2041 The American emergency health system

as explained to an EMT in the UK appears in the comments of Random Acts of Reality, the blog of an EMT. The blog started with a recruiting video for EMTs in the USA, and the Brits were wondering if that's the way it really was, and someone made a remark that the injured would need his credit card to get into the ER. That's where the American EMT jumped in with what I think is one of the best overviews I've heard of emergency care, how it is provided, its speed, and how it is paid for.

"I've never worked a shooting that came from a legally owned gun. From what I've heard, while guns are illegal in England, illegal guns are still available if you know where to look. I've never had a paramedic or EMT shot. Any scenes that sound dangerous automatically have a police car sent to secure the scene before ambulance crew are let in."

"At no point during emergency treatment is a patient asked if they can afford to pay. They may be asked if they have insurance, and what kind if it isn't urgent, as the ambulance crew knows that somewhere down the line the patient will have to pay, and insurance companies may pay more of the bill if the patient is at the "right" hospital. That is waived in a true emergency, and they are taken to the nearest facility that will handle them. Every hospital in the country must post signs either in the ER waiting or triage rooms informing patients that they have a right to medical treatment, regardless of their ability to pay."

". . . the poor recieve medical insurance from state and national programs. Because there is a charge (but usually little or no enforcement) for an ambulance, people tend to call more for true emergencies, and maternataxis are rare (unless you count complications). I have never in my life sent or recieved an ambulance that took more than 6 minutes."

"While it would be nice for everyone to have full and complete (including preventative) care, I prefer knowing that I can always have access to an ambulance in an emergency, that it will usually get there within 4 minutes (the magic time they tell us that it takes a major artery cut to bleed to death), even if it takes me a year to pay it off later. I like knowing that we can prosecute people who purposely fake calls."

"Once a year, many local hospitals and other groups sponsor "health fairs", where for as little as $5-10 US (or less if you qualify for low-income assistance, or have insurance which prefers to pay the lower bulk cost for these tests), you can have a full physical, including a blood draw which scans for 50+ different indicators, and your results are given back to you with directions on who to follow up with."

The UK EMTs were polite and thanked him for the information--most of which they didn't know, and most Americans don't either, unless they know someone who works in the ER.