I just realized that we don’t pay volunteer EMTs or Firefighters. And of course, I’m sure fulltime police officers outnumber the fulltime staffing of both firefighters and EMTs.

How the fuck have we survived this long?

Pricing is weird in the US.

One of the main reasons the list price is so high is because they know the insurance companies will negotiate and reduce the price. It’s like if you’re listing something on eBay or Marketplace and want $500 for it, you might list it for $600 or $650, because you know buyers will negotiate down to $500.

However, they can’t charge the insurance one amount while charging out-of-pocket customers a lower amount, because they’ll be sued by the insurance companies for insurance fraud.

Because of that, hospitals, ambulances, etc. need to initially charge everyone the same inflated prices, but they’ll basically always offer a discount if you say you’re paying out of pocket.

more than double Australia’s $622 average.

I’m from Melbourne in Australia (but living in the US now). In Melbourne, we pay around $60/year for an ambulance membership, and every ambulance ride (both road and air) is 100% covered.

It’s also included in most private insurance plans. We have a hybrid system where there’s both a public health care system (Medicare) as well as a private one. For whatever reason, ambulances aren’t included as part of the public system.

That’s probably a factor (insurers make enough payments to hospitals they can demand lower prices and get them while out of pocket people usually don’t have much power to negotiate), but also this article makes it sound like $1400 is just the base price,

The report estimates the average ambulance ride in the United States costs $1,383.44, more than double Australia’s $622 average. The gap widens further with mileage fees: Americans pay about $19.49 per mile, while most other countries charge little to nothing based on distance traveled.

That makes sense.