Hacker News new | past | comments | ask | show | jobs | submit login

Could he just said "I didn't call for ambulance, charge the guy who did"?



The unintended consequence of allowing that to happen would be that people would be hesitant to call for an ambulance for someone else. It will cost lives. I would expect any sane legal system to have strong legal protections for good Samaritans.


In the same sense that it would protect unconscious people from incurring enforceable debts?

A sane system would look at the incentives structure to devise cartel rules to encourage the individual behaviors that lead to the best group outcome.

The injured party desires swift and effective treatment for their injury. They also desire such treatment to be affordable, preferably at no additional out-of-pocket cost.

Onlookers may wish to help in the moment, but they do not want to incur any future obligations by doing so.

Medical providers want the customer brought to their facility, first to assist with the injury, and then also to be rewarded for producing better outcomes due to their care and expertise.

The move that makes sense is for injured parties and onlookers (they cannot know in advance who would be the unlucky one to get injured) to cartelize, and each pay an amount in advance so that the statistically predictable annual number of ambulance rides are all (theoretically) already paid for. And since it could damage the patient to delay care by attempting to verify cartel participation, it really has to include everyone, or ignore free riders. So the cartel becomes a branch of government, and it pays for ambulance rides with some form of tax. Then to prevent gaming the system by private ambulance companies, the cartel can either announce limits on what it will pay for during one ambulance ride, or it can run its own ambulance service.

And to further control costs, if they haven't already determined that it is an emergency with major traumatic injuries, the dispatcher can even just ask the caller if an ambulance is not needed. Most people can at least recognize if someone else does not need an ambulance, and maybe just needs an ordinary ride to the hospital without all the equipment and paramedics. The dispatcher can summon a cab, or Lyft, or Uber, or a bicycle rickshaw, or church bus, or shuttle van, or any other type of local transportation service, and pay their prevailing rate for a prompt, on-demand ride to some form of medical care facility. Since the patient would have to be conscious in order to get a not-ambulance ride, they could either wave it off, or tell the driver to go to their pick of clinic or hospital and have the ride paid for by their ambulance tax.

Other moves create perverse incentives to ignore injuries or hinder the care of an injured person.

Similar analysis indicates that hospital treatment for life-threatening injuries and other health emergencies should also be paid for out of taxes. The rest of the medical system could possibly operate under a different model, but I think most people would rather not be forced to choose between death and bankruptcy--for themselves or anyone else--when there's a dearth of time to think about it.


Maybe, but he suffered a concussion and reasonably wasn't in full awareness of the situation. Leaving him to suffer on the street until he made that decision on his own shouldn't be the morally correct decision. I stand by my behaviour and would do it again irrespective of the chance I might have to pay for it: there are some moral decisions I would rather not have to think about and instead just do the right thing. I lose enough sleep over more trivial things.


I don't know about Canada but in Australia the person who the ambulance is called for gets charged.


How much is an ambulance in Australia? Last time I was there, I saw a protest against the Abbot government (yea it was that long ago) because he wanted to put in a co-pay (yes, Australians don't have co-pays).

In the US, with insurance, they're typically like $300.


Ambulances are not a nationalised service in Australia. In some States it is State run, in others it is a private company.

I live in Western Australia and it's all done by St John's Ambulance. My partner has needed two non-urgent ambulance call-outs (transfer to a public hospital), which were both charged at ~$500. She's on my private 'extras'* insurance policy, and my insurer fully covers an unlimited amount of ambulance transfers ($50 co-pay for non-urgent). I believe this to be a common thing for this type of insurance policy - I'm not on any fancy tier of coverage.

HOWEVER:

A couple of years ago my significant other had an accident in a public area where she unable to move or call an ambulance. A nearby resident heard her yelling and called the police / ambulance. The paramedics seemingly had the authority to take her away from the police officers who were questioning her. She was taken to the nearest public hospital and was discharged from the ED shortly thereafter. She never received a bill. She's only young and the accident (very apparently) occurred as a result of drug use, so I think that the paramedics operating the ambulance are allowed discretion when deciding whether or not somebody should be charged.

* Physio, psychology, dental.etc. (all non-emergency). These services are not (fully) covered by our public health system, so many people opt for private cover. These policies work heavily on annual limits, so it's a bit unfair to call them insurance.


Just to give you some context, I'm a West-Australian, living in Austria.

I've had to take an ambulance to hospital a number of times. Cost to me: eu0.

I've also had to stay in hospital a couple of times, had a couple operations. Cost to me: eu0.

Of course, I pay regularly into the Austrian health system with portions of my pay check every month. But there is no suffering beyond that, if I have to have any medical procedures or take the ambulance for an accident.


I don’t know if it’s the same for everyone, but about 8 years ago I got gastro and thought I was dying because I was in so much pain. I was a Kiwi living in Australia l, called myself an ambulance and I don’t have Medicare so figured I had to pay the bill.

After being discharged I gave them my passport and the hospital bill was $0 while the ambulance bill was around $950 Aud.

When I moved to singapore to live I got appendicitis. I called a taxi and paid $9 to go to the hospital. Too scared to get ambulance now even if it’s covered by insurance.


So Aussies and Kiwis can live/work in the other country without visas (instant residence) but whoever drafted that agreement really fucked up. Aussies get instant ACC in NZ but Kiwis don't get Medicare in Australia. I remember there were discussions about it on Radio NZ a few years back.

There is a big private health care industry in Australia (for better or worse) that's not employer based (you see adverts on TV), so I'm guessing a lot of Kiwis just get private care in the AU.

But I'm wondering how much it costs an actual Australian resident/citizen with medicare. I know as a non-resident, a doctor cost around $70 ~ $80 (went once in Melbourne and once in Sydney) and I saw a real doctor. That's a far cry from America where you pay $200+ to see a Nurse Practitioner (yes, pretty advanced, but still not an MD).


Oh I could get Medicare, but because I was never in the country for 6 consecutive months at a time over the 5 years I lived there (traveling for short holidays) they wouldn't grant for me.

Doctor + Prescription in Australia is expensive! Would cost me like ~200 give or take.

In Singapore, consultation is like $15 and the medicine is prescribed by the clinic so no need to go to a pharmacy, total is like $50.

So I don't even bother seeing my insurance doctor where it costs me like ~$5 total, I just go see my normal doctor cos I trust him. (been to same doctor for 6 years)


> I'm wondering how much it costs an actual Australian resident/citizen with medicare.

Here's the costs for St John's Ambulance. It's $949 for a life-threatening or urgent call, $510 for non urgent. It mentions that Medicare doesn't cover the cost, and that the costs will always be incurred by the patient. (I actually thought it was covered by my private health insurance, but apparently not.)

http://www.stjohnambulance.com.au/ambulance-and-health-servi...

Some doctors in Australia bulk-bill, so it's free for me to go to see a doctor whenever I want. Though for a short period when the government changed the billing rules, he started charging $25 per visit, but he's gone back to bulk-billing again.


in Canada you get charged only if you get in the ambulance


Actually that is not true in BC, Canada. According to BC Emergency Health Services [1], It charges a fee of $50 if transportation is not required. $80 if transportation is required.

[1] http://www.bcehs.ca/about/billing/fees




Guidelines | FAQ | Lists | API | Security | Legal | Apply to YC | Contact

Search: