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Comment by Avicebron | Hacker News Reader

> The most efficient way to fund ambulance services would simply be to pay for the option the way that options are normally paid for: with a premium, collected from everyone the service stands ready to rescue. That’s how it’s done in the rest of the rich world. Some places, like the United Kingdom or Japan, simply fund ambulance services directly out of taxes; others, like the Australian state of Victoria, sell memberships in “Ambulance Victoria,” with unlimited exercise at the cost of about $70 a year per family.

So there is a solution.

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> “Ambulance Victoria,” with unlimited exercise at the cost of about $70 a year

And even if you don't pay this it still isn't that expensive - US$12873 is more than a helicopter transport would cost here. US healthcare companies somehow get away with charging insured patients 10x more than civilised countries charge uninsured ones.

>from everyone the service stands ready to rescue

So compelled health insurance to use an ambulance? You could just as well make it optional and charge people without the insurance the full price.

So everyone's covered unless you explicitly opt-out?

Everyone is covered and you have the ability to pay someone to take on the risk of having to pay for an ambulance.

what happens to the people who don't pay someone to take that risk when they need an ambulance?

Then they pay for the ambulance.

Well then not everyone is covered.

To me covered means that the ambulance will drive to your location.

Hey man, don't worry about it, this is an international forum, English can be difficult. You seem kind of like a more junior/early in your career guy so, I'm happy to help out and explain.

Covered in this case means that they don't have to pay some third party to take that risk for them, they can just get the ambulance as part of the nominal fee everyone pays per year or whatever.

When you outline a problem statement, you want to map out what the person outlining the specs really mean. It takes practice.

There is no need to be condescending to me and be arrogant despite you being ambiguous over which definition of the word you were using. You could simply end the conversation, realizing we were talking past each other but instead you decided to take jabs such as implying I am ESL, implying I am bad at English, and assuming I'm early in my career in order to attempt to belittle me.

One thing that's often overlooked is the cost of administering a billing system. If you're going to distinguish between the insured and uninsured you need a system that keeps track of who has insurance. You need paperwork (or digital equivalent). You need accounts payable staff to send invoices and chase up unpaid bills. It can, counter-intuitively, work out cheaper just not to charge anyone.

That is not required complexity. You can just send the bill to the customer.

Who is the “you” in this scenario?

The company offering the ambulance surface. Similar to how a pool cleaning company will send you a bill if you call them and have them clean your pool.

Generally, people who want their pool cleaned do so when they are conscious and have their pool very close to their home address. People who need ambulances are usually in a very different condition. That makes it a different prospect trying to chase payment.

But that’s socialism!

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