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Some ambulance systems aren't tax supported and aren't even exactly contracted to the municipality. In our town the BLS EMT's are volunteers (paramedics are paid) who take a ton of training, a ton of ongoing training, they go on runs, and THEN they stand on corners with a boot to raise money. That's (a) dedication on their part and (b) abusive on the part of the community. And patients still pay $2k for the ride. IMO if you live and work somewhere, some of your taxes should go to 911 to make it work right.

That's how it worked in my hometown, but I don't think the bill was 2k as it was essentially ran by the county.

Everything was basically either payed for by donations from a local business or funded by fundraising. Primarily because the county didn't want to have a tax to run the system properly. Same thing happened with my hometown's fire department. Though in that case you could effectively buy fire insurance from the county (and of course, some people decided not to buy that insurance).

Both are a bad way to run critical services, especially since my hometown was surrounded by a lot of farm and state owned land where lightning strikes causing a fire wasn't uncommon. I don't have a big issue with the volunteer portion of it, it was a small town which the county would otherwise not want to service. But the funding portion was just bad. Fire, famously, spreads. And giving people the ability to opt out is dumb because it makes a big problem if a fire starts on their property and spreads to someone else's.

> It's absurd that we can find it in our budgets to pay for fireman and police but for some reason anything related to medicine needs to be privately contracted out.

Seattle spends nearly $400 million a year on the SPD, which is about 25% of their discretionary budget.

That's a more complicated example than I think you intended. Seattle tried to move some of the functions SPD was handling to other people during the badly named "Defund SPD" movement. The police got angry that part of "their" budget and responsibility was taken away, and has spent the past few years successfully campaigning to get it back.

Yeah, my country tried to do a switcharoo in the 2000, by funding what was called 'proximity police' on the national police budget. They couldn't arrest for misdemeanor or traffic infractions, couldn't do an identity check, didn't have any weapons, were only able to call other services in case of an imminent danger, and was tasked to organise regular spelling bees, basketball/football games etc. Basically street councillors. Worked in some areas, worked less in others, still, in most areas where young people violence was an issue, it had promising results.

Turns out the police noticed and lobbied the next government into removing the department and getting all the money back for regular law enforcement.

In my city, the ambulance service is run by a private contractor, but the city government offers ambulance insurance to residents. It's included on my monthly water/sewer/trash bill and costs about four dollars a month. All ambulance services are free. A friend has taken two ambulance rides over the past few years, with nothing out of pocket for either of them.

The insurance is optional. If you don't want to pay the four dollars each month, you don't have to, but it's so cheap and easy why wouldn't you for the peace of mind it offers.

The problem is not that it costs something. The problem is that it is managed for maximum profit, and it kills people!

The woman died.

Even more importantly, no one made a follow-up to ensure she safely reached a hospital.

This is disgusting. And people say the US healthcare is "best of the world ".

No. Just no.

American PR is the best in the world.

If running an ambulance is so profitable, what's stopping anyone from doing it themselves, undercutting everyone else to gain business, and still make a ton of money?

Ironically paying huge amounts for medical care is a tax. A much higher tax.