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0 pointssaiya-jin7y ago0 comments

In Switzerland the system is actually pretty good - ambulances are private companies, it cost +-500$ to get transport to hospital.

Horrible cost on the first glance, but if you actually talk to doctors (my fiancee is one), you realize most of the system is under constant overload. If they have emergency call, it can be (and often is) something trivial, when taking a cab for 5% of the costs would be more appropriate. But you have tons of crazy people (not crazy enough to be in asylum, but enough to wreak havoc on everything and everybody around them) and hypochondriacs. Polytoxicomans that effectively can't be helped.

We're not talking about a drive by a specific vehicle, but locking of 2 highly trained professionals that can't be used for any other emergency, with vehicle full of life-saving equipment. Which can easily mean another ambulance has to come from afar if needed, which can be fatal/debilitating in number of cases.

So its not about US as much, its about making system effective, because resources (people, equipment, ambulances) are scarce and you need to prioritize, or people will die. These things can and should be improved, but until they are, doctors and everybody else need to work with what they have.

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7 comments · 3 top-level

maxerickson7y ago· 4 in thread

Much of US ambulance staffing is done by EMTs that start with less than 200 hours of training.

https://www.nremt.org/rwd/public/data/maps

(the circle thing that should be a table)

JshWright7y ago

That's half true... (or maybe 3/4 true, more accurately).

There are two "halves" to EMS in the US. One half is 911/scene response, the other half is interfacility transports. It's pretty common for interfacility transport companies to staff most of their rigs with EMTs, since those patients tend to be low acuity, and just need to be moved from one hospital to another.

Companies that do 911 response generally staff their ambulances with an EMT and a paramedic. Paramedic training is several thousand hours of classroom and clinical time.

So while it's true that overall EMS is mostly EMTs, in the area we're discussing (ambulances that respond to 911 calls) paramedics are much more common. Granted, that's only a $3-5/hr difference in most places, so it's not a massive difference in cost.

dsfyu404ed7y ago

EMTs spend most of their time picking old ladies up off the floor and feeding blood thinners to people who are having heart attacks. You don't need a combat medic to do that job.

maxerickson7y ago

Right. My point is that when assessing the level of resources the US devotes to ambulances, there's room to argue about whether the responders are highly trained or not. Paramedics certainly are, I'm not sure about (especially newly licensed) EMTs.

gameswithgo7y ago

no, but the other 5% of people who have been obliterated in a car crash would like for one of the EMTs in the vehicle to be a combat medic I'm sure.

CaptainZapp7y ago

In Switzerland the system is actually pretty good - ambulances are private companies, it cost +-500$ to get transport to hospital.

This is not true for the entire country. Emergency services are usually organized on a local level.

For example: In the city of Zurich emergency services are run by the city (which also serves 17 additional communities). It's very much a publicly owned and operated enterprise.

In addition there are private services, but on a very limited manner. For example: The orthodox jewish community runs its own ambulance service.

Details, in German, can be found here : https://www.stadt-zuerich.ch/pd/de/index/schutz_u_rettung_zu...

sonnyblarney7y ago

"Horrible cost"

Actually $500 is cheap. It'd be a no brainer if it were that cheap in the US.

I think 'Ambulance no Ambulance' almost has to be kind of a moral decision, not a cost one: if you don't need it, don't use it because it's a scarce resource that will always be scarce.

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