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Comment by OrganicMSG | Hacker News Reader

A decent emergency medical response service is never profitable.

It requires a vast amount of hospitals to ensure that there is one local enough to wherever you get ill or injured and they all have to be staffed by lots of different highly qualified specialists who are in as regular practice as possible.

If you were going to require that they be profitable, there simply are not enough rich people for the doctors to work on in order to stay in good practice, or to pay for enough suitably equipped hospitals to ensure a short travel time in an emergency.

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In the US, we essentially do require that they all be profitable or else not exist at all. This is "solved" by just charging you (or your insurance company) tons of money if you actually need to use it. A medical emergency requiring an ER and an ambulance can easily cost as much or more than an ordinary person will earn in their whole lifetime.

> A medical emergency requiring an ER and an ambulance can easily cost as much or more than an ordinary person will earn in their whole lifetime.

The majority of hospitals with E.R. in the US are non-profits that receive federal subsidies to help them exist.

But not enough subsidy that they are remotely affordable, hence the outrageous bills foisted upon individuals.

Good point. I should have been more clear about "non-obvious" funding sources. If a service isn't profitable, but has a clear funding source (philanthropy, government, etc), that is a little different. But the motive for that funding would need to be clear as well.

So yeah, charities can be ok.

I can see where you are coming from, I just think obvious profitability is a poor heuristic for trust, not only due to altruism, but also because some people like showing off, some people are pure hobbyists, some people are trying to make art and many people are just downright weird, though not necessarily in a way that is going to really do much damage.

It isn't always as simple as looking for an obvious motive, though I would agree to always keep an eye out for where the money comes from and if there is a game and if you are a mark. However that should apply whether or not something looks profitable on the surface, otherwise you drop all cynicism the moment someone tells you the right story.

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