7A – Testing the Hypothesis, Part 1

Ambulance Service Charges/Fees in the US

• Opportunity: Citizens with and without medical emergencies have to pay costly fees for ambulances in the US given it is not regarded as a public service.
• The Who: Citizens with medical emergencies, regardless if insured or not
• The What: Medical emergencies resulting in costly ambulance fees
• The Why: Ambulance services are not considered a public service/ poorly thought-out comprehensive health care system.
• Testing the Who: I believe it is all US citizens that have this need. It is my belief that health care is a universal human right, and ambulance services should be integrated in a health care system. Whether or not a person has insurance, which is also very costly in the US compared to most nations worldwide, I believe ambulance services should be paid with tax dollars and be considered a public service.  
• Testing the What: While in California, I stepped on some glass and cut an artery, I was called an ambulance as I was losing large amounts of blood. I did not have insurance at the time, and when the medical bill came, it was roughly USD2,000 just for the ambulance. I was fortunate enough to have family members cover my bill, as I did not have the money, though I found it absurd how costly an ambulance service was. 
• Testing the Why: As arguably the most influential country in the world, it is in my opinion one of the most incomprehensible flaws the US has. One could argue that a comprehensive public health care system hasn't been developed in the US, though I'm not quite sure why it is the way it is. I am from Argentina, though I also have US citizenship. Here in Argentina we have a very comprehensive public health care system, as do many countries, Europe. In Europe for example, most ambulance services are public services, paid for by tax dollars, and one may only be charged if the service was requested inappropriately. 
• Interview #1: The first interview conducted was with a good friend of mine from Spain. This particular person was playing basketball with a scholarship at Cuesta College, the community college of San Luis Obispo, CA. He's a big guy, 6'9", and as a kid suffered from heart problems which led to surgery. Because of this, he has to be careful so as to not strain himself physically beyond his limits. During practice running laps under the summer heat, he suddenly complained about his heart and fell to the ground. An ambulance was called, and the bill came to USD3,000. He was baffled at the bill, as even with insurance it was very costly. 
• Interview #2: This interview was with an uncle of mine, who lives in the US and is not financially well off. He was suffering from heart problems as well and had suffered an incident where an ambulance is called. After covering his expenses for the ambulance bill, he was no longer in a situation where he could afford a similar service. The incident reoccured and instead of requesting an ambulance he decided to drive himself, under no appropriate conditions, to the hospital. The incident almost cost him his life. 
• Interview #3: This interviewee is my grandfather who suffers from diabetes and is now obligated to have blood dialysis twice a week. He is from Nicaragua but has moved to Florida because of the medical services/treatments offered. As a diabetic, he has many times had to request an ambulance when his blood sugar levels get either too high or too low, mostly too high as he can't get off the sweets. Given he doesn't work anymore, and lives off his savings, he remarked the ambulance services take a toll financially. He has insurance, but it doesn't completely cover the costs of ambulance services. 
• Interview #4: This interviewee is a family member who works as a nurse in South Carolina. In the interview I asked what his personal thoughts were about the costs of ambulance services, and he remarked that many patients who are not financially well-off and can't afford the best insurances have put their lives at risks for hesitating or refusing to request ambulances. He also said this is a common thing in lower income areas. 
• Interview #5: My final interviewee is my mother, who while my grandmother was sick, accompanied her on many ambulance trips. My grandmother had Medicaid insurance, regardless, she always had to pay a portion of the ambulance service as it was not covered by completely by Medicaid.

• Given your interview, what do you know about the opportunity that you didn't know before?
• Given I had a personal experience with an ambulance trip, I had spoken about this subject many times before with family members and friends who live in the United States. My findings from the interview were not completely surprising, although it was shocking to hear from my uncle (the nurse) that it is common for patients to put their lives at risk because of the financial implications that not only an ambulance trip implies, but medical services in general imply. Personally, I believe I have a predisposition of regarding the US as the most powerful nation worldwide, and it is because of this predisposition that the poor public health care system present in the US baffles me. I can safely say that Argentina, which is very far away from being a nation to exemplify, has better public health care than the US.