Discussion

mjevans: I stopped reading at 'for profit'.Basic functions of society should never be run by 'for profit' standards. Do you want a 'for profit' fire department, medical care system, or law enforcement systems? These are core support services for an orderly society.Citizens that rely upon these services in their time of need often have no other recourse.

2OEH8eoCRo0: Seattle must really be hurting for money. Sounds like a very poor town. /s

wongarsu: So the fire department routes the call to a nurse who decides how urgent the issue is and dispatches ambulances according to that. And that nurse is employed by the same company who operates the ambulances. I can't imagine a clearer conflict of interest

OutOfHere: Move out of Seattle before they do this to you.

cogman10: > They say it’s reducing strain on hospitals and ambulances by diverting low-level patients to more appropriate care.The only reason the city is doing this is because these ambulance contractors are sharks.Ambulatory service is one of those things that should be ran by the city/state and not by some random private company. A private company in this case can only serve to make it much more expensive for the city and people needing emergency services while providing bad service and understaffing and underpaying their staff all at once. You'll get paramedics being paid $15/hr that charge $1500 for 10 minute ambulance ride where the contracting company pockets nearly everything.I get it, cities don't like taxing people for ambulances, so that's why they try and contract it away to avoid that tax line item or savings needed to ultimately buy new medical equipment. That, however, kills people.It's absurd that we can find it in our budgets to pay for fireman and police but for some reason anything related to medicine needs to be privately contracted out.

Aachen: With a title of "Called 911, you won't believe what happened next", this does not belong on HN

imglorp: Some ambulance systems aren't tax supported and aren't even exactly contracted to the municipality. In our town the BLS EMT's are volunteers (paramedics are paid) who take a ton of training, a ton of ongoing training, they go on runs, and THEN they stand on corners with a boot to raise money. That's (a) dedication on their part and (b) abusive on the part of the community. And patients still pay $2k for the ride. IMO if you live and work somewhere, some of your taxes should go to 911 to make it work right.

cogman10: That's how it worked in my hometown, but I don't think the bill was 2k as it was essentially ran by the county.Everything was basically either payed for by donations from a local business or funded by fundraising. Primarily because the county didn't want to have a tax to run the system properly. Same thing happened with my hometown's fire department. Though in that case you could effectively buy fire insurance from the county (and of course, some people decided not to buy that insurance).Both are a bad way to run critical services, especially since my hometown was surrounded by a lot of farm and state owned land where lightning strikes causing a fire wasn't uncommon. I don't have a big issue with the volunteer portion of it, it was a small town which the county would otherwise not want to service. But the funding portion was just bad. Fire, famously, spreads. And giving people the ability to opt out is dumb because it makes a big problem if a fire starts on their property and spreads to someone else's.

Merad: The situation with the ambulance service is obviously disgusting and immoral in a civilized society. But the article fails to address the elephant in the room - her chief complaint was severe pain in her knees due to RA. If she had been taken to the ER she almost certainly would've been given some short term pain meds and sent home unless she was showing some very obvious signs of cardiac issues. The system had already failed her because she really needed skilled nursing or assisted living help, being immobile due to chronic disease. It happens all the time. Several years ago my elderly father fractured an ankle - no surgery required, just a boot - and was sent home even though he was unable to stand or walk on his own. Fortunately he had savings and I was able to talk him into paying out of pocket for a stay in rehab (to the tune of about $18,000).It's also likely that she ended up in this position because she couldn't afford proper treatment of her RA, resulting in it destroying her knees. I also have RA, diagnosed 3 years ago and my treatment costs $15,000 per month. Losing my job and/or having insurance that won't cover it is a terror that knaws at the back of my mind because without the treatment I'll start suffering debilitating symptoms in 3-6 months.

babalulu: In my city, the ambulance service is run by a private contractor, but the city government offers ambulance insurance to residents. It's included on my monthly water/sewer/trash bill and costs about four dollars a month. All ambulance services are free. A friend has taken two ambulance rides over the past few years, with nothing out of pocket for either of them.The insurance is optional. If you don't want to pay the four dollars each month, you don't have to, but it's so cheap and easy why wouldn't you for the peace of mind it offers.

heavyset_go: > It's absurd that we can find it in our budgets to pay for fireman and police but for some reason anything related to medicine needs to be privately contracted out.Seattle spends nearly $400 million a year on the SPD, which is about 25% of their discretionary budget.

AlotOfReading: That's a more complicated example than I think you intended. Seattle tried to move some of the functions SPD was handling to other people during the badly named "Defund SPD" movement. The police got angry that part of "their" budget and responsibility was taken away, and has spent the past few years successfully campaigning to get it back.

realo: The problem is not that it costs something. The problem is that it is managed for maximum profit, and it kills people!The woman died.Even more importantly, no one made a follow-up to ensure she safely reached a hospital.This is disgusting. And people say the US healthcare is "best of the world ".No. Just no.

cogman10: Well, unfortunately there's a herd of elephants in the room when it comes to American healthcare.We spend the most on healthcare vs any other nation while getting results comparable to nations like Cuba (not hyperbole. Go look up infant mortality of Cuba vs US). I mean, no joke, the main thing that harms Cuban healthcare is the US embargo limiting medicine and medical supplies from going in.It's truly embarrassing.

looselygoosy: That's not the title of the actual article

looselygoosy: Obviously this is very distressing and a failure of the system. What I'm curious about is that she didn't call her son to ask for help. I wonder how much of that is embarrassment over her situation. Stories of bodies being found weeks after death by neighbours or relatives are all too common, though I've usually assumed it happens mostly to the elderly who have no surviving friends or family.

Supermancho: Spoiler: She died. Seattle offloading 911 calls to on-call nurses who can say "you're fine" is a dystopian choice.

fc417fc802: It's funny (in a really dark way) because every time I've contacted the on-call nurse for my insurance I've been told approximately "I can't comment, you need to head to urgent care or the ER". It seemed less like an on-call nurse and more like an on-call councilor only there to talk down "patients" who didn't actually have any observable symptoms.

fc417fc802: It's the pattern that the actual title follows.

looselygoosy: The actual title of the article is "Seattle woman’s 911 calls reveal gaps in ambulance service"

fc417fc802: When I visit the page I get a modal paywall, the browser tab (small, could easily escape notice) takes on the title you report, and in huge letters across the page behind the paywall I see:> She called 911 for an ambulance. She got a nightmare insteadAs far as I'm concerned the second one is the title because (regardless of any technicalities such as metadata) that's how it's being presented to me when I visit.

satisfice: American PR is the best in the world.