes to consent for treatment.

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Trai_Dep
July 4, 2009 4:28 PM
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@BZMedia: Err, no. Not if you're judged of not sound mind and body.
I catch a grievous head wound then start dizzily insisting I'm fine - FINE DAMN IT! - in front of a crowd of EMT personnel, they'll apply their professional expertise, then quickly tase, tranq and throw me down all WWE style, before netting me up and carting my non-compliant, bleeding bod down to General.
And the next week, I'll send 'em a keg of beer and more pizza than is healthy for them to eat.

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Bathmat
July 4, 2009 6:32 PM
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@padams89: My ex called 911 on me because she believed I was suicidal. A brief conversation with the EMT crew revealed, at least to them, that while I was angry and frustrated, I wasn't suicidal.

Too bad! I got a ride to the hospital, which left me alone in a silent room with nothing to do for 2 hours (talk about going crazy...), regardless of my actual mental state. The hospital subsequently sent me home with no treatment.

Cost for driving me less than a mile to a hospital down the block: 800 dollars. I seriously considered billing my ex for that crap.

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padams89
July 4, 2009 8:30 PM
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@Bathmat: In almost all psych (or potential psych, such as yours) cases online medical command will order EMTs to take the patient to the hospital for examination. Additionally a police officer can 302 (involuntarily committ) someone on a psych call if (s)he believe the patient is a threat to himself or others. Under both of these circumstances, the EMTs are required by law to bring the patient to the hospital.

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dahlink_natasha
July 4, 2009 4:25 PM
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@BZMedia: Wow, you really don't want the EMT's to follow the rules that were laid down to keep people safe, do you?


I remember when Liam Neeson's wife died and there were people saying that the EMTs should have taken her to the hospital after she refused, because she ended up dying anyway. If the patient ends up being OK, the idiot, meddling, overcharging EMTs should have minded their own business. If the patient ends up dying, then those lazy bums didn't do their jobs.


/wife of an EMT.

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dougp26364
July 4, 2009 2:21 PM
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The sad part is, they might charge this but, for most it will never be a fee that is never collected. I just don't see state wellfare or Medicare paying for the extra charge and I doubt many of these patients have the ability to pay. The ambulance service is compelled to transport regardless of ability to pay and, the hospital is compelled to care for these patients regardless of ability to pay. So good luck collecting this extra fee. I don't see the insurance company, state wellfare or Medicare paying regardless of what the service wants to charge.

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riverstyxxx
July 7, 2009 4:54 PM
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@dougp26364: This is the realistic truth of the whole matter, and a fair example of why health care is somewhat poorly managed. They can charge anything they want, but actually getting people to pay is another matter. The most they can do is send you bills and call you every month until the end of time.
And I'll be honest, I have hospital and ambulance bills that are unpaid, something like 5,000$ is a good estimate. I haven't worked in several years and even then would not have the means to pay those bills.

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Radi0logy
July 4, 2009 2:24 PM
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I think if I ever need to go to the emergency room I'll call a taxi. Should take roughly the same amount of time.

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Trai_Dep
July 4, 2009 4:33 PM
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@Radi0logy: True. And the taxicab guy is awesome at restarting your heart if it stops halfway. Especially if he's seen Pulp Fiction. Although, depending on the cabbie, it's quite possible he has better drugs. And definitely at a better price.

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padams89
July 4, 2009 2:54 PM
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@Radi0logy: Very true. Multiple studies have shown that going to the hospital using lights and sirens cuts only 1-2 minutes off of the average transport time.

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xjeyne
July 4, 2009 2:45 PM
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I think this article should read \"if you're morbidly obese, it's going to cost an extra $543.\" I think it's fair.

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ecwis
July 4, 2009 4:35 PM
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@xjeyne: Seriously. Since when is 350 lbs classified as just \"overweight?\" Unless one is abnormally tall (6'10\" or so), then 350 lbs is morbidly obese.

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hills
July 4, 2009 2:47 PM
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Fair.

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msgfree
July 4, 2009 2:50 PM
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I am an EMT for a company that does MES transports in L.A. County and to be frank, I'm surprised this isn't more common. I know my company doesn't charge if a person is obese. I feel the charge is justified because for large patients we require additional resources for lifting and moving the patient.
Just because a standard Stryker gurney is rated for 500 lbs, don't automatically assume that a person weighing 450 lbs will fit on said gurney (they have a fixed width.)

As for the \"outrageous\" billing mentioned above, in the area my company serves, we collect the total amount billed on approximately 1/3 of our calls, another 1/3 we collect nothing (typically because the patient has no insurace and cannot afford the bill) and on the last 1/3 we only collect >10% of the billed amount from Medi-Cal/Medicare patients because those programs will only pay an amount that they have set, regardless of what we bill. As unfair as it may be, the high cost of treatment and transport is used to cover the losses from the unpaid and Medi/Medi patients.

Our company charges per mile but the first 4 are already included in the bill, so anything longer than 4 miles begins to incur an additional fee. I don't know how other companies operate but maybe this will shed some light on the matter from the ambulance companies perspective.

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frank64
July 4, 2009 4:18 PM
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@msgfree: So if we didn't have to pay for the 2 out of 3 people who don't pay or only pay a fraction, our bill would be 2/3 less?

You see, a $1000 bill looks much better at $333.

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frank64
July 4, 2009 5:37 PM
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@frank64: See if there was a way we could all be charged the $333(as an example) and not the $1000 it would be easier to pay and maybe there would be a higher pay rate.

If the government paid for the outstanding balances and then went after the non-payers with their collection power(like the IRS and Sallie) there could be lower costs for all. This method would mean most would be able to pay the much lower costs and those that couldn't would not have such a big bill and could pay the Federal Gov slow enough to make it palatable. Not THEE answer but a start.

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Torabo
July 7, 2009 11:44 AM
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@frank64:
You do realize people who can't pay CAN'T PAY. Its not like ambulance services or hospitals don't have collection agencies available to them either. You just can't get money out of people that literally can't pay. The result would then be that the government recovers the extra costs from taxes, and you get billed higher costs anyway, except this time you end up paying even if you never used the ambulance.

So the other option would be to blame the government for mandating that ambulances are required to transport regardless of ability to pay then?

Though get ready because a dozen welfare or human rights groups or whatever will go all rabid on you if you say this :P

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Segador
July 4, 2009 2:53 PM
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This is totally unfair! Not only should the government cover the cost for obese patients, it should also pay to feed them an \"obese\" diet in the hospital. These people can't help it if they need to eat more! It's a disease. No one's fault.

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frank64
July 4, 2009 4:24 PM
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@DerangedRoleModel: It really is what is explicitly stated in many social issues. When teen pregnancy, dropping out of school, drug use and minorities in jail is all proof of how life is unfair, and not proof that if you are irresponsible bad things will happen.

The excuses we make and it not being PC to state the obvious are all contributing factors to our society not being able to deal with these situations.

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bumpducks
July 4, 2009 3:08 PM
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I think it's completely fair- some of these morbidly obese patients are too large to move themselves more than a few feet. I feel bad for EMT's and nurses that have to lift and support these patients, putting themselves at risk for sprains, strains and other injuries. Those extra (one, two, ten?) people you call in to properly lift an obese person? they want to get paid too.

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QquegChristian
July 4, 2009 3:36 PM
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As someone whose lived the last few years at the low end of the middle class... I see more and more benefits to just make a few less thousand dollars a year and live off the government's dime.

I could get a low income apartment almost identical to my normal income apartment. Medicare with all the free ambulance rides I can eat. My wife and I could have a baby for free. Then we could feed it for free.

Trust me, I'm not saying it's a glamorous life... but I find it truly disappointing that I could have something so innocuous as a broken bone happen to me and almost go bankrupt. A few broken and I probably would. The crazy thing would be that the $10,000 hospital bill subtracted from my income would actually make me eligible for Medicare. So I end up with less of an income after that than the people actually on Medicare?

Last year, my wife and I couldn't afford to have a baby and our job did not offer health insurance. Outside of our job is a little more complicated because of pre-existing conditions (asthma that hasn't shown symptoms in 15 years!) Yet a hostess at our serving job has no problem having 2 babies back to back, because she makes very little money. After that, of course she needs more money to support them, so she moves up to server. She now shares the same income as us... but had her kids for free?

So when we pay through the nose for the insurance to have a baby, I'll think about that one comment up above that said that they have to inflate prices to make up for how little they get from Medicare.

At least I don't work in a friggin' restaurant anymore.

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corinthos
July 4, 2009 7:13 PM
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@QquegChristian: Agreed. I know a person who's lwo income housing provides basic cable and internet. Only thing she pays is an electric bill and like 45 a month which her baby daddy's child support takes care of. I think thats how I'll retire. I'll just keep saving cash in a safe and then quit my job and go part time and live on the governments dime.

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Clobberella
July 4, 2009 7:12 PM
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@QquegChristian: It's not just a matter of being poor. When I was about 19, I worked at a grocery store and made $6/hour (85 cents above min. wage then, I think). I had lived with a roommate for a while, but she moved out and I couldn't afford the rent on my own. After looking around for another place I realized I really couldn't afford any rent on my own, so I looked into subsidized housing. I went to the only such apt. complex in my town and handed my application to the lady in the office. She glanced at it and said, \"You don't have any children. Are you pregnant?\" When I said no, she replied, \"That's too bad. We could have gotten you in if you were pregnant.\" I've gotten pretty much the same response trying to apply for Medicaid. So I have a feeling that your hostess friend may well have gotten pregnant and then qualified for assistance, in that order. They don't really seem to care much about poor people without children, which I think is really, really funny. The stereotypical welfare poster child is generally a single mom with about twelve children. People look down on such a person for being so irresponsible as to have so many children and then they, the taxpayer must pay for her and her brood-- But ultimately I think it's entirely possible that that person may have that many children precisely because that was the only way to get assistance. She was merely being practical. This is why the system doesn't work, because the system discourages responsibility.

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the_wiggle
July 6, 2009 2:21 AM
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@Clobberella: in plenty of cases, you are so right.

when young & dead broke (2 jobs each & full time school each), my husband & i were having a helluva a time keeping food on the table. we choked down our pride & went to DES for food stamps. same song & dance - you pregnant? too bad. if you were here's a list of all we can do for you.

how can that be justified? i mean there we were - stating we can't feed ourselves and being told to have a kid?!?!?!?!

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Torabo
July 7, 2009 11:51 AM
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@the_wiggle:
This is the end result of having to be PC or having a dozen rabid rights groups going at your throat. As a society we are afraid of speaking out about issues due to a fear of not being PC and being looked down upon. The end result is a system that rewards those at the very top or those at the very bottom. Those in the middle clump will just have to foot the bills.

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Woodside Park Bob
July 4, 2009 3:39 PM
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Ambulance service should be a tax-supported public safety service like police and fire, not a private, for-profit, operation. We'd all save money because paying for ambulance service through taxes would be cheaper than paying for it and profit and overhead through insurance premiums and subsidies for the uninsured.

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QquegChristian
July 4, 2009 3:41 PM
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Oh and as a man who used to be super obese, but now weighs 145 pounds, I see no problem in any of these kinds of stories. Personally, I do think $600 more is a little ridiculous, but hospitals have a broken calculator that adds a 0 to the end of all prices, so I guess it's normal.

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TechnoDestructo
July 4, 2009 9:07 PM
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@QquegChristian:

There's nothing like an ex-anything to bring out the hatred against anything. Ex-fat guy, ex-smoker, ex-catholic, ex-mormon, ex-LARPer...anything.

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QquegChristian
July 4, 2009 3:45 PM
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And anybody that thinks this country's healthcare isn't entirely screwed up... Disney had mass layoffs a few months ago and fired hundreds of people including my mother-in-law, a manager there for 17 years... fired her right as she is about to go into her second round of chemo for stage 3c ovarian cancer. Her health insurance now runs out in one month.

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RedwoodFlyer
July 5, 2009 2:06 AM
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@frank64: You can bet that insurance companies do whatever it takes to keep costs down... it's in their best interest after all.

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frank64
July 5, 2009 4:50 AM
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@RedwoodFlyer: I think they try to to some degree. But they are more concerned with their income of course than our cost. They my find it easier to pay for something that cost them overall 1 million dollars and then add $30 spread out in our policies. The higher overall medical costs, the more they can make because they can charge a certain percentage over costs.

It is the spreading out of individual costs that in each instance don't mean much but taken as a whole end up costing us more. I think if drug companies and medical equipment manufacturers had to ask individuals to pay without insurance companies the dynamics would be much different and they would not be able to charge as much as they due. It is not a conspiracy, but it has the same effect, as they all benefit from the market the way it is- to all our detriment(as long as we are not a part of the industry!)

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mrsultana can't get a password to work
July 4, 2009 3:59 PM
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As an ED nurse and former paramedic, I could tell you some stories about morbidly obese patients. For example, a 975 pound patient had to be brought in one morning and they ended up having to use a pallet jack and a lift 'n' carry tow truck! My county and the private ambulance companies cannot afford the newer equipment. The hospital had to be reworked to accommodate bariatric patients so that certain rooms had 1000 lbs lifts and special bathrooms that the lifts could transport them to. (You should see the size of the toilets!)
All of this costs a whole bunch of money. Not only because of the increased costs for treating obese people, but because of the people who just don't pay.
See, the problem I have with people who don't work in the health care field is that many will say ignorant things (my mom is guilty of this) like, \"If you think health care is expensive now, wait until it is free.\" Unfortunately, we already have a universal health care system, but more expensive than if it was official. A poor or illegal immigrant person will come into my ED, get the same excellent treatment as everyone else, get the bill, and not pay it. Guess who pays for their visit? ALL OF US! Higher costs and more oversight and bureaucracy! The two step process to cutting health care costs is to make sure everyone is paying (single payer or universal coverage) and putting an end to illegal immigration.

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frank64
July 4, 2009 5:31 PM
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@mrsultana: My concern is that one of the reason for our health costs issues is that it is costs are already \"hidden\" from us. What I mean is that insurance and federal programs have already taken away any incentive for hospitals, drug and medical equipment companies to keep costs down. It really is a blank check already. I think any government program is just going to make it worse.

On the other end of the spectrum I do see a real problem with the current situation. When a person gets dropped by their insurance company because they get sick we have a real problem.

I think one course for at least the middle class is concerned is make it affordable for normal care to be out of pocket and allow for a catastrophic policy. When I went for a cut finger it costs around $600 dollars(I didn't even need stitches)because I didn't have insurance. If I had insurance the clinic would have charged around 200. I need insurance just to not get screwed.

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dahlink_natasha
July 4, 2009 4:30 PM
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@mrsultana: agreed. I'm sick of people blaming the EMTs and other first responders who are in the business of saving lives and trying to do their jobs for the state of health care.

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Grrrrrrr, now with two buns made of bacon.
July 4, 2009 4:29 PM
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They should just let all the fat people die.

There, no more obesity problem.

(/sarcasm)

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Rugbydan
July 4, 2009 4:29 PM
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I'm 6'5\" and 340 lbs. and I am totally okay with this. If they need special equipment for huge people, so be it. Charge their asses, if you don't like the charge, lose some weight.

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PsiCop
July 4, 2009 4:40 PM
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I have less of a problem with the added charge for bariatric patients, than I have with the idea that it will not be charged for Medicare/Medicaid patients, thus all the other bariatric patients with private insurance must be charged enough to overcome that. This artificially drives up insurance premiums, because insurance companies are together subsidizing Medicare/Medicaid patients who are not their policy holders.

Note, this is not only the case with this added bariatric-patient charge. It happens with virtually every other healthcare procedure. In virtually all cases, Medicare/Medicaid pays healthcare providers MUCH less than they would otherwise charge ... and all of that is made up elsewhere by other patients and, usually, their insurance companies.

It's a form of cost-passing which is making healthcare financing more inefficient, and thus more costly for those actually paying the bills, than it needs to be. If it costs more to move a bariatric patient, then it costs more to do it ... period ... and that cost does not change based on who pays his/her bill. So why do we bill for it as though it does matter?

The system is broken. The sooner we admit that, the sooner we can find a way to mend it.

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TechnoDestructo
July 4, 2009 9:11 PM
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@PsiCop:

The cost-passing goes both ways. Medicare covers people private health insurers won't touch (the elderly...well, they won't touch them unless they're subsidized by medicare) because they cost too much. Basically the private health insurers cherry-pick the lowest-cost customers, passing costs onto the government, who then pass costs back to the private health insurers.

You're right about what the problem is, but I think you were giving the impression that it only goes one way.

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PsiCop
July 5, 2009 2:39 PM
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@TechnoDestructo: The solution is a simple one, then ... have Medicare/Medicaid fully pay for their patients' care. This will drive down the cost for other patients, making their care more affordable.

But that will never happen, because that would make healthcare more affordable for everyone. It might mean people are less dependent on health insurance or government programs, and would give government officials and pundits less to fight over. The Left doesn't want it, because what they want is to build as large a constituency as possible which is dependent on government largesse. The Right doesn't want it, because they won't be able to use the fear of \"socialized medicine\" like a firebrand to keep their rabid followers in line.

So long as we're locked into the false dilemma of \"keep things as they are, or socialize healthcare,\" nothing will improve. The REAL solution, as I said, is to do NEITHER ONE. It is, instead, to LOWER THE COST OF HEALTHCARE.

By all means, let's keep up the fallacious \"black and white\" thinking. Let's all purposely avoid seeing the (potentially many) alternatives.

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JiminyChristmas
July 5, 2009 6:05 AM
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@TechnoDestructo: You make a point that I often like to make as well. If not for the government, private health insurance could not exist as a profitable business. If private insurers didn't have Medicare to take care of the elderly and disabled and Medicaid to take care of the very poor their business would have imploded 30 years ago.

Another bizarre cost-shifting method is what is charged to the uninsured compared to other patients. Thinking of two medical bills I have faced over the past few years: In one case the provider's 'retail' charge was $1400 and the negotiated insurance rate was $450. In another case, 'retail' was $2250 and the insurance paid $880.

So, in both of these cases the provider agreed to perform a service for the insurer for at least 60% less than their 'list' price. Since these are negotiated rates I'm assuming the providers aren't losing money on the deal. Meanwhile, I can't think of a better way to herd the working poor and lower middle class uninsured into personal bankruptcy.

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TechnoDestructo
July 5, 2009 8:20 AM
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@JiminyChristmas:

Nothing keeps the middle class (shrinking as it is) in line like torturing the poor.

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Cant_stop_the_rock
July 4, 2009 4:47 PM
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Lol winches

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Crim Law Geek
July 4, 2009 5:11 PM
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I remember when I was an active EMT we had a patient who weighed 400 lbs, which is generally fine because our stretcher topped out at 600 lbs. The problem was this lady was only like 4'11\", so she was literally 4'x4'x4', far too wide for the non-bari stretcher.

The bari equipment is not cheap in any ways, there is increased risk to EMT's carrying a bari patient, and generally they require additional manpower to load, unload, etc. I think it's fair to charge these patients more.

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JulesNoctambule
July 4, 2009 5:31 PM
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@Steve Pan: Yeah, look at how they're all suffering from all that Marxist health care over in western Europe and Scandinavia!

. . .oh, wait.

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lilspooky
July 4, 2009 6:04 PM
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I think all health care in the US should be FREE!

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TechnoDestructo
July 4, 2009 8:46 PM
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@lilspooky:

If it meant fewer people had diabetes go untreated, there would be fewer 350 pound people to begin with. (Being fat doesn't just increase your risk of being diabetic...being diabetic can make you fat.)

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padams89
July 4, 2009 10:27 PM
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@TechnoDestructo: I'd love to hear your plan for making that happen.

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Anonymous
July 4, 2009 6:19 PM
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As a Paramedic I can honestly say that these fees are warranted and make sense. When a patient pushes the 350-400lb mark the responding crew is faced with several challenges.

Firstly, while most stretchers are rated to 500lbs they are far too narrow for a large patient to comfortably sit on. This is where the oversized or bariatric stretchers come in as well as winch systems.

Secondly, when faced with a large person the amount of manpower needed can easily rise from 2 to 6-8 personnel. In order to safely lift and extricate a larger person from their home (and it's always inevitably the back room of a home with small corridors) an ambulance crew typically has to enlist the help of the Fire Department. In some municipalities the FD is unwilling to help and therefore a second (or sometimes) third ambulance must be summoned to assist in safely moving the patient.

Lastly, there is the human cost. I treat all of my patients with dignity and would never discriminate on the basis of weight, race, or even a sour attitude. However, it is a fact that moving large patients greatly increases the chance of injury for the caregiver. It makes sense that attempting to take a 500lb patient down stairs and through their yard greatly amps up the chances of a back/knee/other injury. These injuries cost EMS systems millions of dollars a year. If a paramedic blows their back out it is typically the end for them. The system they work for therefore is on the hook for rehabilitation as well as disability in attempting to find that person a job with less demanding physical requirements. I would like to see this overweight patient charge put into a fun that would be used to assist medics who are injured in the course of performing their daily functions.

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verdegrrl
July 4, 2009 6:53 PM
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Many of the people who go bankrupt from medical expenses in the US have health insurance.

As for charging overweight people extra for the extra services they require, that seems fair enough. If you're going to charge individually for medical care, then it should be based on the individual.

Given that most of the rest of the world manages to be skinnier, America is either somehow the land for the people with fat genes, or they have developed some really bad habits they themselves are responsible for correcting.

Maybe health care should be free for those who pursue a healthy lifestyle (determined via checkups and blood samples), or have a proven disease or genetic condition, while those who choose to smoke, gain weight, or do other things to their bodies that are unhealthy, should be billed for insurance on a gradually increasing scale depending on risk factor. You're never going to be totally fair, and people are going to try and con the system, but it might provide some incentive. If the money is deducted from their paycheck, then they can't dodge the issue - unless they are unemployed. In which case they are automatically enrolled in a \"volunteer\" position. Which leads to another topic for another time.

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TechnoDestructo
July 4, 2009 8:49 PM
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@fembot:

We have developed some really unhealthy infrastructure that individuals CANNOT correct. There is not enough room for everyone to live in the few walkable cities the US has, and the fact that people continue to live in places like Phoenix is taken by developers as a cue that there is continued demand for such places.

That that's only considering people who aren't limited by their jobs in where they can live.

The single worst thing about the American lifestyle is NOT a matter of personal choice. Blame the Streetcar Conspiracy and Eisenhower.

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Mari Walker
July 4, 2009 7:12 PM
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@fembot: Yeah, then you'll get to the point where \"unhealthy\" people can't afford medical treatment for their \"unhealthy habits.\" Yes, please, help perpetuate the nasty cycles that got them started in the first place!

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verdegrrl
July 4, 2009 9:32 PM
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@Mari Walker: Yeah, then you'll get to the point where \"unhealthy\" people can't afford medical treatment for their \"unhealthy habits.\" Yes, please, help perpetuate the nasty cycles that got them started in the first place! -

Drinking, smoking, and eating to excess all tend to cost (more) money to the individual and the system.

If you reread what i said, people with inherent health problems would be automatically covered as would the healthy. It's those who *choose* an every day lifestyle that places them at risk they might not otherwise experience, that should bear some responsibility for the extra cost they impose on the system.

If the person imposing extra risk to themselves and paying into the system falls ill, they have at least gone some way to mitigating the costs.

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lockdog
July 4, 2009 7:10 PM
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@fembot: My guess is that when we finally do have a universal healthcare system of some sort you will see this happen. Not so much in the form of bills, but probably as sin taxes on junk food and alcohol, and a lowering of agricultural subsidies to corn growers (the subsidized costs of HF corn syrup are often blamed as being a key ingredient in the obesity epidemic). A friend and I were talking the other day about several states that had recently gotten rid of their helmet laws for motorcyclists. He guessed that as soon as the state was paying the full costs of their care those laws would come back in a hurry. My theory is that without a helmet in a motorcycle wreck you die, which is a heck of a lot cheaper than patching you back together if the helmet managed to keep your brain all in one piece.

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TechnoDestructo
July 4, 2009 8:40 PM
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A tow truck only costs a fraction of that.

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MasterShazbot
July 4, 2009 8:48 PM
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Having never need an ambulance I had to check with a friend who's a paramedic, but in Ontario an ambulance ride has a $50 admin charge that you have to pay the hospital. They mail you a polite letter asking to pay, and if you ignore it, they don't send you to collections. As for hospital treatment levels, a couple years ago I went to the ER with some food lodged in my throat, I could breath but it was laboured. In my 5 hour stay, I saw a general practioner and a gastro-intestial specialist (who was at home on call), received x-rays, an ultrasound and had a camera shoved up my nose (about as pleasant as it sounds). Total bill $0.00, bash Canada's health care all you want, but it works just fine.

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yevarechecha
July 5, 2009 5:11 AM
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@MasterShazbot: For comparison's sake, this exact thing happened to a friend of mine a few months ago, in the US. Food lodged in her throat, not choking, but couldn't swallow it or cough it out. She had to go to 2 different hospitals. She did not get the x-rays, ultrasound, or endoscope you mentioned. They just sedated her and went in there with forceps to pull the chunk of meat out.

Cost: $20,000. Yes. Twenty. Thousand. Dollars. If she had been uninsured, that would have been it for her financially, at age 22. As it were, she was stuck for a few thousand. I had to pick my jaw up off the floor when she told me the cost.

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theblackdog
July 6, 2009 3:05 PM
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@yevarechecha: Okay, that's screwed up, I had to have my appendix out and stay overnight, and it would have cost me $12,000 if I didn't have insurance.

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frank64
July 4, 2009 9:25 PM
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@MasterShazbot: Your experiences are different from others I have heard from Canada.

But many Canadians complain about the cost of buying things because of the high tax. You may think it is a fair trade-off- but there is a cost.

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MasterShazbot
July 5, 2009 6:17 AM
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@frank64: Another example of the medical system up here... I threw my back out and could barely move, getting to the bathroom was difficult enough... getting to a clinic would be impossible. I made a quick call, explained the situation. A couple hours later a doctor came TO MY HOME, assessed me and perscribed some really good drugs. Again, completely covered by Ontario Health.

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MasterShazbot
July 5, 2009 6:12 AM
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@frank64: Just go to Alberta, no provincial sales tax. And generally, the high cost here has more to do with the exchange rate than taxes

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mizmoose
July 4, 2009 10:02 PM
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Once again, Consumerist turns into that other web site with the F name as the bigotry runs free. How dare fat people demand competent health treatment, they don't deserve it! If Famous Person isn't over 350 lbs, nobody else should be! Fat people choose to be that way, everyone knows they eat more than everyone else and live on junk food and twinkies!

If people posted here insisting that all black people eat watermelon or every gay person spreads AIDS, they'd be disemvoweled and/or banned from the site. Way to go, Consumerist. Another fat-people bashing fest is yours.

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RedwoodFlyer
July 5, 2009 2:09 AM
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@mizmoose: It would be more like saying that Consumerist posted a story about Smokers being charged more for health insurance. Higher risk = higher cost that has to be absorbed somewhere.

And statistically, homosexuals DO have a much higher rate of AIDS/HIV infections per capita

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frank64
July 4, 2009 11:25 PM
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I think it is more that a person needs to pay for what it costs, that whatever reason you cost a business more than normal it is OK for a business to charge it. Your rights don't go as far to impose them on others.

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mythago
July 5, 2009 1:03 AM
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@Radi0logy: Are these mythical rich Canadians hitching rides with Reagan's mythical welfare queens?

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CompyPaq
July 5, 2009 1:58 AM
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I am a volunteer with a First Aid Sqaud and while the cot may support 500 pounds, usually, that is in the lowest position and our backs can't support that much. Taking a large patient puts alot of strain on us and our equipment and often forces us to call for additional man power.

BTW, it does cost quite a bit to roll and ambulance and run an IV, not to mention the costs of the health-care providers insurance and training.

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zekebullseye
July 5, 2009 11:57 AM
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I agree. More manpower, risk and equipment should mean more cost.

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clarkbarr
July 5, 2009 8:55 PM
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Funny how my Canadian friends never have a problem getting the health care they need in Canada.

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George Gilliam
July 5, 2009 11:03 PM
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This is robbery in the first degree. Simple.

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btrotta
July 6, 2009 1:22 AM
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@George Gilliam: It's only robbery if you don't know, or understand, the costs involved in caring for these patients.

The upcharge is cost recovery. Period. If you haven't noticed, America is getting fatter. And ambulance services have to equip and staff for those people. We routinely pick up people who are over 500 pounds. Two people can't lift that much, so that means you have to take two trucks out of service to lift the patient in and out of their home.

Regular stretchers can hold 600 pounds, but are narrower than an airline seat, so most obese people won't fit on them. Bariatric stretchers will hold 1200 pounds, and and much wider but won't fit in a small Type III van. That means the providers have to buy a large type II box ambulance, equip it with the stretcher, and add ramps and a winch to safely get the patient in and out.

All of that costs money. Bariatric stretchers are $10K a pop, a box ambulance starts at $150K, the modifications for bariatric patients add $15K to the base cost, then you need another $50k to equip the truck.

All that money for a truck that will be used on a half dozen transports a week, a third of which the company will never collect a dime on.

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grapedog
July 6, 2009 2:33 PM
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I think one thing should be stated, most other countries offering their own health care don't have a population close to our size. There are 33 million people in Canada, the entire population of Ireland does not even equal Boston. We have 300+ million people...the logistics are a bit different. I'm not saying it couldn't or shouldn't be done, just that to compare us to countries with 1/10th the population is not really fair.

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