<instructions>Your goal is to analyze the following comment and estimate how highly it will be upvoted by the Hacker News community.</instructions><comment><author>yellowapple</author><text>&amp;gt; Assuming that was under the deductible, so the ambulance provider did not get paid anything else&lt;p&gt;Hm?  The insurer would&amp;#x27;ve paid the difference (minus some additional discounts depending on the size of the insurer and its bargaining power).  That the patient paid $500 does not in the slightest bit indicate that the insurer negotiated the rate down to that pricepoint.&lt;p&gt;Even at $500 (and let&amp;#x27;s assume that was an hour-long ride, for easy math that&amp;#x27;s maximally generous to your argument), EMTs on average make around $20&amp;#x2F;hour at best, and maybe double that for a nurse - so a fully staffed ambulance would run around $80&amp;#x2F;hour for labor.  Round it up to $100 to be generous and that still leaves $400 for the ambulance itself.  Ambulance itself costs up to $150,000, so earmarking another $100 would pay it off after 1,500 hours of service - so less than a year, even if it&amp;#x27;s only running for 40 hours a week.  Maybe it&amp;#x27;s &lt;i&gt;really&lt;/i&gt; fuel-inefficient and breaks down frequently, so we&amp;#x27;ll say another $100 for fuel and maintenance.  Throw in another $100 to pay off $150,000 worth of equipment and medical supplies.&lt;p&gt;So of that $500 price the patient pays, we&amp;#x27;re left with $100.  At the price billed to the insurer, that&amp;#x27;s an eye-watering $11,600 of what appears to be pure profit.  Maybe there&amp;#x27;s some excuse for that, but to me it&amp;#x27;s pretty obvious that something&amp;#x27;s way out of whack.  $500 or even a bit more than that would be reasonable if EMTs and nurses were being paid better, but they largely ain&amp;#x27;t.</text><parent_chain><item><author>lotsofpulp</author><text>$500 for a specialized vehicle on demand 24&amp;#x2F;7 with somewhat trained workers who have to deal with undesirable work seems pretty good.&lt;p&gt;Assuming that was under the deductible, so the ambulance provider did not get paid anything else, and $500 was the negotiated pricing for members of your insurance plan.</text></item><item><author>morelisp</author><text>My last ambulance trip in the US was billed at $12000. With my (good!) insurance I still had to pay $500.</text></item><item><author>pigtailgirl</author><text>-- An ambulance in Ontario is $40 if you have OHIP - I know plenty of non-OHIP folks who have gotten hit with $200+ ambulance bills - myself included --</text></item><item><author>Waterluvian</author><text>I don’t disagree. But I’m not sure what alternative I have to hoping this might be the start of something.&lt;p&gt;In Ontario an ambulance trip is about $40. But in the US it can be crippling.</text></item><item><author>nimbius</author><text>call me a cynnic but as an american...this is theater.&lt;p&gt;people already avoid a call to 911 because the subsequent ambulance service is unaffordable and can land you in collections.  they avoid the ER for the same reason.  988 assumes anyone who needs crisis care will be able to get it, or even afford it and the ecosystem of services and medications that may ensue.&lt;p&gt;988 gives, as amber alert did, a can for politicians to kick down the road and cheerlead.</text></item><item><author>Waterluvian</author><text>Policing is in such a horrible state in America that an emergency number that excludes police involvement seems increasingly necessary.   I wonder if you can get paramedics through this route or if it just rings and you eventually get a counsellor.</text></item></parent_chain></comment><story><title>U.S. transition to 988 suicide and crisis lifeline begins Saturday</title><url>https://www.hhs.gov/about/news/2022/07/15/us-transition-988-suicide-crisis-lifeline-begins-saturday.html</url></story>
<instructions>Your goal is to analyze the following comment and estimate how highly it will be upvoted by the Hacker News community.</instructions><comment><author>oops</author><text>The $40 in Ontario sounds even better tho right? Just as the billed imaginary $12k figure that only exists to make “$500 seem pretty good” sounds absurd.</text><parent_chain><item><author>lotsofpulp</author><text>$500 for a specialized vehicle on demand 24&amp;#x2F;7 with somewhat trained workers who have to deal with undesirable work seems pretty good.&lt;p&gt;Assuming that was under the deductible, so the ambulance provider did not get paid anything else, and $500 was the negotiated pricing for members of your insurance plan.</text></item><item><author>morelisp</author><text>My last ambulance trip in the US was billed at $12000. With my (good!) insurance I still had to pay $500.</text></item><item><author>pigtailgirl</author><text>-- An ambulance in Ontario is $40 if you have OHIP - I know plenty of non-OHIP folks who have gotten hit with $200+ ambulance bills - myself included --</text></item><item><author>Waterluvian</author><text>I don’t disagree. But I’m not sure what alternative I have to hoping this might be the start of something.&lt;p&gt;In Ontario an ambulance trip is about $40. But in the US it can be crippling.</text></item><item><author>nimbius</author><text>call me a cynnic but as an american...this is theater.&lt;p&gt;people already avoid a call to 911 because the subsequent ambulance service is unaffordable and can land you in collections.  they avoid the ER for the same reason.  988 assumes anyone who needs crisis care will be able to get it, or even afford it and the ecosystem of services and medications that may ensue.&lt;p&gt;988 gives, as amber alert did, a can for politicians to kick down the road and cheerlead.</text></item><item><author>Waterluvian</author><text>Policing is in such a horrible state in America that an emergency number that excludes police involvement seems increasingly necessary.   I wonder if you can get paramedics through this route or if it just rings and you eventually get a counsellor.</text></item></parent_chain></comment><story><title>U.S. transition to 988 suicide and crisis lifeline begins Saturday</title><url>https://www.hhs.gov/about/news/2022/07/15/us-transition-988-suicide-crisis-lifeline-begins-saturday.html</url></story>