Ambulance Delays: Why The Wait?

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Ambulance services are a pain point in America. Many people are afraid of the medical bills associated with a ride to the hospital and, therefore, don't want to call an ambulance when they are seriously injured and require immediate medical attention. This raises the question: what happens if someone calls an ambulance for you or if you can’t consent to medical care?

If you’re in a serious crash, a witness may call 911 to get a police officer and ambulance on the scene. EMTs on the scene will provide first aid and check you for injuries. If you’re bleeding or sense you have a broken bone, it’s wise to accept this care. Typically, you don’t receive an ambulance bill unless you are taken to the hospital. However, if you are incapacitated, unconscious, or show symptoms of a brain or spinal injury, EMTs may take you to the hospital without your consent. When this happens, you will receive the bill.

In some cases, you may not want to call an ambulance and find a different way to get to the hospital. If you are not sure if you need an ambulance, it is better to call 911 and they will assist you directly. It is likely that an ambulance is appropriate if you see that a person’s condition is potentially life-threatening, they are choking, or their heart has stopped.

In addition, if moving the patient may further injure the individual, such as in motor vehicle accidents or falls or other trauma, an ambulance should be called. Similarly, if you are unable to get yourself or the patient to the Emergency Department due to a fall, injury, or weakness, an ambulance is the best option.

Characteristics Values
Ambulance costs $3,532 for a 20-minute ride
Ambulance availability Not available in some areas
Ambulance preference People prefer taxis over ambulances due to the high costs


Ambulance costs

The cost of an ambulance ride depends on several factors, including whether the individual has health insurance, the type of ambulance service provided (basic or advanced life support), the distance travelled, the number of services provided by emergency medical technicians, and the supplies used.

In some cases, individuals may be entitled to discounted rates or financial assistance if they cannot afford the full cost of an ambulance ride. However, it is important to note that ambulance costs are not always covered by insurance, and even with insurance, individuals may still be responsible for a significant portion of the bill.

The high cost of ambulance services can be a burden for many people, especially those without insurance or with high deductibles. It is not uncommon for individuals to receive surprise bills for ambulance services, which can lead to financial strain and anxiety. In some cases, individuals may choose to decline ambulance services due to the potential cost, even when they require immediate medical attention.

To avoid unexpected costs, it is essential to understand the terms and conditions of your insurance plan and ask for cost estimates before receiving treatment. Additionally, having an emergency fund or savings can help cover unexpected expenses like ambulance rides.


Fear of medical bills

In one example, a person shared their story of calling 911 when their daughter went into anaphylactic shock. They had a top-tier health insurance plan and expected to owe a reasonable amount for the ambulance ride and ER visit. However, they were shocked to receive a bill for $3,532 for the 20-minute ambulance ride, on top of the ER costs.

Another person shared a similar story, where they received a bill for $1,645 for a 20-minute ambulance ride after their 11-month-old daughter had a febrile seizure. In both cases, the ambulance providers were out-of-network and the insurance companies only covered a small portion of the bill, leaving the families with large unexpected costs.

These surprise ambulance bills can have a significant financial impact, especially for those without stable jobs or government health care subsidies. It can lead people to avoid seeking medical attention out of fear of financial ruin, which is not right.

To avoid these surprise bills, some people suggest having an ambulance service membership, where you pay an annual fee and the ambulance company bills your insurance, but you don't have any out-of-pocket costs. However, this may not be necessary for most people and is just another way the system traps people in a never-ending cycle of making more money.

It is important to be aware of the potential costs and have a plan for how to deal with them. Fighting the bill, negotiating with the billing companies, and working with an attorney to reduce or eliminate the charges are some options. Additionally, having a pre-mortem checklist for emergencies and knowing what to do in case of an allergic reaction or other medical issue can help reduce the chances of needing an ambulance.


Ambulance availability

When an Ambulance May Not Be Sent:

  • Non-life-threatening situations: In cases where the condition is not potentially life-threatening, such as minor injuries or illnesses like a sore throat, alternative transportation methods may be suggested. This is especially true in rural areas where response times can be longer, and non-emergent transport options may be available by calling 911.
  • Choking or CPR in progress: In these situations, calling 911 prior to performing abdominal thrusts (Heimlich maneuver), back blows, or CPR is crucial. The dispatcher can provide life-saving instructions while also ensuring an ambulance is dispatched promptly.
  • Motor vehicle accidents or falls: If a person is involved in an accident or fall and their movement may cause further injury, EMS agencies are trained to safely extract them from the scene.

Factors Affecting Ambulance Availability:

  • Geographic location: Response times can vary significantly depending on whether you live in a rural or urban area. Rural areas may have longer response times due to the distance of the ambulance from your location, while urban areas with congested traffic can also experience delays.
  • Cost: Ambulance services can be extremely expensive, often costing hundreds or even thousands of dollars. If the situation is not an emergency and the patient can be safely transported by other means, calling a friend or family member, or using a taxi or ride-sharing service may be more cost-effective.
  • Insurance coverage: Health insurance may cover part or all of the cost of ambulance transport, depending on your specific plan and whether the ambulance service is in-network or out-of-network. It is important to understand your insurance coverage to avoid unexpected expenses.

In conclusion, while ambulances are crucial for life-threatening emergencies, there are situations where alternative transportation methods may be considered. It is always best to call 911 when in doubt, as dispatchers can provide guidance and ensure an ambulance is sent if necessary. Additionally, understanding the factors affecting ambulance availability, such as location, cost, and insurance coverage, can help individuals make informed decisions during medical emergencies.


Ambulance refusal

In the United States, the fear of receiving hefty medical bills prevents many individuals from calling an ambulance, even in serious situations. This has led to a rise in surprise ambulance billing, where patients are charged exorbitant fees for out-of-network emergency transport. The cost of an ambulance ride can vary significantly, and insurance coverage may not always be sufficient. It is essential to understand your insurance plan and know what is covered in case of an emergency.

Additionally, the location of the incident plays a crucial role in ambulance response times. In rural areas, volunteer rescue squads may take longer to reach the scene, while in urban areas, traffic congestion can also delay the ambulance's arrival. These delays can have detrimental effects on the patient's health, especially in time-sensitive situations.

To address these issues, some states and locales have implemented laws to prevent surprise ambulance billing. However, ambulance transport is often excluded from such legislation, leaving patients vulnerable to unexpected charges. It is important to advocate for comprehensive legislation that includes ambulance services to protect citizens from financial ruin due to emergency medical care.

When faced with a medical emergency, it is always better to err on the side of caution and call 911. EMTs on the scene will provide first aid and assist in determining the best course of action. While it is understandable that individuals may hesitate due to financial concerns, one's health and well-being should always take precedence.


Ambulance alternatives

Alternative care routes

Alternative care routes refer to the different destinations that non-urgent patients can be transported to instead of the emergency department. These include:

  • Referrals to primary care, including general practitioners or nurses
  • Urgent care centres
  • Psychiatric or social teams
  • Minor injury units

Patient transport services

Some ambulance services offer non-emergency patient transport services for patients who require assistance getting to their appointments but do not require an ambulance. These services are a more affordable alternative for patients whose condition does not meet the definition of "medical necessity".

Community paramedicine

Community paramedicine is an alternative care pathway where paramedics provide proactive home visits, fall pathways, or alcohol detoxification services.

Frequently asked questions

There could be a number of reasons why an ambulance wasn't sent to you. Here are some of the most common ones:

- You didn't request one: If you didn't specifically request an ambulance, one may not have been sent to you. In some cases, a witness or bystander may have called for one without your knowledge.

- Your condition wasn't life-threatening: If your situation wasn't deemed life-threatening, an ambulance may not have been dispatched. This could be due to a lack of available resources or a determination that your condition could be managed by other means.

- You were in a rural area: If you live in a rural or remote area, ambulance response times can be significantly longer. In some cases, volunteer agencies or fire departments may respond instead of a traditional ambulance service.

- Traffic congestion: In urban areas, heavy traffic can delay the arrival of an ambulance. In such cases, alternative transportation methods may be considered if your condition is not critical.

- Financial considerations: Ambulance services can be extremely expensive, and some people may choose not to call an ambulance due to financial concerns. In the United States, the cost of an ambulance ride can be in the thousands of dollars, even with insurance.

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