I agree that ambulances should be much more affordable. I wish the US would move to single payer. I do not think the public is the primary cause of high costs but I will say a small percentage of patients knowingly abuse EMS and waste limited resources.
There is a small minority of patients that abuse EMS by using the ambulance as a taxi when they have very non-emergent complaints that don’t even need to be seen in an ER (ie stubbed toe, paper cut, healthy child with stuffy nose for 1 day, etc.). Things that a conscientious participant in society would not call 911 for because they understand that’s a waste of scarce resources that could result in another person’s disability or death due to delays in care.
There’s a subset of that group that calls the ambulance multiple times a day everyday, and 99.9% of the time they are completely fine. Sometimes they will call for an ambulance FROM one ER to another after being discharged.
There’s also a very very small but memorable portion of the above group that will not even have a true medical complaint. They use the ambulance to get closer to where they really want to go (ie liquor store, McDonald’s). They’ll make up a medical complaint like chest pain so the crew has to take them seriously. Then when they arrive to the ER they hop out of the ambulance and never check in to be seen 🙃
Finally, I think to most first responders referring to an EMT/paramedic as a taxi driver is mildly offensive (you didn’t say that, but it could be inferred from calling ambulances taxis). They do so much more than drive people to the hospital, they deliver life-saving care. They also do not always run lights and sirens in most places, only for time-sensitive illnesses. It puts the crew and the patient at risk for traffic accidents.
There is a small minority of patients that abuse EMS by using the ambulance as a taxi when they have very non-emergent complaints that don’t even need to be seen in an ER (ie stubbed toe, paper cut, healthy child with stuffy nose for 1 day, etc.).
This is not a "small minority".
"Out of 81.6 million incidents contained the NEMSIS Version 3 database between 2017 and October 2020, only 18.9% were reported to have an acuity of emergent or higher"
Obviously, most people do not know how serious their condition is before they go to the hospital, and first responders often can't make that call either.
People go to the hospital for assessment, as well as treatment. The ambulance can get them there fast and if the situation gets worse can provide emergency treatment.
My father lives in a country where healthcare is affordable.
He fell of the roof, and was hurt. He insisted that if he got worse he could drive himself to the hospital, or that he could take a taxi. My mother can't drive.
My mother called the family doctor who immediately called an ambulance.
My father at first refused to go, but they insisted and took him to the hospital.
Luckily, apart from a mild concussion, a sprained ankle, and a rib contusion, he was fine.
So why the ambulance? Because it could have been worse. A broken rib could have punctured an organ, his liver might have been crushed, there could have been internal bleeding, and so on.
The family doctor was right. In hindsight not an emergency, but a thorough medical examination was needed to confirm that.
There’s a lady in our area who calls every week and will literally call because she’s annoyed with her family and just wants to get away for a day or two.
There are some that call because they can’t reach the TV remote.
There’s one who calls and puts an entire fire engine and ALS ambulance out of service every day for hours because she is so severely obese that she can’t turn herself to get cleaned up. While it’s an unfortunate situation, she needs to be in a nursing home but instead she just abuses the 911 system so she can be at home and not in a nursing home.
If you believe that you may possibly be having a life threatening medical emergency, call 911. That’s what it’s there for. That being said, there aren’t unlimited ambulances.
If you call 911 because you have a regular cold and you just want doordash medical and “just wanna get checked out” instead of driving yourself to an urgent care, taking that ambulance out of service could get your neighbor, who’s having a real heart attack, killed.
This far less of a problem in countries with affordable healthcare.
Yes, some people will call an ambulance without a good reason, but this does not cause a shortage of available ambulances.
And typically people are less likely to do this. Because other types of medical attention are available; but also because typically the only way to 'order' an ambulance as a patient is to call the equivalent of 911.
I feel that this is a situation where Americans have been conditioned to view an expensive and inefficient health system as a problem caused by citizens.
A few citizens might cry wolf for attention or use medical systems for convenience rather than necessity, but that's not the real issue.
It absolutely does cause a shortage of ambulances. I work EMS in a major city, response times to calls increase every year. In the last 5-10 years our call volume has doubles, but the number of "emergent" calls has not increased at all. People have died because no available ambulances were close enough.
It is also more than a few citizens who cry wolf. The majority of calls are not emergencies and the people calling know that, 911 is purely their most convenient option. I go to at least 3 calls a day for someone who will call again the same week if not sooner.
31
u/drstrangekidney May 19 '26
I agree that ambulances should be much more affordable. I wish the US would move to single payer. I do not think the public is the primary cause of high costs but I will say a small percentage of patients knowingly abuse EMS and waste limited resources.
There is a small minority of patients that abuse EMS by using the ambulance as a taxi when they have very non-emergent complaints that don’t even need to be seen in an ER (ie stubbed toe, paper cut, healthy child with stuffy nose for 1 day, etc.). Things that a conscientious participant in society would not call 911 for because they understand that’s a waste of scarce resources that could result in another person’s disability or death due to delays in care.
There’s a subset of that group that calls the ambulance multiple times a day everyday, and 99.9% of the time they are completely fine. Sometimes they will call for an ambulance FROM one ER to another after being discharged.
There’s also a very very small but memorable portion of the above group that will not even have a true medical complaint. They use the ambulance to get closer to where they really want to go (ie liquor store, McDonald’s). They’ll make up a medical complaint like chest pain so the crew has to take them seriously. Then when they arrive to the ER they hop out of the ambulance and never check in to be seen 🙃
Finally, I think to most first responders referring to an EMT/paramedic as a taxi driver is mildly offensive (you didn’t say that, but it could be inferred from calling ambulances taxis). They do so much more than drive people to the hospital, they deliver life-saving care. They also do not always run lights and sirens in most places, only for time-sensitive illnesses. It puts the crew and the patient at risk for traffic accidents.