# Is it true that when you call an ambulance for someone, you have to pay for it? (need answer fast) **URL:** \ **Category:** Great Debates\ **Created:** [September 23, 2016, 4:24am UTC](https://boards.straightdope.com/t/is-it-true-that-when-you-call-an-ambulance-for-someone-you-have-to-pay-for-it-need-answer-fast/766621 "2016-09-23T04:24:10Z")\ **Posts on this page:** 20\ **Page:** 8
**Author:** ![Malthus](https://avatars.discourse-cdn.com/v4/letter/m/85f322/32.png) [@Malthus](https://boards.straightdope.com/u/Malthus)\ **Post date:** [September 29, 2016, 3:17pm UTC](https://boards.straightdope.com/t/is-it-true-that-when-you-call-an-ambulance-for-someone-you-have-to-pay-for-it-need-answer-fast/766621/141 "2016-09-29T15:17:26Z")
> [@wolfpup](#): > > I have to emphatically disagree. This is why generalized health care debates are becoming so frustrating that I’m inclined to stay out of them. [According to the OECD](https://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_per_capita), the UK spends about $3235 per capita on health care. Canada spends $4429. The US spends $9523. That’s not just slightly more – it’s _ **several multiples** _ more! And in speaking to my many friends and relatives in the US, it’s abundantly clear where this money is going: to a vast disorganized patchwork of private insurers who require mountains of paperwork to empower them to meddle in the doctor-patient relationship to minimize medical outlays and maximize profit, and to the entire system of health care delivery that has no effective means of cost control. > > You cannot possibly try to argue that you’re financially better off than your UK or Canadian counterpart because of private health insurance – the math just doesn’t work. You may be financially better off for other reasons, _ **despite** _ private health insurance, but certainly not because of it. You’ve essentially taken the math and combined it with several incorrect assumptions and put the whole thing through a meat grinder in order to arrive at preconceived and incorrect conclusions. > > You seem to be making the assumption that the higher taxes or lower income in the UK are solely due to health care costs. They are not. Not by a long shot. Both the UK and Canada, just for one example, have vastly greater non-health social spending than the US, because that’s the kind of society they’ve chosen to have. Canada, for instance, spends two to three times as much as the US as percentage of the GDP on non-health social programs like social services, income security, and housing. > > You also cite this irrelevant mystery number of $120 a month. Look at the costs given above. On average, that’s not within a country mile of paying the real average costs of health care, and you can’t just ignore your employer contributions as if they were magic or money from trees. For one thing, that’s money that you’re not getting because it’s going to health insurers instead, and for another, what if you had no employer? What if you were self-employed, or the economy tanked and people lost their jobs, or someone lost their job at an older age where they were more or less unemployable just at the time that they started needing health care the most? What happens after you retire? If you think Medicare is sufficient, prepare yourself for a shock. > > And regarding point #2, you say your co-pay is $15 “for most things”? What about annual deductibles? Or what if you were hospitalized and needed heart surgery and the total bill came to $150,000, which isn’t all that unusual. Hospitalizations and surgeries are frequently very much more. Would your co-pay still be $15? Not only would it be substantial, but you might end up fighting the insurance company to get any coverage at all. These are precisely the kinds of things that make health care costs the #1 cause of personal bankruptcies in the US, and most of those people were insured. It wasn’t $15 that bankrupted them, or forced them to sell their houses and lose their life savings. This is a very good post, **Wolfpup**. As a Canadian who has numerous friends and family in the US, what I can say is this: on this particular point, the Canadian system - while by no means perfect - is generally superior, in that it tends to be, on average, able to provide more or less the same level of service, with fuller coverage over the population, at a more or less much lower average cost per person - so much lower that it is remarkable. In short, this appears to be a case where “privatizing” a service has lead to greater inefficiency rather than greater cost savings. The consensus appears to be that where the US system excels over the Canadian, is in providing specialist services. However, part of that may be through economies of scale - if one wishes to treat a rare disorder, it is far easier to put together a team or institution to do this where the population is far greater (and so the number of that rare condition is far greater). I don’t have any figures to support that, though. ---
**Author:** ![Chisquirrel](https://avatars.discourse-cdn.com/v4/letter/c/6bbea6/32.png) [@Chisquirrel](https://boards.straightdope.com/u/Chisquirrel)\ **Post date:** [September 29, 2016, 3:30pm UTC](https://boards.straightdope.com/t/is-it-true-that-when-you-call-an-ambulance-for-someone-you-have-to-pay-for-it-need-answer-fast/766621/142 "2016-09-29T15:30:17Z")
> [@Northern\_Piper](#): > > Really? No wait times in ER in the US? You walk in and see a doctor right away, no waiting? > > And there’s no wait time to see a specialist, get tests done, or have a hip replaced, _even if you’re one of the 11% without insurance, cited earlier?_ > > Because if people without insurance don’t get follow-up care once they’re discharged from the ER, their wait time is infinite. How do you include the value of “infinite” in your calculation of average wait time in the US? > > Or, do you just drop those 11% out from the calculation of US wait times? > > If the 11% are not included in the calculation of wait times in the US, then it’s not appropriate to compare that calculation of wait times to the wait times for patients in a country with UHC, because the whole point of UHC is that 100% are covered. > > In UHC countries, you don’t need to drop 11% of the population from the calculation to improve your wait time, nor try to factor in a value of infinite for 11% of your population. It’s obviously not infinite. Eventually they die. ---
**Author:** ![PatrickLondon](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/patricklondon/32/4422_2.png) [@PatrickLondon](https://boards.straightdope.com/u/PatrickLondon)\ **Post date:** [September 29, 2016, 4:36pm UTC](https://boards.straightdope.com/t/is-it-true-that-when-you-call-an-ambulance-for-someone-you-have-to-pay-for-it-need-answer-fast/766621/143 "2016-09-29T16:36:55Z")
> [@D\_Anconia](#): > > In the U.S., getting in to see a doctor, specialist, hospital, or having a procedure done all vary by insurance, providers, hospitals, and I’m sure location. > > When I needed to see a dermatologist, I didn’t need a referral from my PCP, I just chose one in my insurance company’s network. Saw the dermatologist a week or two later, at my convenience. Not six month later. > > Very recently, my gastroenterologist ordered an endoscopy for me on an outpatient basis, but performed at the hospital due to anesthesia and other considerations. The scheduler offered me an appointment for later that same week, but I scheduled for two weeks out. Again, not six months later. IME, the NHS, at least in London, is not so far out of that range. When I mentioned to my GP I was having a problem with indigestion and gastric reflux, he referred me for an ultrasound to look for ulcers and took a stool test for helicobacter (all done in two weeks) and eventually decided an endoscopy was necessary: it had to go for specialist approval, but it was all done in two-three weeks. Perhaps we have different concepts of what a PCP/GP is and should be: for us, a GP is supposed to be the diagnostician who has the long-term overall view of your health, and the expert in what services are available to deal with any issue. Collectively, they also manage the bulk of NHS funding for specialist/secondary care: in effect, the same as your insurance company’s network. I don’t know where you get six months from. The standard is 4 hours from arrival to admission or discharge in A&E, and 18 weeks from GP referral to specialist treatment. But, of course, it does depend on governments keeping the funding and staffing up to the necessary levels, and the NHS is complaining furiously at the moment that they aren’t, and adherence to the targets is being squeezed. But governments usually want to avoid paying the price of stinginess at the ballot box. The most recent median waiting time figures for specialist treatment\* are between 6 and 10 weeks. Some small numbers (i.e., less than 1000 in 3.5 million on the most recent figures) do wait for a long time, but this is usually for clinical reasons. \*[http://www.england.nhs.uk/statistics/wp-content/uploads/sites/2/2013/04/RTT-Annual-Report-2015-16-v3\_final.pdf](http://www.england.nhs.uk/statistics/wp-content/uploads/sites/2/2013/04/RTT-Annual-Report-2015-16-v3_final.pdf) A&E waits: [http://www.qualitywatch.org.uk/indicator/ae-waiting-times#](http://www.qualitywatch.org.uk/indicator/ae-waiting-times#) ---
**Author:** ![DrDeth](https://avatars.discourse-cdn.com/v4/letter/d/b487fb/32.png) [@DrDeth](https://boards.straightdope.com/u/DrDeth)\ **Post date:** [September 29, 2016, 5:04pm UTC](https://boards.straightdope.com/t/is-it-true-that-when-you-call-an-ambulance-for-someone-you-have-to-pay-for-it-need-answer-fast/766621/144 "2016-09-29T17:04:23Z")
> [@wolfpup](#): > > I have to emphatically disagree. This is why generalized health care debates are becoming so frustrating that I’m inclined to stay out of them. [According to the OECD](https://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_per_capita), the UK spends about $3235 per capita on health care. Canada spends $4429. The US spends $9523. That’s not just slightly more – it’s _ **several multiples** _ more! > > You seem to be making the assumption that the higher taxes or lower income in the UK are solely due to health care costs. They are not. Not by a long shot. Both the UK and Canada, just for one example, have vastly greater non-health social spending than the US, because that’s the kind of society they’ve chosen to have. Canada, for instance, spends two to three times as much as the US as percentage of the GDP on non-health social programs like social services, income security, and housing. > > You also cite this irrelevant mystery number of $120 a month. > > And regarding point #2, you say your co-pay is $15 “for most things”? What about annual deductibles? Or what if you were hospitalized and needed heart surgery and the total bill came to $150,000, which isn’t all that unusual. Hospitalizations and surgeries are frequently very much more. Would your co-pay still be $15? You are comparing apples and oranges. $$ per capita spent on health care is not what we we discussing. We were discussing how much **I** spent compared to **Novelty Bobble**. I again, for the third time quote **"According to the estimates that I see you pay a lot out of every paycheck (far more than I do and I earn a very good wage) "**. I do _not_ pay\* a lot more \* out of every paycheck than Novelty Bobble does, in fact, as I showed, i pay far less. Perhaps the average person pays more, but that’s not the argument. I, **Dr Deth** pay _Less_ than **Novelty Bobble**. Got that? No assumption made. I compared who had the greater take home after taxes and insurance. There’s no "irrelevant mystery number "- $120 a month is what is withheld from _my_ pay. No annual deductibles, Heart surgery is like a $200 co pay. I belong to a **HMO,** not a PPO. As long as I go to my org, the care is covered. Do you understand the difference between a HMO and a PPO? There are also POS and HDHPs. ---
**Author:** ![DrDeth](https://avatars.discourse-cdn.com/v4/letter/d/b487fb/32.png) [@DrDeth](https://boards.straightdope.com/u/DrDeth)\ **Post date:** [September 29, 2016, 5:06pm UTC](https://boards.straightdope.com/t/is-it-true-that-when-you-call-an-ambulance-for-someone-you-have-to-pay-for-it-need-answer-fast/766621/145 "2016-09-29T17:06:28Z")
> [@Novelty\_Bobble](#): > > It does get frustrating doesn’t it? > > and thanks **Wolfpup** , I was going to pen a response to **DrDeth** (how apt) but rather lost the will to live (again…how apt). > You said all I wanted to say so you’ve saved me time and effort there. You claimed ""According to the estimates that I see you pay a lot out of every paycheck (far more than I do and I earn a very good wage) “.” I showed that in the case of _my paycheck_, this is not true. You have to read the whole thing not just knee jerk. ---
**Author:** ![DrDeth](https://avatars.discourse-cdn.com/v4/letter/d/b487fb/32.png) [@DrDeth](https://boards.straightdope.com/u/DrDeth)\ **Post date:** [September 29, 2016, 5:08pm UTC](https://boards.straightdope.com/t/is-it-true-that-when-you-call-an-ambulance-for-someone-you-have-to-pay-for-it-need-answer-fast/766621/146 "2016-09-29T17:08:41Z")
> [@Grim\_Render](#): > > Actually, waiting times in ER rooms in the US does not compare well to other nations. That is not unexpected since the US has a large fraction of its population with the ER as their only source of healthcare. > . There are two kinds of ERs in the USA, General/County and private. The ones that the poor go to as their healthcare do have long wait times. My HMO has very short wait times. Pretty much walk in. ---
**Author:** ![D\_Anconia](https://avatars.discourse-cdn.com/v4/letter/d/67e7ee/32.png) [@D\_Anconia](https://boards.straightdope.com/u/D_Anconia)\ **Post date:** [September 29, 2016, 5:30pm UTC](https://boards.straightdope.com/t/is-it-true-that-when-you-call-an-ambulance-for-someone-you-have-to-pay-for-it-need-answer-fast/766621/147 "2016-09-29T17:30:53Z")
> [@PatrickLondon](#): > > I don’t know where you get six months from. People in this thread were saying it took 4-6 weeks in the U.S. See posts #104, 123, and 131. That does not match my experience, in the U.S. ---
**Author:** ![Novelty\_Bobble](https://avatars.discourse-cdn.com/v4/letter/n/a3d4f5/32.png) [@Novelty\_Bobble](https://boards.straightdope.com/u/Novelty_Bobble)\ **Post date:** [September 29, 2016, 7:49pm UTC](https://boards.straightdope.com/t/is-it-true-that-when-you-call-an-ambulance-for-someone-you-have-to-pay-for-it-need-answer-fast/766621/148 "2016-09-29T19:49:36Z")
> [@DrDeth](#): > > You claimed ""According to the estimates that I see you pay a lot out of every paycheck (far more than I do and I earn a very good wage) “.” > > I showed that in the case of _my paycheck_, this is not true. You have to read the whole thing not just knee jerk. I don’t understand your point, I pay £0 out of my wages every month for healthcare, your own figures show that you pay far more than me. And in any case, it is pointless to compare how well a healthcare system works for the well-paid because the answer will be, no matter where in the world or the system used, things are fine. The wealthy will always be fine. The true test of the system is how well it works for the disadvantaged. It is an ideological and, I believe, a moral question. ---
**Author:** ![DrDeth](https://avatars.discourse-cdn.com/v4/letter/d/b487fb/32.png) [@DrDeth](https://boards.straightdope.com/u/DrDeth)\ **Post date:** [September 29, 2016, 9:25pm UTC](https://boards.straightdope.com/t/is-it-true-that-when-you-call-an-ambulance-for-someone-you-have-to-pay-for-it-need-answer-fast/766621/149 "2016-09-29T21:25:14Z")
> [@Novelty\_Bobble](#): > > I don’t understand your point, I pay £0 out of my wages every month for healthcare, your own figures show that you pay far more than me. > . You pay 7000 Pounds more per year. TANSTAAFL. ---
**Author:** ![sweat209](https://avatars.discourse-cdn.com/v4/letter/s/9fc348/32.png) [@sweat209](https://boards.straightdope.com/u/sweat209)\ **Post date:** [September 29, 2016, 9:47pm UTC](https://boards.straightdope.com/t/is-it-true-that-when-you-call-an-ambulance-for-someone-you-have-to-pay-for-it-need-answer-fast/766621/150 "2016-09-29T21:47:32Z")
It is interesting how some places in US people are force to wait hour or two in the ER before they see doctor and other places 30 minutes to hour!! Why longer wait times of forced to wait hour or two in ER before they see doctor. I heard some places in north east part of the US people wait longer some long two hour wait time to see doctor!!!:eek::eek::eek: I wonder why that is the case? I know some cities population of 1,000,000 people that have 10 to 15 hospitals!! And yet some other cities 1,000,000 people hardly any hospitals some low as only 5 hospitals!! Yes only 5 hospitals!! Some insurance companies only cover treatment and care and some hospitals but not other hospitals. I thing this was problem Obama was trying to fix. ---
**Author:** ![Novelty\_Bobble](https://avatars.discourse-cdn.com/v4/letter/n/a3d4f5/32.png) [@Novelty\_Bobble](https://boards.straightdope.com/u/Novelty_Bobble)\ **Post date:** [September 30, 2016, 10:30am UTC](https://boards.straightdope.com/t/is-it-true-that-when-you-call-an-ambulance-for-someone-you-have-to-pay-for-it-need-answer-fast/766621/151 "2016-09-30T10:30:35Z")
> [@DrDeth](#): > > You pay 7000 Pounds more per year. > > TANSTAAFL. Not for healthcare I don’t. It is quite possible that my taxes are higher overall than yours but it is impossible to slice up that difference and say you are £7000 better off by being in the USA. **Wolfpup** ’s post suggests reasons why you can’t do that. What has been shown time and time again is that…on average…you pay far more of your taxes on public healthcare provision (that is nowhere near universal) that you then have to supplement with additional insurance (which many working poor can’t afford) which then leaves you liable for co-pays (which bankrupts people or puts them off seeking help). or tries to avoid covering your condition (so what’s the point?) Trading individual cherry-picked personal examples is pointless, what matters is the whole picture. e.g. I did a very rough calculation of the tax I’d owe if I was a single man earning the average wage of £27,600 in the UK. (the equivalent of $37600 in the USA). These are purely the unavoidable deductions. Turns out I’d stump up around £4900 in the USA (I haven’t included any state income tax) and £5700 in the UK Neither of those figures include health insurance. For that tax figure in the UK you get full access to the services of the NHS and there are no out-of-pocket expenses. ---
**Author:** ![Grim\_Render](https://avatars.discourse-cdn.com/v4/letter/g/a87d85/32.png) [@Grim\_Render](https://boards.straightdope.com/u/Grim_Render)\ **Post date:** [September 30, 2016, 10:31am UTC](https://boards.straightdope.com/t/is-it-true-that-when-you-call-an-ambulance-for-someone-you-have-to-pay-for-it-need-answer-fast/766621/152 "2016-09-30T10:31:36Z")
> [@D\_Anconia](#): > > I don’t consider my experience with access to specialists to be poor, at all. > > For the dermatologist, I scheduled the appointment when I did largely for my own convenience, due to work schedules and the like. > > And the hospital procedure could have been done within a few days, but due to the anesthesia, I had to arrange for a family member to drive me home after the procedure, so I scheduled it for about 10 days out, again, by my choice. My point was that you appear to hold your own anecdotal experience up against some kind of six-month mark, while my own anecdotal experience shows far faster services. And I don’t know where your six-month benchmark came from. ---
**Author:** ![Grim\_Render](https://avatars.discourse-cdn.com/v4/letter/g/a87d85/32.png) [@Grim\_Render](https://boards.straightdope.com/u/Grim_Render)\ **Post date:** [September 30, 2016, 10:59am UTC](https://boards.straightdope.com/t/is-it-true-that-when-you-call-an-ambulance-for-someone-you-have-to-pay-for-it-need-answer-fast/766621/153 "2016-09-30T10:59:17Z")
> [@sweat209](#): > > It is interesting how some places in US people are force to wait hour or two in the ER before they see doctor and other places 30 minutes to hour!! > [@DrDeth](#): > > There are two kinds of ERs in the USA, General/County and private. The ones that the poor go to as their healthcare do have long wait times. My HMO has very short wait times. Pretty much walk in. The average waiting time in a US emergency room in 2011 was [four hours and seven minutes.](http://www.businessinsider.com/utahs-eight-hour-emergency-room-wait-time-average-is-a-us-record-2011-11?r=US&IR=T&IR=T) In the NHS, one of their key targets is that [95 % of patients should be seen within 4 hours](http://www.bbc.com/news/health-34939034), and they mostly manage that. In 2011, the median wait was 130 minutes. So just over half the US average. > [@DrDeth](#): > > You pay 7000 Pounds more per year. I don’t think you fully grok what we are talking about. You have money taken of your paycheck by taxes to pay for healthcare. More than someone form the UK does. Then, unlike someone in the UK, you have to pay again to actually receive healthcare. This comes in form of direct costs, co-pays and employer contributions that further reduce your paycheck. You seem to be arguing that the fact that you are getting paid more than you would in the UK is somehow an argument against this. Your pay is affected by many other factors than what you pay for healthcare. This does not change the fact that the amount you pay for healthcare is **far** more than someone from the UK does. > [@DrDeth](#): > > TANSTAAFL. I addressed this earlier. > [@Grim\_Render](#): > > As for the first part of the statement, “_There is no such thing as a free lunch_” that seems to assume that things are being run at such a high level of efficiency that different setups cannot provide better results for less money. > > This is fairly obviously incorrect as regards the US healthcare system. ---
**Author:** ![D\_Anconia](https://avatars.discourse-cdn.com/v4/letter/d/67e7ee/32.png) [@D\_Anconia](https://boards.straightdope.com/u/D_Anconia)\ **Post date:** [September 30, 2016, 12:40pm UTC](https://boards.straightdope.com/t/is-it-true-that-when-you-call-an-ambulance-for-someone-you-have-to-pay-for-it-need-answer-fast/766621/154 "2016-09-30T12:40:13Z")
> [@Grim\_Render](#): > > My point was that you appear to hold your own anecdotal experience up against some kind of six-month mark, while my own anecdotal experience shows far faster services. And I don’t know where your six-month benchmark came from. I answered that in post #147. ---
**Author:** ![DrDeth](https://avatars.discourse-cdn.com/v4/letter/d/b487fb/32.png) [@DrDeth](https://boards.straightdope.com/u/DrDeth)\ **Post date:** [September 30, 2016, 4:35pm UTC](https://boards.straightdope.com/t/is-it-true-that-when-you-call-an-ambulance-for-someone-you-have-to-pay-for-it-need-answer-fast/766621/155 "2016-09-30T16:35:40Z")
> [@Novelty\_Bobble](#): > > Not for healthcare I don’t. It is quite possible that my taxes are higher overall than yours but it is impossible to slice up that difference and say you are £7000 better off by being in the USA. I dunno, your fellow brits can do so easily: > **[Just where does all your tax go?](https://www.express.co.uk/news/uk/297810/Just-where-does-all-your-tax-go)** > > THE huge burden on struggling families to help pay for Britain’s cash-guzzling public services is laid bare today. For a salary of 50K £ you pay £ 2666 or $3500 USD. ---
**Author:** ![DrDeth](https://avatars.discourse-cdn.com/v4/letter/d/b487fb/32.png) [@DrDeth](https://boards.straightdope.com/u/DrDeth)\ **Post date:** [September 30, 2016, 4:42pm UTC](https://boards.straightdope.com/t/is-it-true-that-when-you-call-an-ambulance-for-someone-you-have-to-pay-for-it-need-answer-fast/766621/156 "2016-09-30T16:42:54Z")
> [@Grim\_Render](#): > > The average waiting time in a US emergency room in 2011 was [four hours and seven minutes.](http://www.businessinsider.com/utahs-eight-hour-emergency-room-wait-time-average-is-a-us-record-2011-11?r=US&IR=T&IR=T) > > I don’t think you fully grok what we are talking about. You have money taken of your paycheck by taxes to pay for healthcare. More than someone form the UK does. Then, unlike someone in the UK, you have to pay again to actually receive healthcare. This comes in form of direct costs, co-pays and employer contributions that further reduce your paycheck. > . That’s a bad site, according to the CDC: [http://health.usnews.com/health-news/patient-advice/articles/2015/05/08/enduring-really-long-waits-at-the-emergency-room](http://health.usnews.com/health-news/patient-advice/articles/2015/05/08/enduring-really-long-waits-at-the-emergency-room) \*In May 2014, the Centers for Disease Control and Prevention reported average emergency department wait times (about 30 minutes) \* They take 1.45% out for Medicare . That’s all I pay by taxes for healthcare. I pay $120/mo for insurance. You pay £ 2666 or $3500 USD on a modest salary. ---
**Author:** ![theR](https://avatars.discourse-cdn.com/v4/letter/t/977dab/32.png) [@theR](https://boards.straightdope.com/u/theR)\ **Post date:** [September 30, 2016, 6:22pm UTC](https://boards.straightdope.com/t/is-it-true-that-when-you-call-an-ambulance-for-someone-you-have-to-pay-for-it-need-answer-fast/766621/157 "2016-09-30T18:22:40Z")
> [@DrDeth](#): > > That’s a bad site, according to the CDC: > > [http://health.usnews.com/health-news/patient-advice/articles/2015/05/08/enduring-really-long-waits-at-the-emergency-room](http://health.usnews.com/health-news/patient-advice/articles/2015/05/08/enduring-really-long-waits-at-the-emergency-room) > > \*In May 2014, the Centers for Disease Control and Prevention reported average emergency department wait times (about 30 minutes) \* > > They take 1.45% out for Medicare . That’s all I pay by taxes for healthcare. > I pay $120/mo for insurance. You pay £ 2666 or $3500 USD on a modest salary. You are comparing two different things. The treatment time is what was mentioned in the BBC article while the CDC listed time is initial contact with a doctor, physician’s assistant, or nurse practitioner, in other words the wait until they first make contact with the medical practitioner. Still, the [actual CDC report](http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6319a8.htm) shows the median treatment time as a little over 90 minutes, not the four hours mentioned by Grim Render. Note that all these USA numbers reflect ER visits from at least five years ago, so may no longer be accurate. ---
**Author:** ![Novelty\_Bobble](https://avatars.discourse-cdn.com/v4/letter/n/a3d4f5/32.png) [@Novelty\_Bobble](https://boards.straightdope.com/u/Novelty_Bobble)\ **Post date:** [September 30, 2016, 6:55pm UTC](https://boards.straightdope.com/t/is-it-true-that-when-you-call-an-ambulance-for-someone-you-have-to-pay-for-it-need-answer-fast/766621/158 "2016-09-30T18:55:43Z")
> [@DrDeth](#): > > I dunno, your fellow brits can do so easily: > > [Just where does all your tax go? | UK | News | Express.co.uk](http://www.express.co.uk/news/uk/297810/Just-where-does-all-your-tax-go) > > For a salary of 50K £ you pay £ 2666 or $3500 USD. As I freely admit, a portion of my taxes go to fund the universal healthcare in the UK, the NHS. As that table shows it also goes to fund lots of other things as well. The thing is, whether I contribute that much in taxation, or the £1000 on a £26k wage or the £500 on a £15 wage…or even £0, the healthcare I get is exactly the same and costs me exactly the same in out of pocket expenses…£0 Now then, do tell, how much of the taxation on an equivalent £50k in the USA is taken to fund government supplied healthcare? A healthcare provision which, by the way, you can’t access unless you pay extra out of your pocket ---
**Author:** ![wolfpup](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wolfpup/32/10618_2.png) [@wolfpup](https://boards.straightdope.com/u/wolfpup)\ **Post date:** [September 30, 2016, 7:03pm UTC](https://boards.straightdope.com/t/is-it-true-that-when-you-call-an-ambulance-for-someone-you-have-to-pay-for-it-need-answer-fast/766621/159 "2016-09-30T19:03:21Z")
> [@DrDeth](#): > > You are comparing apples and oranges. $$ per capita spent on health care is not what we we discussing. We were discussing how much **I** spent compared to **Novelty Bobble**. I again, for the third time quote **"According to the estimates that I see you pay a lot out of every paycheck (far more than I do and I earn a very good wage) "**. I do _not_ pay\* a lot more \* out of every paycheck than Novelty Bobble does, in fact, as I showed, i pay far less. No, I’m not comparing apples and oranges. The per capita health care cost is a standard methodology for comparing the relative costs and therefore the relative efficiencies of different countries’ health care systems. Not surprisingly, it turns out that these numbers track the relative costs of specific health care services fairly closely, too. I once looked into this in detail, and though I don’t have numbers in front of me at the moment, would it surprise anyone to learn that many health care services cost two or three times as much in the US as they do in Canada, reflecting on average the same disproportionate ratios as the per capita totals? Somebody has to pay for that – namely you, and you do so through some combination of dollars and/or being stiffed with limited or substandard services, plus paying for insurance company administration and profit on top of that. > [@DrDeth](#): > > Perhaps the average person pays more, but that’s not the argument. I, **Dr Deth** pay _Less_ than **Novelty Bobble**. Got that? I get it, you don’t. > [@DrDeth](#): > > No annual deductibles, Heart surgery is like a $200 co pay. I belong to a **HMO,** not a PPO. As long as I go to my org, the care is covered. Do you understand the difference between a HMO and a PPO? I understand enough to know that HMOs can be pretty damn shitty, with many restrictions and limited coverage. Where I live we don’t have HMOs, PPOs, or any other alphabet soup. We also don’t have medical “networks” that you are allowed to use and those that you’re not. What we have are doctors and hospitals, period. You use the ones you like, and it doesn’t cost you a cent. And the total cost of this, amortized over the whole population, is a small fraction of what you (or youse, on average) have to pay for equivalent services. > [@DrDeth](#): > > I dunno, your fellow brits can do so easily: > > [Just where does all your tax go? | UK | News | Express.co.uk](http://www.express.co.uk/news/uk/297810/Just-where-does-all-your-tax-go) > > For a salary of 50K £ you pay £ 2666 or $3500 USD. No, you can’t do it that way, either. The NHS is primarily funded out of general taxes, and the more you make, the more taxes you pay. That chart just shows the relative allocation of tax dollars to different program expenditures. It tells you nothing about the relative burden of health care costs, which _ **by definition** _ of what “per capita” means is just a fraction in the UK of what it is in the US. You might as well take as an example someone making £2,000,000 a year and use that as an example that health care in the UK costs a fortune because he’s paying, proportionately, hundreds of thousands of pound for it! Here’s a good illustration of why this kind of figuring makes absolutely no sense. I’ll use Canadian numbers because I’m more familiar with them. Would you care to guess how much the US federal government spends on health care compared to the Canadian government? It turns out that it’s almost exactly the same – it might have changed slightly since I last looked it up, but some years ago it was 6.7% of the GDP for the US government and 7% in Canada. That’s for things like Medicaid, Medicare, public hospitals, the NIH and CDC, etc. Guess who pays for that? _ **You do.** _ And then you (and your employer) have to pay for your own private health insurance, too, on top of that. In Canada that covers a big chunk of the public health insurance system, with the rest coming out of some combination of provincial taxes and/or direct health insurance surcharges. [Here is what the surcharges are in Ontario](http://www.taxtips.ca/ontax/ontariohealthpremium.htm). You can see that they’re geared to income and the most that anyone would ever pay is $900 a year ($75 a month) and only if you make over $200K; the average person would pay about half that. And for that, you get unlimited, unconditional health care coverage anywhere you please with zero co-pays and zero deductible. With that rational way of looking at it, it suddenly starts to make a lot more sense that the per capita cost of health care in Canada – and in the UK, and in every other nation on earth – is so much less than in the US. As opposed to your convoluted logic trying to show that it’s actually way cheaper in the US! It just isn’t. I know someone in the US who just recently retired and was shocked to discover that to maintain the standard of health care coverage to which he was accustomed would cost him nearly $900 a month, and that’s just to supplement Medicare. Yet somehow you get perfect coverage for just $120, even though it would take four or five lifetimes of premium payments just to cover the typical cost of a single major medical event. That is one generous health insurer you’ve got there! > [@DrDeth](#): > > They take 1.45% out for Medicare . That’s all I pay by taxes for healthcare. > I pay $120/mo for insurance. You pay £ 2666 or $3500 USD on a modest salary. It doesn’t matter how often you repeat nonsense, it’s still nonsense. ---
**Author:** ![DrDeth](https://avatars.discourse-cdn.com/v4/letter/d/b487fb/32.png) [@DrDeth](https://boards.straightdope.com/u/DrDeth)\ **Post date:** [September 30, 2016, 7:06pm UTC](https://boards.straightdope.com/t/is-it-true-that-when-you-call-an-ambulance-for-someone-you-have-to-pay-for-it-need-answer-fast/766621/160 "2016-09-30T19:06:52Z")
> [@Novelty\_Bobble](#): > > As I freely admit, a portion of my taxes go to fund the universal healthcare in the UK, the NHS. As that table shows it also goes to fund lots of other things as well. > > The thing is, whether I contribute that much in taxation, or the £1000 on a £26k wage or the £500 on a £15 wage…or even £0, the healthcare I get is exactly the same and costs me exactly the same in out of pocket expenses…£0 > > Now then, do tell, how much of the taxation on an equivalent £50k in the USA is taken to fund government supplied healthcare? A healthcare provision which, by the way, you can’t access unless you pay extra out of your pocket Again, we were comparing how much\*\* _I_\*\* pay as opposed to you. Medicare and medi-cal is mostly free to the recipient. [Previous page](https://boards.straightdope.com/t/is-it-true-that-when-you-call-an-ambulance-for-someone-you-have-to-pay-for-it-need-answer-fast/766621.md?page=7) [Next page](https://boards.straightdope.com/t/is-it-true-that-when-you-call-an-ambulance-for-someone-you-have-to-pay-for-it-need-answer-fast/766621.md?page=9)