30 Days of US Healthcare: Surprise Billing

Day 7 - Surprise billing
You can learn more about this video's topic on our blog (glaucomflecken.com/the-no-sur....
Here is the 30 Days of US Healthcare playlist: • 30 Days of US Healthcare
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[@AliciaMcIntire]

This was me after a bike accident. Some good Samaritans found me in the road and asked if I needed an ambulance. I told them that I was a broke college student and couldn't afford it. They, being Americans, understood my predicament, and they drove me the mile to the ER

[@Withpeace7597]

US Healthcare is more screwed up than anything else on the planet.

[@felipercalvo]

Fun (not so fun) thing, if you had suffered any form of injury that could be atributed to their means of transporting you, you ould sue them for life. That is one of the reasons that the formal recommendation is to call an ambulance and nothing more

[@BytestormYT]

@@felipercalvo Wouldn't that be covered by Good Samaritan protections?

[@jerrykinnin7941]

There was a dump truck driver I worked with. He got the truck loaded at the quarry. When he pulled up to the window for his gravel ticket. He told the scale man to call his boss to have them meet him at the hospital. Cause he was having a heart attack. Then call the hospital to tell them he's coming in He parked the truck in the ER ambulance entrance. He survived that one. But died on the job a few years later.

[@jeffslote9671]

If you’re that close and talking you don’t need an ambulance

[@hockeynpolo1]

As a flight nurse, I love the fact that your patch says “Flight Ophthalmologist.”

[@ArkienII]

What does the Flight Jonathan do?

[@jamesmatthews291]

​​@@ArkienIIAll the paperwork involved in emergency eye treatment on an aircraft! And pretty much evrything else...

[@North_West1]

@@ArkienIIwho do you think is flying? Jonathan is the Co-pilot…Texaco Mike is the captain/instructor

[@rofljohn23]

@@North_West1Beat me right to it!

[@ShuRugal]

@@ArkienII left hand on the collective, right hand on the cyclic, nod until the engine starts.

[@carols-corner]

Had to take my son to the ER in the middle of the night a couple weeks ago. My brain actually had to debate whether to go to the nearest hospital or drive an extra 10 miles (on wet roads after midnight) to an in-network hospital. I reminded myself that in true emergencies, I was pretty sure my insurance would cover an ER visit at any hospital… but I wasn’t completely sure… but it was my son’s health on the line… I went to the closest hospital. Everything turned out okay (I think… still waiting for the bills to arrive). But the fact that I had to have that internal debate is MESSED UP.

[@raphaelledesma9393]

Welp fingers crossed that the insurance company considers it a true emergency. Just one of many loopholes I’m seeing.

[@feha92]

Why didn't you pick the cellular-/tv-network insurance that covered your closest hospital? Feels like that is the kind of thing you check before selecting a provider for essential services (like broadband). It is just like how you need to check if the tv-/broadband-provider even offers services to your apartment complex before signing up to one. And yes, I am intentionally having fun with americas intentionally confusing words. "network"? For insurances? Really?

[@james.telfer]

It's messed up healthcare for anyone under 18 is charged for. You don't even pay for prescriptions in the UK until you've left education (at 18-22)!

[@Kait2478]

And then you wonder whether the insurance company will deem it a “true” emergency

[@purpleunicorn87]

@@feha92 most people have far more important things to worry about when choosing insurance, like making sure the plan is affordable and covers doctors, medications, and conditions that they already have/need

[@virginiamoss7045]

Every American citizen needs to view this series in full! I follow government health care stuff pretty closely and I did not know this.

[@LeighaThorne]

I really hope he puts them all together in the end so I can send it to my dad

[@SenthilKumar-yx8up]

They should also have a clown makeup set by the side so they can be in character.

[@Emilio1985]

If only there was a relationship between what the American people want and how the government operates. Instead, our government only acts on behalf of rich people.

[@Flowmada]

I found this out with a spot on $1200 ambulance ride to the hospital after a car accident where I hit my head and they refused to allow my mom to drive me there. Evidently ground ambulances are separately billed because they are typically contracted or not. Sometimes thru the city and sometimes thru thru the hospital. Sometimes they're employees of the fire department or hospital. Sometimes they're county owned. It's no surprise that Congress would have a time untangling the legal constraints presented in insuring, what should be a required first responder, life saving transport of a person to higher echelon care.... They are made up of representatives from different states and are themselves... Tangled up

[@MSte21]

@@LeighaThorne He has a playlist he's adding to with every new skit in the series.

[@clearlyconsistent1728]

I once drove myself to the hospital with a spurting artery wound. The policeman who stopped me for my erratic driving understood that I had no money for an ambulance and cleared the way for me to drive the last 4 blocks to the hospital.

[@james.telfer]

Did they at least give you a tourniquet so stop you bleeding out?!!?

[@sopyleecrypt6899]

Holy sh*t they let you drive with uncontrolled bleeding?! That’s insane!

[@tammymavery]

Dear god. Though, my grandfather drove himself to the hospital during a cardiac arrest.

[@turtlrunr]

Dad drove himself to the local DALLAS Tx hospital having his Heart attack #1. SMH... Mom has an emergency ambulance ride ,3 months later,after she dies, City DEDUCTS it from the City WATER BILL...2023..Tx healthcare....SMH

[@turtlrunr]

**clarification.. CITY ADDS THE ambulance ride to the City water bill...edited for accurate account. Can provide screenshots .. 😂 SMH

[@celticwolff5429]

Any viewers who know someone who works for the press, ask them to a story on this series. They can connect it to the 2024 elections. If we can get the story to go viral, it will educate more people and increase Dr, G's views & subscribers.

[@jerseygirlinatl7701]

NPR has a monthly story on the 'Bill of the month'. They talk to the patient and/or patient's family (August was a bill the widow received a year after her husband had passed). They also talk to a Medical expert or the reporter who did the research, When NPR trys to contact the hospital/doctor/insurance company they normally don't get an answer but, surprise surprise, the issue is usually solved.

[@MauriceOfInfiniteAtrocities]

It’s very naive to assume the media is at all interested in what bankrupts working class Americans. Modern journalism was invented by the same guy that invented modern propaganda tactics. Which is to say, the media is built on the premise of controlling your thoughts and emotions.

[@TroIIingThemSoftly]

LOL, like Republicans care about helping people with healthcare.

[@Raevarie]

Bumping up ❤

[@AlloftheGoodNamesAreTaken]

@@jerseygirlinatl7701I saw that once. I can’t remember the specs, but that poor patient had been put through so much by the insurance and hospital. And to have it resolved merely because the press got involved tells you how disgusting the system is.

[@aubryreynolds9344]

I'm an EMT in Utah. I will probably discuss how much transport could cost every other day. The problem with this is that the crew in the truck has no idea how billing works or how much anything is set to cost. We are only told that there is a set fee to transport, and then we charge by the mile plus supplies used. Explaining that to a sick person or their family can be frustrating and confusing.

[@lechatbotte.]

It’s been that way longer than this clip alludes to believe me.

[@HisameArtwork]

your dystopia is so much weirder than when we had communism. if you complained they'd send you to hard labour to die of starvation and exhaustion. You may or may not get raped, probably did get and tortured of course. So many people died. but at least things were clear: beatings, starvation, hard labour, despair and hopelessness, high certainty of death. the American healthcare system is some advanced soul crushing strategy. very creative psychological torture. admirable, satan would be so proud.

[@virginiamoss7045]

Way back in the 1990s Colorado Springs decided to get more tourists to come to their area by expanding their little airport to accommodate larger jet liners. They offered round trip air fare from Atlanta on a certain airline for $99. I thought, heck why not; I packed, hopped on that flight and when I got off, I found myself strangely not well and assumed it was the altitude. All I wanted was to get my rental car and head to my hotel. There was no place anywhere to sit down so I asked the rental desk where I could find a seat. They jumped up, led me to their back office, called the medics who gave me sugar paste even though I had just eaten a hot dog and fries before the flight and called an ambulance. I refused it because I was hardly in that bad a shape; I was breathing fine. They would not rent me a car thinking I was unable to drive. I finally gave in and spent half the night in ER where they said I was fine. There's way more to the saga, but when I got home I got a full bill from the ambulance company for the expensive ride. I responded that insurance should cover it, which it did for the usual and customary amount. Bills kept coming for the balance of the super-extra amount they originally charged. I was not going to pay one penny. I decided to submit a letter to the editor of the local Colorado Springs newspaper describing my "welcome" to their area; it was published. A week later I received a letter from the ambulance company indicting my account was paid in full. I guess some city leadership didn't like them taking advantage of the very tourists the city was trying to attract.

[@iguanazilla]

Our ambulance rates are posted on the wall. Its pretty cool

[@EastonJackson-GMC]

I hear you. I'm an urgent care doc in Utah. And I regularly want to call an ambulance to transport a chest pain or stroke patient to the hospital. Kind of a time-sensitive issue. Much more often than not, they refuse transport to the hospital (which is about a mile away) with, "Nope. No way. I did that once and it cost me $4,000. My wife (similarly elderly person) will drive me." Yeah, I've had STEMI's refuse transport for this reason. It's insane and easily fixable.

[@gibronimo]

For this 30 days of Healthcare series, we definitely need laugh cry button instead of just the like/dislike buttons.

[@PatrickKQ4HBD]

But it has to be the same button!

[@whoshotashleybabbitt4924]

“Congress typically does what it says it’s going to” 😂😂😂

[@ukahchiagoziem570]

Uh huh 😂

[@mdyas1711]

Well when it comes to voting on their pay raises they always do what they say their going to do.

[@SubMeISubYouu]

Best joke

[@loribach534]

Yeah, like "kicking the can down the road"!

[@johnswanson2600]

As an American Paramedic this didn't make me angry as much as sad. The amount of times I've had to tell patient's they need to go and not to worry about the bill is depressing. At my last job - a private company - we had a phone number we could call for someone in the billing office, who would assure them their bill wouldn't be sent to collections and they'd work out a payment plan. At my current job, a city owned service, I have tell people that billing is above my pay grade. It really hurts that I work for a public tax supported entity and people still worry about how much their city is going to bill them for ambulance service.

[@turtlrunr]

City will actually cut off the electric or water service over a 200$ or whatever, ambulance ride...it's ethically wrong.

[@xc5103]

Then it should make you angry more than sad

[@johnswanson2600]

@@xc5103 It used to make me angry. Now I'm just worn down and out by it.

[@Xtermy]

​@@turtlrunrThat's horrible! Can I ask which state this happens in?

[@KevinJDildonik]

"Work out a payment plan" in my rural home area, rolling an ambulance is a base ~$10,000 fee. One company worked out how to monopolize the fleet, and how to get maximum dollars from a federal program to provide ambulances in under served areas. This works out, somehow, to a $10,000 fee that state insurance won't cover even if the patient is flatlining. And they get additional federal money to run the fleet. So they just keep both payments.

[@thomasmoeller3446]

Scary but true. Over $200 per mile for ambulances. Since ambulances require prior authorization, it's an uphill battle for a patient to fight. Had to be rushed to an ER by ambulance a few years ago and insurance said it wasn't prior authorized. I shot back "I had no plan to get hit by a car while walking my dog. We do a walk at least 2x daily. How do I submit prior auth request for potential BID services for the next 10 years?!!!!" They finally paid the bill.

[@Emojibones]

Prior authorization is a scam. Healthcare providers spend more time preparing the documents then insurance does reading them. There is no way that the insurance company is reading all that documentation. But if it’s missing? Denial.

[@andynonymous6769]

My favourite part is that most medics make about 20$/hour

[@arty1813]

@@andynonymous6769 And some EMTs only get paid "standby" pay when not on an active call, which is far below minimum wage. So on a slow day, they make nothing.

[@waffles3629]

​@@arty1813 yep. In my area paramedics get paid state minimum wage. The companies also can't figure out why they can't find anyone to work for them.

[@driftwolf]

"Ambulance requires prior authorization". This for an EMERGENCY service that, by definition, can't really be foreseen. I'd be flabbergasted if I hadn't been watching Americans get screwed over for the last few decades. And then so many dare claim they have the "best system"? One message: keep the American style "health care" scam FAR from Canada please. Thank you.

[@webbowser8834]

I feel like 70% of health insurance laws/regulations passed can be summed up with "yeah we tried to make things better, but the insurance company's found a loophole to make everything still suck." The remaining 30% of course are "we are codifying that yes, this terrible insurance practice is totally legal."

[@drac124]

The word you are looking for is corruption not loopholes.

[@offmetasounds4361]

Called an ambulance when my partner was having a stroke. It took him to the nearest hospital, about a 5 minute drive away. It was about $3000, with insurance covering only $1000, because that was the max that they felt the ambulance should be charging. We paid the rest out of his short term disability payments, nearly wiping them out.

[@deepwater3646emt]

Like most states CT regulates how much an ambulance can charge, but then turns around and says they won't pay that for a medicaid patient. It is mind blowing.

[@joshuamurphy75]

Mine was about 3 grand out of pocket too

[@danwieland7597]

I’m a career paramedic and unfortunately have to have these conversations a lot. One thing I think people don’t understand is that outside of major cities the vast majority of ambulance services are not municipally run. Most of these companies are either nonprofit ambulance companies or volunteer fire companies. This means without meaningful municipal funding they are almost completely dependent on billing to support their services. Unlike large hospital systems these small diffuse companies have no bargaining power with insurance companies driving reimbursement rates down. Ambulance services are almost always out of network bc in network reimbursement rates are too low to keep the lights on. It’s a bad situation for patents and providers and is killing EMS, particularly in our rural areas.

[@drac124]

And yet don't blame the government. Americans way of thinking is amazing

[@LHCB6]

$24 per mile. Plus other fees. That seems like it would cover costs and then some. Edit: This isn't a suggestion, it's disbelief, and possibly me lowballing the number.

[@maryann9400]

The times when hospitals, of any size, ran their own ambulance services is long gone. Ambulances may stop/deliver to hospitals, but they are run by either the city/county/private sources.

[@end3rsgam325]

We need a returning character that is an EMT or Paramedic!

[@jamesburton1050]

Yes!!!

[@grmpEqweer]

Thirded.

[@AlexandraMcFadden]

Fourthed.

[@andynonymous6769]

Fifthed

[@ItsAsparageese]

Yes to this, but also, omg can you guys imagine a collab with Jason/Fire Department Chronicles? With their respective brilliant senses of humor and excellent acting, that would be INCREDIBLE

[@proudvirginian]

I have had this conversation multiple times in my career. People with life threatening problems are legitimately concerned about the cost of the ambulance. When I volunteered it was easier. No cost. When I go to work, "it's a crap shoot" "no idea" . I have even told people that"in the grand scheme of all the bills, this one will be the least." I'm expected to fill out insurance information as part of my call sheet and put "reason for transport". #MedicLife

[@meowww7308]

The sad reality is that most Americans can’t even afford a 500 dollar surprise expense, so the thought of surprise medical care is incredibly stressful. I have insurance + emergency fund so I know I’d be fine, but me last year would be in so much debt if I needed emergency care.

[@tscimb]

Our "volunteer" ambulances still send us a bill, just about as high as the local hospital ambulances.

[@proudvirginian]

@@tscimb wow! We never sent anything. Tax money, fund raisers, donations and proffers funded us.

[@tscimb]

@@proudvirginian nice to hear there's still a good group of people out there.

[@turtlrunr]

​@@tscimbtrue, VOLUNTEER AMBULANCE isn't FREE!!

[@graysonaldridge7011]

Please keep up the great work! This topic is something everybody theoretically can get behind, and if we all come together we can fix!

[@shallbetterdj]

Best way to accomplish this is by contacting your representative you can do so through this site www.house.gov/representatives/find-your-representative. Enter your zip code and then click on your rep. There you will have the option to mail, or email your concerns directly to them. If enough people demand congress to act, they will be forced to if they want to keep their jobs.

[@drewidlifestyle7883]

The Profitcare lobbyists want that money so who cares about the citizens they’ve gerrymandered themselves into security and only have to do what their O̶w̶n̶e̶r̶s̶ Donors say

[@HyperLuigi37]

What a guy Dr. Glauckenflecken is, posting at Midnight JST. The perfect time for my ass in Japan to sleep well knowing I’m not in the US healthcare system anymore 😌

[@talithasuya8908]

lol. Sweet dreams.

[@VolatileBullfrog]

Begrudgingly giving you +1. The envy is real.

[@Dan016]

@@VolatileBullfrogindeed 😒

[@sharktrap267]

How is it in japan in comparison?

[@safaiaryu12]

Lucky dog... isn't it really hard to immigrate to Japan?

[@KvenKing]

$6,000 for a 25 mile ride from one hospital to another. Not covered. My wife needed to be transferred from one hospital to another for a heart catheterization procedure. It cost over $6000. No lights, no sirens, no emergency care. Basically just a taxi ride.

[@maridiancrest243]

I would have simply taken her myself? Whats she going to do sue her husband if something goes wrong?

[@rickwrites2612]

​@@maridiancrest243 either or both hospitals may have required her to go in ambulance transfer

[@KvenKing]

@@rickwrites2612 It was required, I asked if we had a choice.

[@cmccullough12C]

In my Canadian province, if a doctor wants a patient referred to another hospital for a procedure not done in the original hospital then the ambulance cost is FREE no matter the distance they may travel. Also in my province if we need an ambulance for any other reason then we pay a flat rate of $150.00. As a side note,I’ll use an example of a serious injury to a child being transported to a hospital would cost the family $150.00 but needed immediate emergency services at the nearest children’s hospital (5-6) hours away then air ambulance would be used for transport with a doctors referral at NO COST to the family. Also in my province if 65 years and older the ambulance are FREE. If you came to my province and needed an ambulance and you had no travel insurance then the flat rate would be $600.00

[@lh3540]

On the flip side, EMT's make as much as a sandwich shop employee, and my friend who tried a school program got saddled with an insurmountable amount of technical college debt and went bankrupt for it.

[@Bajirkus]

"Well surely with these enormous fees, the EMTs must make very good money and have very secure futures for themselves and their families!" "Actually we don't really get paid much better than grocery store cashiers."

[@grmpEqweer]

Yeah, it's ridiculous.

[@normamarotta7765]

I had a part time ED receptionist job at a community hospital when my kids were babies, so 20ish years ago. I made $17/hr + differential for evenings, weekends, holidays. The EMTs at the time were making $11/hr.

[@waffles3629]

I made more as a swim instructor than paramedics did.

[@MushuBear]

I was an international student in the states when my wife had an allergic reaction which required an ambulance ride to the hospital. Ended up being the most expensive part of her experience and most traumatizing as we were immediately sent to collections and dealt with that for 6 months.

[@james.telfer]

"Sorry, we don't live here and no you can't have my home address" Good luck extorting us!

[@MushuBear]

@@james.telfer pretty much what I did. 😆

[@terpman]

Thank you so much for shedding light, in PLAIN LANGUAGE, on the ridiculousness of our healthcare system.

[@ItsAsparageese]

"I hope taking brief moments to discuss highly relevant pertinent needful considerations doesn't impact your job performance metrics" Awwww wholesome working class solidarity ✨💖🌟

[@amylynn3821]

I’m a doctor and when I went to urgent care and was diagnosed with pneumonia and low oxygen they wanted to send me to the ER in an ambulance. I signed out against medical advice and drove myself. ( Also because I knew the nearest hospital was out of network and I didn’t want to deal with that).

[@garrybrown3165]

F-Bomb to the 5th power. Thank you for a month of promoting awareness of our "health" insurance industry. I am just finishing ten years of $50/month payments for a corrective procedure not covered by my insurance when I was living in Missouri (pronounced Misery).

[@grmpEqweer]

I got stuck behind a tourist from Missouri when I was running late. I call it "the slow-me state," now.

[@garrybrown3165]

@@grmpEqweer Josh Hawley seems to be able to run pretty fast!

[@jedinxf7]

​@@garrybrown3165😂

[@shawnycoffman]

Retired paramedic here. Freakouts about insurance happened on the regular. There are workarounds, but I will neither confirm nor deny that I participated in any. And this is going back nearly thirty years. Sadly, it's nothing new.

[@hawktheelfowl]

The only reason I wasn’t in the hole $40,000 for being air lifted for immediate life saving surgery was that No Surprised Act. Infuriatingly the air ambulance run by the hospital is considered a “subsidiary company” so naturally the insurance companies negotiate separately. Hospital in network, airlift out of network.

[@Restlessmedic]

Flight ophthalmologist? Every single time you make a new video, you find new and exciting ways to make me laugh. Two things, though coming from a medic of nine years. One, us taking the time to educate patients on the scene about literally anything (billing practices, how to correctly take their medication, some of the intricacies of their condition, etc.) is usually looked down on because it keeps the ambulance out of service for longer. Two, a significant number of ambulances in the US are owned by private, for-profit companies. What's worse is these companies have a large number of contracts to provide sole ambulance transportation (911 and interfacility) and double dip since they're the only game in town.

[@Sahdirah]

+

[@Flyboy_73]

Fortunately with where I live we have a $3 EMS charge added to our trash/water bills which covers ambulance service to any hospital within the metro area regardless of whether or not your insurance will cover it. Granted that doesn’t help when I’m traveling but I’m only away from home maybe 3 weeks out of the year.

[@SifuPaladin]

Where is this at?

[@Flyboy_73]

@@SifuPaladin home of the Thunder

[@NguyenM9]

There's a lot of nuances when it comes to understanding how EMS works in America. Nuances that affect how they run and operate including billing, John Oliver did a really good piece over it a few years ago, would encourage those interested to look it up. I worked for a small volunteer rural service, if it was a local resident, we would bill only Medicare/Medicaid and private insurance if they had it, our residents wouldn't see a bill from us. And if they did, we'd never go back to try to collect on it. That being said, that is just how my service worked - which is saying if you understand one service, you only understand one service. It will differ depending on what EMS service and company covers your area.

[@jimdawdy6254]

As a flight paramedic, I approve of the "Dr. Glaucomflecken - Flight Ophthalmologist" patch!

[@evajaz16]

The stories where people run away from the ambulance. Just cause they can’t afford the bill.

[@SifuPaladin]

In Minnesota at least there is a law that people can sign a waiver saying they refuse the ambulance once it arrives and can't be charged for it. It hasn't all the problems but at least most of the times we can call an ambulance for someone when we aren't sure if they need it without risking putting them in financial peril against their will.

[@ada5851]

That's so messed up

[@feha92]

@@SifuPaladinFun fact, if someone is in a coma and taken by ambulance to a hospital, that's kidnapping! You can't charge for kidnapping (outside america)! Also, if they put you in a room in a hospital then it continues said kidnapping, and is [insert lawyer terms for imprisoning someone against their will]. You can't charge ppl for imprisoning them [outside of america]!

[@tscimb]

​@SifuPaladin that sounds like a terrific law, even though I wish it wasn't needed.

[@screenmonkey]

@feha92 funfuct you are wrong, it the patient is unconscious, unresponsive or in a serious Altered Mental Status we have implied consent to transport you by ambulance, also the cops are also there to enforce that implied consent idea, and protect the medics.

[@jodil1209]

I never knew ambulance rides cost anything until I got a huge bill from them for taking me to the hospital for passing out. Luckily, when I called their billing department, they gave me instructions on what to do to get insurance to cover it. I always thought that emergency services were part of our taxes. Like firemen or police calls.

[@laurahardgrove955]

They should be.

[@goodfortunetoyou]

This is one of the aspects of healthcare that needs to be forced to work by congress nationally. I don't care if they're OON, patients shouldn't foot the bill on emergencies.

[@Kairamek]

Covering an emergency is the definition of Insurance. This is ridiculous.

[@arty1813]

@@Kairamek Nah, exploiting loopholes to pay the absolute minimum is the definition of insurance these days. Or, in some cases, full on cancelling your coverage because you, or whatever is being covered, is an inconvenience.

[@turtlrunr]

​@@arty1813Almost confused Healthcare Insurance with our wonderful legal system...Where attorneys search for every loophole to avoid convicting criminals ...

[@secretspy44]

The slow loss of steam, confidence, and enunciation while finishing the sentence "...congress typically does what they say theyre going to do." is masterfully done.

[@SAmaryllis]

Thanks for highlighting this, I had no idea about the No Surprises bill (good) or the ground ambulance exclusion (bad)

[@darianbroadhead2863]

Sad and true conversation. I shattered my wrist this past summer mountain biking and my first thought was “how much is this going to cost?” 4 months later I’ve got hardware removal scheduled in 3 weeks and have hit my out of pocket max and deductible. These videos are too damn good right now!

[@basedokadaizo]

"please don't nod, you technically don't have a C Spine anymore." if i had a nickel every time a doctor said something very similar to very sociable but dumb me every time i try to lighten the mood for us both when i'm injured, i could afford my insurance premium.

[@AznJsn82091]

I took an EMT course and I was 🤏🏻 close to making that my job. By the way, the snarkiness and I-don't-careness of the EMTs were good!

[@ChipCheerio]

I feel bad for the paramedics, EMTs, and nurses who have to work on those rigs to get people to care. They bust their ass through 10, 12, or 24 hour shifts being paid just a bit more than minimum wage and all because they want to help people. Yet they’re always aware they could bring someone to financial ruin just because they were the ones dispatched to a scene instead of an in network ambulance or they just dropped them off at an out of network hospital because it was the closest point.

[@marcoa.2585]

Cracked me open: 'we take lengthy discussions about insurance into account for our call-response times'.

[@deepakrajendra8019]

I love the introduction of the paramedics! A nod to the fire fighter that saved your life I assume (from the podcast)?

[@gamingnerdgirlz]

I recall a Reddit post about this, he called his insurance to check about the surprise Bill thing, the hospital it was one block away, the ambulance was not part of his insurance, but the helicopter was, he asked them, so if you’re covering the helicopter, are you sure?, Because the ambulance is cheaper. He eventually got it in writing that the ambulance was covered. Because it was cheaper. 🎉 It was an funny post. Like are you sure.

[@starrychan33]

I absolutely had the time measurements implemented in so many jobs. It incentivizes sloppy and rushed work and it ruins the ability to just be a human on the job. People used to know and chat with their mail person, now they don't have time to even say hi because they need to rush off to the next delivery

[@maggie6152]

The fun part, folks, is having these conversations when you might be literally dying and are in so much pain your mental faculties are working at 0-40% of their normal capacity. A perfect, completely humane practice to force patients to take a math and complex reasoning test before getting in an ambulance. 😎👍 Definitely, certainly, absolutely, most likely, maybe not speaking from experience...

[@someguyontheinternet4277]

residents never have to pay for ambulances because they already live in the hospital 😎

[@BlackCanary87]

In grad school I got an unending respiratory infection and wound up fainting in the bathroom and hitting my head on the bathtub. My roommate waited for me to come to and made sure my school insurance covered an ambulance before calling 911. No idea how she would have managed if I'd said it didn't; the EMTs had to carry me down the stairs because I was so loopy. (I was completely fine -- didn't even have a bruise from hitting the tub, it just made a really loud sound.)

[@james.telfer]

What would she have done if you didn't come round immediately?? 😳

[@_Dwarkin]

I had to use an ambulance a few times in my life (both for me and close relatives), it didn't cost anything, including hospital stay and everything else. After watching these vids it feels so good to live in Europe😂

[@floricel_112]

Yeah but sometimes there's jackasses who take advantage of the system to cut in line of the people with ailments who managed to come to the ER by themselves

[@McMindflayer]

@@floricel_112 ER triage does not act as if every ambulance is life or death. If you come in on an ambulance with a sprain, they will happily put you in a chair for 8 hours while they take care of patients that need more immediate care. People who think that taking an ambulance cuts in line are in for a loooong wait and a bonus bill.

[@North_West1]

Grumble grumble….

[@james.telfer]

@@floricel_112 That's literally what triage in the ER is for - the sickest are treated first. At least here it is!

[@michaelst.germain3530]

I work at an urgent care and on two ground ambulance services. This hits so hard.

[@xerk2945]

My dad was released from a hospital to a nursing home literally across the street from the hospital. It was maybe a third of a mile trip, and it cost $800 because there was no in-network option to transport him, and he was on a ventilator, so we didn't have the option of taking him ourselves. This was In 1997. I can't imagine what it would be now.

[@nicolemyers4584]

Oh man. Our healthcare system is so messed up. I have three adopted kids with free state health care through their adoption agreement and three kids who are under my husband’s BCBS plan. My kids with free healthcare get much better medical care. My BCBS covered four year old currently has ten stitches in her big toe. Her pediatrician wanted me to take her back to the ER to get them removed (another $350). I seriously considered taking them out at home, which is not what she needs. After a few calls, we found an urgent care willing to do it. But I will say having access to time sensitive and preventative health care just makes sense instead of making poor choices because of cost.

[@rlight7334]

Um, why couldn’t the pediatricians’s office do it? It makes me crazy the things these offices “can’t do” (won’t do).

[@nicolemyers4584]

@@rlight7334 I have no idea. My mom is a hospice RN and she said they have kits and can remove sutures. Not sure how an RN can remove sutures, but an MD can’t. 😒

[@bdaily3]

“Flight Ophthalmologist” hahaha

[@cavsfan9025]

Hopefully you make one of these about how little medicare values cataract surgery and pays so little!!!

[@curiouslycs]

I once walked with a stranger four or five blocks to the ER--he had broken ribs and was trying to make it on his own, but needed to lean on my arm to get through that last bit. Didn't want me to call an ambulance, and he was panicked when I pulled my phone out to check the directions until I reassured him that I understood and was just checking the route. He was in obvious pain and distress and all but collapsed when we made it through the door. I was already radicalized from my own experiences working in a hospital, but that was a helluva thing.

[@veronicaholme803]

This month’s series has me edified, entertained, and deeply upset. Great content!

[@tails359]

Paramedic here. Doc, you are a hero sir. Everyone needs to see this. People just don't -know- this stuff and how it effects them. They don't realize how badly their leaders have failed them.

[@Mike-zf7lo]

Nothing like making a rational billing decision that could cost you thousands of dollars while you're in excruciating pain and not thinking rationally.

[@castle843]

I once had a seizure in class. I returned to consciousness as they were loading me onto the ambulance and started panicking saying "woooaahhh, no I can't afford this, I'm fine", despite being in post ictal phase. They helped me off the stretcher and I was extremely off balance and wobbly so they asked if I needed a ride home. And i just straightened up my wobbly frame and staggered back to class. I wasn't missing my overpriced classes for an overpriced ride to the hospital for my health.

[@user-cw3lg2pk5t]

I watched this during some down time in my ER shift. It is stunning how often I have this conversation with patients in need of transferring from our critical access hospital. Keep up the good work!

[@mzthorn]

My mother is a retired postal worker and has exceptionally good insurance. Nothing is out of network. We still got a bill for the ambulance because they need extra permission to bill her insurance. They literally said they have her insurance, but she has to consent to them billing it. Which she can't do because she has advanced dementia and is technically a ward of the state.

[@SifuPaladin]

I found out the hard way that insurance also doesn't cover an ambulance until you've met your deductable.

[@darthimperious1594]

I once had a fever of 106F. I was feeling very light headed and was starting to get that confusion you get with high fevers. Turns out I was going septic from a recent surgery. I drove myself to the hospital, because I knew I'd be unable to pay the ambulance charge. It's a year later, and I'm still paying off the emergency room bill. My treatment, by the way, consisted of 3 IVs of antibiotics and 2 bags of fluids. Life saving, to be sure, but I saw medical personnel for about a grand total of 20 minutes, and otherwise was simply laying on a bed, out in a hallway by the way, for around 4 hours.

[@EdjieboaNova]

Absolutely true. You can make change happen with work like this. Thank you 💙 Dallas, TX 🌻

[@ironshield2154]

I feel so sorry for you guys... as a french guy, I truly am Some years ago I litteraly exploded my hand against a mirror, went to the hospital's emergency room, to the clinic specialized in hand injuries, got operated, stitched up, received prescription meds, and had a nurse come to my home every 3 days to change my bandages, and then remove the stitches. I don't know how much it would have costed an american citizen The whole thing costed me 25€, for the use of the ER at night if I recall Your country's health system is nuts

[@Madamchief]

Home health would cost the most. Probably around $12000 for that many visits

[@grmpEqweer]

And your system is cheaper per person than ours is. By a lot.

[@lh3540]

My pre Obamacare tonsillectomy was $45,000. We don't have home visits here, so what you described is probably like $50,000.

[@WildflowersCreations]

Thanks for the education, our health care system and government is a real nightmare to say the least.

[@kylafarris5582]

This is so true! Each time I have had to call an ambulance for my husband's heart attacks, it cost us $2,000 even though he had met his deductible and out of pocket cost for the year!!! Once Congress passed the no surprise billing, the cost for a ground ambulance double for us.

[@FayeVert]

"Flight Ophthalmologist", I love it.

[@Murraysmom2318]

Fun fact. I worked in ambulance billing. Prices were decided by the government and our service had to follow through. They upped it wvery year and at minimum it was 3500 in our rural area if the insurance didnt cover. That did not include the mileage. Im glad I dont do it anymore.

[@AzraNoxx]

That last line actually seems like something an administrator would do. "One minute discussion of injury and/or insurance coverage."

[@316Autos]

I got a gnarly stomach bug that had me projectile vomiting nonstop, couldn't even keep water down for more than 10 minutes. This dehydrated me to the point that every single muscle was cramping. Try to stand up, leg cramp, bend over in pain from the leg crap, and the abs cramp, try to stretch leg, foot cramps, it was absolute torture. I live 5 miles from the hospital and I can't get off the bathroom floor, and I know there will be a wait at the ER. In my desperate state of mind, I think if I call an ambulance, they can at least get a saline drip started. What a mistake that was. They had no medical supplies onboard, not saline, not even gauze, they made me walk to the ambulance, drove me 5 miles, and charged me $2500. I was fortunate enough to have a county program that reduced costs by half, but still, most expensive Uber ride I've ever taken.

[@spencers4121]

I had an ambulance ride around 1997, in the hospital with a head injury for 4 days. $32k later, and out still recovering. I have debt collector coming after me for a $350 ambulance ride. I never received any contact from them, and this was no joke less then a month later from the ride. Frankly it never crossed my mind back then, that the ambulance was, even separate from the hospital.

[@dianagibbs3550]

"we factor in a lengthy discussion about health insurance into our call response times" killed me dead.

[@SarafinaSummers]

I laughed so hard at that my dad messaged me to see what I was laughing at and so I sent him this.

[@KnightMD]

This series is inspiring to move back to Canada after residency training.

[@happyperson01]

AMEN !! right back atcha

[@paws315]

Proud to be an American. My vote really brings the change I want to keep up with Western Europes basic standard of living. Woo!

[@ItBePatYo]

I actually didn't know about the No Surprise thing. Great video, eye bro!

[@LUCTIANITO]

When I was a little boy and watched series and movies about some stuff in America I thought it would be a great place to live. Now I appreciate that I live in a country where I know I won't get ripped off for a medical bill. The health service here isn't the best but at least I know I would be attended ASAP without any questions about insurance.

[@davardi]

During the first day of college, the person next to me told me, "I have seizures occasionally, if I do don't call an ambulance if it lasts less than 3 minutes, just try to protect my head"

[@SarafinaSummers]

That's std for known epileptics, though. Why call an ambo for a known cronic health condition?

[@carsonkahla9162]

For those that think this is satire look up Katie Porter appendix burst. Long story short, she didn’t take an ambulance cause it would cost a lot, and specifically went to the in network hospital not the closest one and still got hit with an out of network bill cause the surgeon she saw wasn’t covered by her insurance.

[@simonederobert1612]

In my ignorant child- and young adulthood, I was taught and thought the United States of America was the best country in the world to live in. Best schools, best health care, best electoral system, best retirement system, safest. Well, with age comes hindsight and wisdom, and now there are many days when I look at the political fiasco that is our "Electoral College" (more like Nursery School), where one-person-one-vote and your vote counts is a joke, our healthcare system (screw the common person who wants to stay healthy), school system (rapidly becoming the worst educated in the world), entitled two-tiered policing system with over-crowded prisons and jails where the rich get away with whatever Supreme Court "Justice" they can afford to buy. Looking back, if I were 30 years younger I would have left.

[@grmpEqweer]

The best PR department. Hollywood. A lot of refugees get here and feel shortchanged too.

[@redflamearrow7113]

I totally agree! What a mess everything is here.

[@mrychards6682]

Yes, by the time I figured this all out, I was too old and too poor to move.

[@georgh.]

Once I observed a situation in Shanghai, China. A pedestrian was hit by a car and was unconscious and bleeding. He was with a friend who called an ambulance and cared for him as well as he could. When the ambulance arrived, the paramedics first requested a credit card payment and literally did not touch the patient until the payment had gone through. That man sitting on the ground, holding his unconscious bleeding friend trying to make the payment while the paramedics couldn't have cared less remains one of the most disturbing things I ever witnessed.

[@Ushio01]

Yeah in the US they treat him while he is unconscious then when he wakes up in the hospital he finds out he has a 5 or 6 figure bill that his insurance won't cover because it was all 'out of network'.

[@grmpEqweer]

​@@Ushio01it's usually more like $2,500-ish. Which is still bad.

[@JGBeagle]

And that man was Albert Einstein and then the entire class stood up and clapped.

[@grmpEqweer]

Yup, if something bad happens, I'm like "DON'T CALL AN AMBULANCE!" If I'm not actually spurting blood or losing consciousness I can get a ride or just drive myself to the ER.🤷‍♂️

[@docniksnk]

😵‍💫 This is just overwhelming for me. We have free health care and the service is not totally satisfactory but I feel we need to be thankful for not having these worries in Emergencies 😢

[@millersam07]

As a former EMT the most heart breaking thing was seeing the patient begging me not to take them. They were near death, and wouldn't make it an hour if they didn't go, but they still begged to drive themselves, take an Uber, or just not go. One guy said his funeral was prepaid but this ambulance ride isn't. To him it really was cheaper to die. He signed the form. My coworkers were called back the next day to confirm death. He was barely 50, left behind his wife, 2 adult daughters, and 3yr old grandson. That man could have lived, instead I blame our broken healthcare for his death.

[@thatmom402]

Paramedic in Texas. Thank you. Also, for anyone reading: in Texas, they can't take your assets for medical debts. Just… FWIW. Also $1200 is BLS. ALS is usually around $6k if there's significant interventions. And thanks for the hat tip to performance metrics. We literally get graded not off the quality of our care, but off of how fast we provide it. 1 minute chute time, 8 minute response, 30 minute scene, 15 minute transport (aka the patient punishment time because we're required to go where the patient requests and then punished if they ask for one that's too far away). Once we get handoff done, we've got 10 minutes to clean and chart and then we’re back. Sounds great till you realize that many of these metrics include things completely outside of our control. Oh, also, if we wind up with a patient refusal rate of greater than 10%, we have to go through remedial training.

[@plusultrafitness]

My fiance's best friend when she was 19 died of an allergic response to nuts in some food she ate on her own. She couldn't afford an ambulance so she tried to ride her bike to a nearby hospital and never made it. Its unbelievable that when you are in an emergency and potentially on deaths' door you have to think about how much is in your bank account before you can think about surviving...

[@emort1814]

$1200 ambulance ride? Nope. $3088 for a 4.2 mile trip. Not covered, of course.

[@Ianjoel58]

I week for this country… I weep for both patients and doctors. Overworked doctors get most of the blame for a lot of issues in our healthcare system, when a lot could be fixed by not putting the weight of a such an unnecessarily complex billing and insurance system on their backs. Then they struggle with performance metrics and then they make mistakes.

[@spencers4121]

The system is going to crash, insurance and other factors are putting a huge burden and stress on doctors to even get treatment for their patients. And doctors are starting to see a lowering in overall pay, factor into cost for schooling and their own insurance. It's going to drive people away from the career.

[@andynonymous6769]

Wow Doc Glauc made a video about EMS! As a paramedic I kind of feel like I just got a celebrity autograph or something

[@TheMegaross91]

Government worker here, it's a constant battle against arseholes who don't actually give a damn about the public and don't want to put the graft in. It's honestly not by accident that there are almost always glaring cracks in government policies - mostly they just don't care enough, and provided they're not upsetting a financial controller or a politician? No one calls them out on it, it only screws over a few people and votes are what matter right? Hateful situation. Thankyou for raising awareness about this kind of thing.

[@scottfitzgerald5423]

Figuring out insurance discussion into call response time. SO WELL DONE!

[@sciencebunny]

I was unconscious and an ambulance came. I woke up in a hospital. Soon after, I left the source of my incident - the apartment I lived in with my ex. I didn’t know I had an ambulance bill until almost a year later when a collections agency hit my credit score with a large unpaid ambulance bill. They also took the liberty of adding on a giant late fee. They wouldn’t remove it from my credit history until everything was paid in full…even though I had no knowledge of the bill and it was sent to the wrong name because I wasn’t conscious to give my name to anyone (so didn’t get forwarded to my new address). I love healthcare in the US. It’s so much fun

[@gwine9087]

In Ontario, the fee is $45, if you are a resident, or $240 if you are not.

[@essexhudsonurology1369]

30 Days of US Health care should MANDATORY viewing for the US Congress along with a presentation from his truly. I will throw money into the pot to pay for Bill's trip.

[@javiercastro4561]

Love this series

[@bazrule95]

Everything about this is PERFECT.

[@archimedesscrew3710]

Brilliant. Well done for highlighting this!👍🏻👏🏻

[@leorosenthal]

my son had to be transported between hospitals because the one he was at couldn't treat him. We had no option to not use their ambulance service for the transport (which was only 1 mile) and then we got a bill for $5.5k.

[@jimbelter2]

The Surprise Act. Where you think you are covered with no hidden surprises and then 60 days down the road SURPRISE! You now have a big bill for services insurance should be covering. It's nice to know that the government is on our side

[@ideasmatter4737]

Our insurance covered ambulance transport but because so many plans don’t, our local government would not bill our insurance directly. We had to submit the bill where it had to sit “at least 3 months” before it would be processed to sit in another queue indefinitely! In the meantime our local gov kept billing us and we kept telling them what was and wasn’t happening. Maybe because it’s a small town or maybe because we’ve always paid all our government obligations promptly, or maybe because we had offspring work for the local gov, or maybe because my husband helped train the EMTS, the clerk finally agreed to bill insurance directly. They received payment in short order! Heaven help the other citizens!