John Oliver sounds the siren over our broken EMT system
When people are calling Uber instead of an ambulance, your country's healthcare system is screwed
TV News John Oliver
Hey, remember all those signs and speeches during the pandemic praising America’s essential workers for literally putting their lives in the line every single day to keep the country functioning? That was really nice, especially as COVID (currently incubating new and adaptively murderous strains in the unmasked bodies of the selfishly unvaccinated) reminds us that a pandemic isn’t fucking over because Fox News and your conspiracy-prone racist uncle on Facebook claim it is. Well, John Oliver—as is his way—pumped the brakes on the little back-patting party we beleaguered citizens are throwing ourselves for paying lip service to legitimate heroes like our local EMT workers on Sunday, dedicating his main story to showing how low pay, dangerous conditions, and unfathomably stingy government policy routinely short-change the very people communities count on to keep them alive.
And, sure, Oliver did note the ridiculously expensive, often sucker-punching cost of an ambulance ride in this country at the outset. A story about a poor commuter pleading for helpful bystanders not to call an ambulance even as said samaritans are trying to extricate her leg from between a subway platform and an entire train isn’t going to make anybody forget how fun it is to get a crippling surprise ambulance bill at the worst possible time. But, as Oliver traditionally does, the Last Week Tonight host showed how blaming EMT workers for big bills is some seriously misguided scapegoating of hard-working people also being crushed by a broken-down system.
How broken is the country’s EMT network? Well, as Oliver notes, in 39 states, ambulance drivers and paramedics aren’t even classed as “essential,” even though, for many rural areas, the sparse ambulance crews are literally the only medical lifeline people have. Or how, like their unlucky, under-insured patients, EMT crews are routinely turning to crowdfunding pleas in order to make up constant budget shortfalls. Or how, even in big cities like Chicago, Oliver plays a terrifying clip of one dispatcher uttering the phrase to a 911-calling victim, “We’re all out of ambulances, we’ll let you know.” Plus, as Oliver complains, our ambulances ear-shredding sirens don’t even make the undoubtedly tension-puncturing sound of their cousins in Brussels, where an oncoming emergency vehicle sounds, in Oliver’s words, “like Mickey Mouse getting fucked on a washing machine—in a good way.”
And while Oliver does decry commonplace policies like the “you call, we haul” system, where EMTs are incentivized to take every patient to an emergency room (because, in many cases, that’s the only way the often privately-owned company gets paid), he notes again that it’s not the EMT’s fault. Once more picking out a representatively loathsome villain of the week to illustrate just how screwed up this whole system is, Oliver made merry sport at the expense of one Lynn Tilton. If that name sounds familiar, it’s probably because the self-proclaimed corporate savior parlayed her success in swooping in to squeeze cash out of failing businesses into a reality show called Diva Of Distressed (since cancelled). Or, you know, from the bankruptcy court ruling that named Tilton responsible for running the struggling private ambulance company TransCare into the ground, laying off scores of those EMT heroes after forcing them to work in increasingly decrepit ambulances and urging workers to just go ahead and swipe expensive medical supplies from their local ERs. (She’s also showed telling the workers of a company she’s just acquired, “No pussies in my mill,” while somehow not being pelted with rocks.)
As ever, Oliver concludes by noting some common sense solutions and ruefully mocking the fact that we’re not going to enact them any time soon. Medicare For All would fix a lot of this snarled and unfair billing, but apparently making sure everyone can call an ambulance when a train falls on them without fear of crippling debt is socialism. There’s a bill that would stop surprise billing of the type one family saw when, after pulling over a few blocks from the hospital so the very pregnant mom could give birth in the family car, they were smacked with $3,500 in bills from an ambulance ride the rest of the way. But, as Oliver notes, some people in congress thought that was too beneficial and exempted everything but medical chopper rescues from being regulated. So, as the COVID wards are filling up again with the patriotically un-vaccinated choking on their own lung tissue, Oliver sent out an emergency call for people to put their money where their colorful bumper stickers are to actually work toward getting these no-joke heroes the living wage and job security they undeniably deserve.
55 Comments
So, that de Blasio guy sure is a slimeball, huh?Seriously, what a godamn cartoon villain politician move is “throwing a parade” instead of actually changing anything? That is almost laughable, except it is really, really sad.
What’s cool about NYC is that the mayor essentially just functions as a person for the public to hate, so it’ll be exciting to see Adams slight into that role. Much like Lori Lightfoot he just seems to have the exact kind of goofball weirdo personality mixed with genuine shitiness that will make him easy to hate. Despite any ideological differences that makes him a perfect followup to BDB.Cuomo’s the real piece of shit, far more power over NYC than the mayor and has presided over some really awful shit. He’s undermined Democrat elections by supporting Republicans, which somehow doesn’t get brought up every single time he’s on any screen anywhere, along with the whole nursing home COVID spreader shit that happened last year.
He’s an idiot that was propelled into office by a PAC focused on getting the horse drawn carriages off the streets of NYC. No kidding. Torpedoed his competition over this issue (and not much changed).
And the best part of that is that it wasn’t the treatment of the horses pulling the carriages that fueled the PAC, but the idea that the major contributor would be able to get his hands on the horse stables to tear them down, and build an apartment building on the site. Bill deBalasio is truly nature’s nitwit.
But if you get rid of the stables, what animal is left for John Wick to kill people with?
Steel Flying Platypus?
don’t get fancy
even a cat can be deadly if thrown with accuracy
How is the greatest country in the world so bad at SO many things most other developed countries more or less mastered?
Simple answer: because we are stubborn, dumb, and easily manipulated.In reality, it’s because the country is very large and sparsely populated compared to most. Europe as a whole has more than double the population of the US in about the same area. But still huge – 4 times the population of Germany in 30 times the space. Add on to that the fact that the central government was intentionally designed to be fairly weak, especially as regards local matters and governance. To top it all off, a fractured, de-centralized, system for anything (health care in this case) creates much more niches and opportunity for people to make money – both legitimately and by taking advantage – and you get a lot of people with a vested interest in preventing improvement.
If the United States was a shopping mall, the parking lot would always look empty.
That place was the best!
The Dirt Mall?!
Although Australia and Canada are also large, sparsely populated countries that have managed to socialize health care. I think your point about the government set up to delegate a lot of power to the states has a lot to do with it, as well as weird American attitudes about any kind of social safety net.
Australia and Canada have roughly one tenth the population of tge US and that can’t be discounted. I’m not defending US Healthcare, but the problems involved in covering 330 million people from very diverse backgrounds are far, far, bigger than any other western style democracy has to deal with.
Oh, I didn’t think you were defending the system, just pointing out that while challenging, it’s not impossible to have universal health care in a country with the size and population of the US. The bigger obstacles are political, and the deference to the individual authority of states both helps and hinders that. Helps in the sense that states can implement some of their own fixes, like CA might do, and hinders it, such as when states turned down the medicaid expansion because a black man was president. I think if it ever happens it will be because of ever incremental expansion of medicaid and medicare.
Problems of distance are a major issue for a tiny percentage of Americans living in the middle of nowhere, sure. But most Americans live in dense urban areas – more so than in Europe – so healthcare provision shouldn’t be greatly impacted by the amount of empty space between those areas…
sinpler answer: you are neither the greatest country on in the world, nor great.
What’s the sinful answer though?
DAMMIT GALVATRON
Frank’s not American, so unless you are talking about Germany….
only an American would call America the greatest ANYthing
And yet…Frank’s German.And probably being sarcastic.
Sarcasm.I know, Germans aren’t supposed to laugh, but we know the basic theories of humor…
DAMMIT YOU MONSTER
Seems it turned out not to be so simple for you to type, though I might agree with the sentiment, if I could parse it out.
Health care is bad, because it’s designed to make companies profit in the U.S.It’s basically treated like a car dealership at this point.
Private EMS companies are just a symptom.
Racism has been extremely effective in dividing the US working class and making a large portion of poor people side with ruthless pirates against their own interests. This tweet thread about the history of pellagra in the US made me think about this recently:
Because John Oliver. Oh, how WOULD I know what to rage about if not for the delightful John Oliver? What was life like before we found our purpose: spending every fucking moment hand-wringing over some policy.
The simple answer: America became great by being rich; it got rich by ruthlessly incentivising profit above all else. This, combined with solid democratic and legal institutions, plentiful natural resources, and NOT having two apocalyptic world wars fought on its territory, lead to a thriving, efficient private sector that dramatically lowered prices while maintaining high wages, delivering prosperity for… well, not all, but at least for a large middle class.
Unfortunately, the profit motive is useless in areas where there can be no meaningful competition (like public transport), in areas that are inherently loss-making (like universal medicine), and in areas where actors can easily externalise or procrastinate losses to create artificial profits (like pollution, or financial volatility). In these sectors, the American system of capitalism – which is genuinely wonderful and useful in many ways – is doomed to failure.At the same time, disengagement from politics has made it impossible to solve these problems through regulation and central investment – disengagement from national elections allows minorities of extremists too much power, and while much of that could be ameliorated by strong state and city government, disengagement means that politicians at those levels have almost no practical accountability.
American love to say they love capitalism, but they have no idea how it works. We have a religious belief in markets; that regulation is a heresy rather than a requirementh for a free market to function; that extraction wealth from a business is a moral good even if the business fails in the process. We worship Mammon, and it makes us horny.
That Belgian siren would take some getting used to.
As would the animation of Goofy pounding Mickey in the mouse hole.
Though it is a small chance, it is a slightly larger chance I’ll have a medical emergency in Belgium than ever have to look at that again.
It sounds like a magic flute
Is it leading the children out of Brussels?
Any mention of the ambulance bill that was sent to the family of Tamir Rice? Because that was seriously messed up.
National health service.
As a Briton, I fist-pump this wholeheartedly.
How do you feel about moistened bints distributing swords as a basis of government?
If you mean, should we just dunk Victoria Coren-Mitchell in the Isis, hand her Excalibur and let her decide who should be in charge of what……then that’s not an ideal system, but to be honest it’s also not the worst!
Fox News: “COMMUNIST!”but seriously, to want free health care for people in this country would require people to develop empathy, and that is a non-starter. For an allegedly Christian nation we do not give two fucks about others. We are doomed to limp along like a shitty, dysfunctional 1982 Lincoln.
I’m just waiting for the disintegration of the country into smaller countries. Some of them will be socialist democracies and the South will turn into a “Christian” hellscape that makes Gilead look like a paradise.
We fought a big ol’ war over secession, now it’s like “Fine, go! Please!”
LOL hasn’t that kind of already happened? Look at how aggressively Texas is attacking abortion rights, or how generally shitty states like Louisiana, Alabama, and Florida are when it comes to life expectancy, abortion rights, overall education, etc. If they weren’t all on the water and warm they probably would be 90% less populated; they would be Montana.
Hey, remember all those signs and speeches during the pandemic praising America’s essential workers for literally putting their lives in the line every single day to keep the country functioning? I sure do, and even then I knew it was utter bullshit, because too many people in this country have 9 second attention spans; attending a parade like that would take effort; and more seriously, who wants to remember anything about 2020? It fucking sucked in every way possible except Dipshit wasn’t re-elected and that was sheer dumb fucking luck (thanks, pandemic, at least you did one thing right). The federal government should pass a law to forgive their student loans and/or the loans of the spouses or survivors of those who died; let them put their ample money where their mouths are, because crowd-sourcing some kind of compensation (applause and free pizza) is bullshit.
I hadn’t known private equity companies were in the EMS business as well. Like a deadly virus, they pervert and destroy anything they touch. They should be abolished or deeply regulated.
Medicare For All would
fix a lot of this snarled and unfair billing, but apparently making
sure everyone can call an ambulance when a train falls on them without
fear of crippling debt is socialism.
As if Medicare fraud isn’t common and they don’t do it to old people. Private insurance ambulance policies are incredibly simple for the patient: if the insurer can’t prove that you didn’t think the care you needed was emergent and needed care faster than you could get it by hopping in private transport (or likewise for needing the gurney to protect you spine), the insurance is on them. Hospital transfers can be a bit more dicey because ambulettes are a preferred option, but it’s still not that difficult and the hospital staff should have someone with reading comprehension.I should know, I wrote the policy for one company and a part of it benchmarked all the other companies present in our area. Actually, the only one that wasn’t simple was CMS (Medicare), which has its policies spread over six or seven large documents and is internally contradictory in both terminology and outright intent, so our Medicare Advantage policy is basically “we pay according to CMS, as outlined in Medicare handbooks A, B, and C, NCD’s X, Y and Z, LCD’s P and Q, and we don’t even know what Aleph. You figure it out, and maybe call us up if you can figure out why wheelchair vans are listed as disallowed air transport and helicoptors are paid as water transport.”
Yeah, I think some of the people who are all in for Medicare for All should see what happens to some people who are left to Medicare’s tender mercies. We need to reform Medicare to begin with. My family wasn’t particularly well treated by private health insurance over the past year but they were utterly betrayed by Medicare in a heartbreaking way.
My NHS ambulance policy is also incredibly simple: if I use an ambulance, it’s free.
It can be simultaneously true that Medicare is terrible and Medicare would be a feasible improvement over the status quo.NHS is has been cited by many commenters here and an example. By European standards it sucks, yet it would be an improvement over Medicare for All.
Medicare For All would
fix a lot of this snarled and unfair billing, but apparently making
sure everyone can call an ambulance when a train falls on them without
fear of crippling debt is socialism.
As if Medicare fraud isn’t common and they don’t do it to old people. Private insurance ambulance policies are incredibly simple for the patient: if the insurer can’t prove that you didn’t think the care you needed was emergent and needed care faster than you could get it by hopping in private transport (or likewise for needing the gurney to protect you spine), the insurance is on them. Hospital transfers can be a bit more dicey because ambulettes are a preferred option, but it’s still not that difficult and the hospital staff should have someone with reading comprehension.I should know, I wrote the policy for one company and a part of it benchmarked all the other companies present in our area. Actually, the only one that wasn’t simple was CMS (Medicare), which has its policies spread over six or seven large documents and is internally contradictory in both terminology and outright intent, so our Medicare Advantage policy is basically “we pay according to CMS, as outlined in Medicare handbooks A, B, and C, NCD’s X, Y and Z, LCD’s P and Q, and we don’t even know what Aleph. You figure it out, and maybe call us up if you can figure out why wheelchair vans are listed as disallowed air transport and helicoptors are paid as water transport.”
I had to fight my insurance company for about six months to get them to pay for my ambulance ride. Somehow they just couldn’t get it through their thick skulls that I wasn’t even conscious at the time, meaning I wasn’t the one who called 911.Even when they did pay, they still claimed I’d intentionally gone with an out of network EMT provider. As if the person who called 911 had any say over that, or even knew what my insurance situation was like.
this is why so many of us switch to nursing.
I was shaking my head once again at americas fucked up systems, then got curious and looked at canada’s. I guess EMT’s aren’t considered an essential service here either.They do however get paid reasonably, and when you need one, most, if not all of it is covered.