01/12/2018

Move Over Ambulances, Uber’s Coming

Charles Hughes, Foundation for Economic Education

As a mode of transportation to a hospital when a patients’ illness, injury or affliction precludes them from driving, ambulances are a blunt method that is far from perfect. Patients sometimes find themselves hit with substantial bills or end up at out-of-network hospitals that raise the price of care. Recent policy changes may also be exacerbating the situation, as one study found that the Affordable Care Act slowed ambulance response times by almost 20 percent.

According to a new working paper by David J. G. Slusky of the University of Kansas and Leon S. Moskatel of Scripps Mercy Hospital, some people are foregoing ambulances and opting for ride-hailing services instead.

Ambulances Are Insufficient for All Needs

A person suffering from a heart attack could certainly require an ambulance complete with paramedics and their tools to give some medical care en route to the hospital. The minutes the ambulance could shave off transport times because it does not have to follow traditional traffic rules could prove important. But a recent Washington Post article cited one patient who was charged $3,660 for a four-mile ride in an ambulance.

While a traditional ambulance often makes sense, a person might need quick transportation to get medical attention in a range of less urgent situations. In some circumstances, these alternatives can offer a less expensive option, and also allow the patients to choose their hospitals.

Previous research had found that some degree of unnecessary ambulance use in the past was due to a lack of feasible alternatives.

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Thanks to "bracket creep," the inflation of the 1970s pushed millions of taxpayers into higher tax brackets even though their inflation-adjusted incomes were not rising. To help offset this tax increase and also to improve incentives to work, save, and invest, President Reagan proposed sweeping tax rate reductions during the 1980s. What happened? Total tax revenues climbed by 99.4 percent during the 1980s, and the results are even more impressive when looking at what happened to personal income tax revenues. Once the economy received an unambiguous tax cut in January 1983, income tax revenues climbed dramatically, increasing by more than 54 percent by 1989 (28 percent after adjusting for inflation).

 

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