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Comment by zepolen | Hacker News Reader

A 6 hour stay plus a few bios for $1000 is not reasonable.

For that money you can get a week's care at a premium private hospital in Europe.

An emergency ambulance costs 100 euro.

I think America has been with an extortionate health care system for so long you guys are starting to consider it 'reasonable'

It isn't.

Let me put it another way. You can fly from America to Europe three times for $1800.

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Why is how many times you can fly between two places relevant to how much medical bills cost? All you did was choose a metric that makes your argument appear more reasonable, even though they are entirely unrelated.

You also seem to be arguing that Europe healthcare is cheaper and therefore better, even though it obviously is not that simple (I'm sure you know it isn't that simple. That's just how your reply comes across). For example, if I get cancer I would much rather be in the United States, despite the problems with their health care system, simply because I have a higher chance of living.

Except the US has a much higher cancer mortality rate than almost all of Europe: https://www.wcrf.org/dietandcancer/cancer-trends/data-cancer...

That doesn't prove anything about hospital quality.

From your source: "Around 40% of cancer cases could be prevented by reducing exposure to cancer risk factors including diet, nutrition and physical activity".

Americans live a lifestyle (fast food, less walking) that leads to a much higher risk of cancer than Europeans, the difference in mortality rate is mostly explained by this.

Another way of thinking about this, looking at your data, do you really think Australia has the worst hospitals in the world because they have the highest cancer rate?

And as a critical care patient he dies during the flight. Now what.

Also, emergency last minute round trip flights to Europe are absolutely not $600 as you claim.

I didn't claim emergency flight though, I said you can fly to Europe for less than $1800.

Also no wonder healthcare is so expensive in the US - you're actually arguing for it...

Fine. Last minute round trip flights to Europe from the US are not $600. PROVE ME WRONG.

Return flight for 30 July from New York to Madrid for 354 euro ($394)

https://www.google.com/flights?lite=0#flt=/m/02_286./m/056_y...

I think the point here is that you're making a completely irrelevant comparison. Comparing an ER visit to a transatlantic flight isn't even apples and oranges, it's apples and the kuiper belt.

The estate is billed, and the collectors do anything in their power to block inheritance until paid.

To be fair, a $111 (100 euro) ambulance ride would not be a reasonable amount if you were paying for it outright. You're paying for the time of 2 EMTs, your share of the supplies in the ambulance, your share of the ambulance vehicle, gas. Plus you're not just paying for the time it took for your ride, you're paying for your portion of the entire day (since not all their time is utilized). Even without considering profit, that's well over $111.

The fact that you're paying 100 Euro for the trip means is subsidized. Which is great, and it should be, but don't pretend 100 Euro is a reasonable price if you're actually paying for it.

No subsidy, these are for private ambulances and a result of real competition.

Using an average wage in the US to be double of Europe I'd say $200 for an ambulance ride in the US is a reasonable price.

Also an ambulance ride is like 20-30mins tops and within a day there can easily be 4-5 calls in a larger city - that's more than enough to be profitable.

Wait, are you saying that 30k/mo gross is enough to run an ambulance service?

Easily.

  2 x EMTs @ $2,000 = $4,000 / month
  1 x $100,000 amublance amortized over 3 years = $3,000 / month
  150 gallons gas (150 miles per day @ 30mpg) x $2.50 = $375 / month
  Callcenter = $500 / month
  Overheads = $1000 / month
  Supplies = $1000 / month
  -----
  Total cost = $10,000 / month

Go to a busy ER and you'll discover that ambulance crews may have to sit around for 2-3 hours at times until they can fully hand off the patient.

The omission of things like liability insurance is curious, as well.

From what I hear in the UK, ambo crews don’t wait around, definitely not 2-3 hours.

(And they are all employed by the state [NHS], the state self-insures for liability, just like it self-insures for the ambulance’s car insurance.)

Perhaps you know better, but my uneducated guess would be that just an ambulance vehicle costs 15k/month, then every medic costs 10k/month at least and there will be expensive weird things like commercial insurance that costs another 5k/month. 100k/month might make you break even in the long run.

> You're paying for the time of 2 EMTs

For a fun little exercise, look up the average salary of an EMT.

When I did it on the side, six years ago, starting salary was $9.60/hr. (Thankfully I was doing it for experience, not a living).

I considered it reasonable given our current horrible medical system.

I want a single payer system.

That requires ethical people to run and heavy enforcement otherwise it turns in to a corruption fest where doctors run their own private practices in addition to state funded and waiting lists run rampant forcing you to go private.

What is needed is real competition in the health care sector - because at the moment the whole thing in America is a coalition/monopoly between insurance, pharma and health care companies with the sole intent of giving you no choice but to pay and say thank you.

> where doctors run their own private practices

The supposed evil sole individual human you postulate as the source of dire evil is not the problem usually, rather the evil collective corporation or other organization calls the shots when we see these sorts of industry wide systematic abuses.

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