My mole inside the American health care system called today with a story. She was at a mid-sized hospital seeing a patient who had come into the emergency room with a heart attack. She determined that the patient needed a stent. The hospital could not put a stent in. She called a bigger hospital’s doctors-only hotline to arrange a transfer. They promised to send an ambulance within 20 minutes. After 30 minutes, they called back saying that the ambulance can’t come for 60-90 more minutes. “Every minute counts with heart attack,” said my mole. She came up with a solution that she had never tried during her years of practice: calling 911 to get out of the hospital rather than to go in. The longest part of the call was her trying to explain to the 911 operator that she was already in a hospital emergency room and needed to get someone out. When the 911 ambulance arrived they made her go with the patient to the bigger hospital. Then she had to catch a ride back to the original hospital where she was still on call.
Separately, a friend of a friend wrote up this story about going to the emergency room in Mexico. The charge for the ER visit and stitches seemed rather steep, at $900, so I’m wondering if it was a private hospital rather than a government-run one. The ambulance was cheap, at least ($60 round-trip).
good thing that 911 took the call, there is an instance (in California) that 911 refused to take someone to another hospital. see the link
http://www.msnbc.msn.com/id/19207050/
First of all, congratulation to your mole! In my book she just won the prize for quick thinking on her feet.
Secondly, that $900 does seem steep at first glance. Your friend of friend was probably taken to a hospital that specifically caters to tourists (being in a very touristic spot, Playa del Carmen). Or this hospital very likely has a 2 tier pricing system, one for Mexicans, and one for foreigners.
The last is not uncommon at all, at least in India. Foreigners pay a higher price for hotels, airlines, and visiting all govt. owned tourist spots. These rates are very clearly marked whenever you go online or to ticketing window to make the purchase. My last India visit for example, my wife paid Rs. 250 (around $5), while I paid Rs. 10 (around 20 cents) to enter the grounds of a temple outside Chennai.
You think that’s bad, there are stories in Japan where ambulances drive around for hours, stopping by 20+ hospitals, to be turned away at each one for some reason or another (lack of space, usually). One I remember two years ago was finally resolved when the patient died in the ambulance, so they didn’t need to bother checking the 31st hospital. (http://search.japantimes.co.jp/cgi-bin/nn20071229a3.html)
There is something in the ambulance policy that tells them they are responsible for transporting a person only to the closest available emergency room. I have tried to request a particular hospital for my father and the 911 crew refused. They suggested that I could call one of the commercial ambulances and they would take my Dad anywhere for a fee.
Mexico and most other less developed nations use tiered pricing not just for rich foreigners but rich locals. They’ll get priory in service, better accommodations, etc. It might not seem very plush being in a 4 person room, but if the alternative is 40 you are getting the best they got. If you a rich you’ll probably get better pain management and brand name medication. Things like that add to the bill.