From a USA standpoint the thread is almost as surreal. You either call an ambulance or drive them yourselves. At no point would it ever come up to send them in a taxi where I work.

Now depending on the issue it is faster to drive/be driven from where I work so an ambulance is often not that useful. For example a while back a coworker ate a tamale off the food truck only to find out that it contained peanuts. After noticing the reaction the owner took him to the ER personally (Coworker used his epipen as soon as it was known he needed it.) It is ~8 mins by car and at best an ambulance would have been 6 here and 6 back for an arrival time of 12 minutes. Now had they not been breathing they probably could have gotten a fire truck here in 2-3 mins to administer some epinephrine but they would still have had to wait the same 12 minutes to make it to the hospital because the fire truck EMT's can only do on site treatment.

So unless it is extremely dire taking a coworker to the hospital can be faster than an ambulance. That said a crushed hand or cut off finger? That is one of those where seconds matter and the fire truck/ambulance combo would be used.

You're lucky and probably in a cushy white collar gig.

My uncle worked for a place where a vendor CE had a heart attack and died in the early morning in a raised floor space control room. Someone called 911 multiple times and due to bureaucratic fuckery security didn't let the EMS in multiple times. In short, the dead guy was wheeled back and forth by operators for 12 hours, when the plant manager dropped in and lost his shit and took care of it.

Like I said somewhere else, this topic is a corner of the world that sounds insane if you're not in it.

Where I work, 911 has no idea where we are for reasons, and a serious incident where a person isn't vocal requires a floor sweep. The emergency services don't have the time or interest to handle your company's internal stuff, particularly if you have a high call volume.

Pretty sure an electronics tech for a small machine shop (20 employees or so) does not count as white collar. Some days I envy coal workers. At least their stuff is dry unlike the atrociously bad coolant and grease I am often in.

> That said a crushed hand or cut off finger? That is one of those where seconds matter and the fire truck/ambulance combo would be used.

Unless there is uncontrolled bleeding that is definitely not a "seconds matter" situation. Sure, you want to get to a surgeon sooner rather than later, but an extra 5 minutes isn't going to matter.

How do you suspect fingers become severed? As if intentionally with surgical precision? Or by more violently messy and accidental means? Do you think only a trickle of blood comes out when one of your whole digits becomes separated from your hand? How certain are you that "5 minutes" isn't going to matter in most cases? And how certain are you that in most cases there won't be "uncontrolled bleeding?"

Where do you even begin to make that sort of claim?

Fingers that are torn or crushed don't tend to bleed much, in my experience. The ragged edges of the injury site make for quick clotting.

So true! Since I follow US politics more closely (2016, roughly), I realize how damn good life is in Europe for the average joe.

I just skipped through the comments, and the fact that hardly anybody points out the fact that an employer should care for his employees and follow all applicable regulations is mind boggling.

But it could also point to a general issue regarding SV and SV-style disruption. Build a business around ignoring existing regulations, because of disruption.

It's an extremely selfish country. Some people are less than others and deserve less is exactly the mindset in USA now.

HN appears to have a more highly paid engineer out-of-touch with financial reality user base, it's not everyone, and I don't think they're doing it on purpose, but it's certainly noticeable. Even on my barely-enough-to-live wage in Seattle it's tough to not find myself forgetting the struggles of people lower in class than I. Workers rights are not popular here, and I'm guessing it's because engineers and higher paid people are often treated pretty fairly and have workplace freedoms the rest of the workforce could only ever imagine in their dreams.

True that. I dis not mean that people think likevthat on purpose. For me, I can now appreciate much more what previous generations did in Europe regarding workers rights and civil rights. I took all of that more or less for granted in the firsz world, but it isn't. No suprise back the day these fights has to be litterally taken to the streets. I'm happy people did that.

Also zrue that a person tends to stay in their own social bubble, I do it myself. Lucky me I don't have to worry about money most of the time. But that doesn't mean that you cannot be aware of others that are not in that situation. Not that I care about that often enough. Again something I realized lately.

> I just skipped through the comments, and the fact that hardly anybody points out the fact that an employer should care for his employees and follow all applicable regulations is mind boggling.

Bear in mind that europe also has 10%+ unemployment.

Unemployment rate in Europe is at 6.8%. Spain and Greece are the only countries above 10% with 15.2% and 19.1% respectively. Both countroes have been hit hard by the 2008 financial crisis, especially Greece got screwed by everyone.

Major countries close to 10% are Italy and France with 9.7% and 9.3%. That, obviously, is not good. The country that surprised me was Germany with 3.4%. No idea why this is not celebrated more, I wasn't aware of that number until now and I live in Germany.

What is worrying so is youth unemployment of people between 15 and 24. It is roughly twice as high as the rates mentioned above, in Italy even three times as high. I considee that to be extremely dangerous for a society.

There are several ways to cut it and I admit I made a sweeping statement. There is high variation with youth and country as you mention correctly, but in all ways it has a higher level of unemployment. And I concurr, the really high youth unemployment is going to be a wreck: these people will get to later ages with no savings, no investment and lower skills.

Your post made me want to go deeper in german and came across an interesting bit: german has a very low minimum wage, and also some antics around the lower eschelons. https://www.quora.com/Why-is-the-German-unemployment-rate-co....

Yes, the points in the Quora-link are valid. Also something everyone with an extreme political position is using to dismiss the official unemployment rate.

That bein said, this is a terrible thing to do to people if you ask me. And maybe not doing it and having higher unemployment would be more humane. But I'm no eypeet, just a guy with an opinion.

Also, out of experience, in Germany you are not officially unemployed if you are in a training program sponsored by your oocal unemployment agency. Also a nice way to optimize your numbers. And the explanation why there is a whole industry built around just these trainings.

When Germany introduced all these thing back in the early 2000s, it was tough. Germany was called the sick man of Europe. Maybe, these initiatives, Agenda 2010 it was called, were not totally wrong. Downside was the creation of whole class of people that aee basically stuck at the lower ranks of the social ladder. So, good for the economy, yes. Good for the country maybe. Good for society, I would say no.

All good comments. My original and main point is that there is a trade-off between the high-protection for workers and unemployment levels. My own home country boasts worker's rights constitutionally but has 30% of poverty level and 50% of child poverty. 40% of the population is not covered by the "worker's protections" because they are not employed.

Highest income workers always get the benefits of workers perks first, and this is unavaoidable. Look at google, famous for giving benefits to employees like good, gym, juic etc, but buildings maintained by swathes of contractors that dont have access to these services.

The more of these you pile up, the bigger the divide.

There's nothing American about not using ER/Ambulance services. FYI - the employee still keeps his rights to call 911 on his own volition.

This is in no way a defense of Tesla's on-site medical facility's policy of not calling 911 without authorization, but the location of Tesla (U.S.A) is not somehow responsible for draconian policies, nor is it fair to assume that if Tesla operated in the EU, such policies wouldn't exist.

FYI - from the way the article paints it, Tesla's policies are in clear violation of U.S. law.

Normalization has nothing to do with it. Americans at large didn't choose this, nor are we comfortable with it, we're simply stuck under it with no perceptible solution to it and we have to accept the financial consequences of medical choices because to not is to invite bankruptcy.

> under it with no perceptible solution

It’s to vote, convince and then copy the model from every other 1st world country... super hard sure but perceptible

Or apply the ideas used in all other markets in the same country that work incredibly well.

Oh so "just adopt universal healthcare," it's so simple, I can't imagine why no one's attempted it.

Here people refuse ambulance rides in some circumstances because as soon as they take you somewhere it's $2-3000 dollars. Bonus injustice: emergency medical technicians are generally poorly paid. I have a friend who works as an EMT trainer because he can't afford to live on what he'd get paid if he were actually working in an ambulance.

It's the way USA rations healthcare. I've had serious knee injuries from biking this summer that I had to decide to just 'walk off' because I don't have the finances to go to a doctor, get an MRI/Xray, potentially more tests. My knees are probably screwed for life now. I feel like a good portion of the USA is going to be deformed because they can't get quality health care or avoid it at all. It's really weird having to decide that your finances and rent are more fragile than your health.

My insurance for an ER visit would be roughly $4500 right when I walked in, or they wouldn't cover anything. Every time after that though would be $300 until next year when I'd have to pay $4500 again.

Reducing health care costs should be the #1 priority in america. Whatever achieves that will make drastic changes for the better in both incomes and quality of life. It is the KEY issue.

There's unfortunately no consensus on how to solve it.

From a cost stand-point, an ambulance ride in the US might be 10x the cost of an ambulance in european countries. At that price point some decisions start to become serious trade-offs.

Precisely, I mean for sparsely Trainer personell it’s Not Even allowed to give Aspirin because some people are allergic to it.

This is what libertarian and 'eliminate regulation' types want.

Human life isn't worth anything if the people can't use legal means to protect themselves.

For these US citizens (SV elite), healthcare is akin to a status symbol or a luxury that only rich people or people bestowed by the rich (think: employment) should be able to attain.

And then look at how much hatred there was when Obama tried to implement the Heritage Foundations plan, which was done by Mitt Romney in Massuchusetts. Republican, btw.

These people really don't care about the "rest of us". That's why Trump was elected. He showed he had the similar hatred and focused it. Don't get me wrong- he's done horrible for the US... But that's why.

EDIT: I would love to hear a description why I'm wrong. I've lived through the creation of Obamacare, my diabetes T2 diagnosis under it, and now the structured destruction of it, along with trying to eliminate 'preexisting conditions' exception. In short, if they get their way, I'll be dead sooner. Like 10 years sooner. Lack of health care + diabetes = death sentence.

But in the end, having us "dead weights" dying isn't a bad thing when you boil us down to $$$.

I'm perplexed by why you think the SV elite voted in donald trump to keep the dirty masses down. Perhaps you should look at a county-by-county electoral map some day.

https://en.wikipedia.org/wiki/United_States_presidential_ele...

> This is what libertarian and 'eliminate regulation' types want.

False. Healthcare is not a human right, but the insane inflation of healthcare costs would be avoided by removing a large portion of the regulation surrounding it. If hospitals actually had to compete to get patients, based on affordability, among other factors, healthcare would be far cheaper, and private charity/need-sharing would take the place of insurance.

That's not true. Healthcare has always been expensive. Even before regulations. Hundreds, even thousands of years back. The same regulations you're whining about made snake-oils illegal and other quacks from practicing on people who don't know better. The good old days of unregulated healthcare... Google "doctors agree cigarette" and look at the Images. See all those ads. Those ads that cigs are good for your health and infants. Yea...

Back when people thought that healthcare should not be regulated.

Now, there's a lot of fuckery in the healthcare industry. A lot. Both, business side and gov side. Both are to blame. But just saying regulation is flat out bad. That's stupid. There are many issues and each have to be addressed.

Not just a one MAGIC PILL solution.

False, healthcare is a human right

False. Healthcare requires care, as in, labor. A right to someone else's labor is a right to enslave. Healthcare is about the most sugar-coated version of it imaginable, but it doesn't change that fundamentally the "right to healthcare" is the right to force others to take care of you.

Or, it’s an obligation on society to organise in such a way that healthcare is provided to anybody who needs it by whatever means you like. Taxes, charity, whatever else. Obligations are not per se unethical - the most basic one being not to cause harm to people in carrying out whatever you’re doing, but there’s many others - and current society uses taxes to ensure that their obligations are fulfilled, but there’s other options too.

>A right to someone else's labor is a right to enslave.

And yet there is a Constitutional right to a lawyer in most criminal cases if you can’t afford one. I can assure you, while public defenders might not get paid well and maybe many can’t afford their student loans, they are not slaves.

The slaves are the tax payers in your analogy, because they pay for the public defenders.

But that case is more defensible: the enforcing of the rule of law is powerful for freedom. So sacrificing some freedom to get a lot of freedom is an easy case.

Health services do not relate to freedom, but to the cost of insurance. If the government can provide a cheaper healthcare then it should provider a cheaper healthcare, and citizens can choose the government's plan and it will eat out the competition.

Why would the government need to ban the competition if its so good at providing insurance?

> Why would the government need to ban the competition if its so good at providing insurance?

In no country ever is private healthcare and competition banned. There is a free* hospital across the street from me and I have private healthcare.

It’s about acknowledging that a) it is cheaper for everyone if people with no money go to the doctor early, because a GP is 1k% less expensive to society than a hospital bed runout. This is one of the reasons healthcare in single payer countries is ~50% per capita.

B) people without money don’t deserve to die because they are poor and should have basic treatments, even when it is their own fault they are poor and make bad decisions.

* I pay tax which pays for the hospital

> In no country ever is private healthcare and competition banned. There is a free* hospital across the street from me and I have private healthcare.

Thats not factually true: there are many places that ban private healthcare, including canada. Then there are other conditions that punish private disproportionately: like funding public healthcare with taxes, but private healthcare with private funds: that means a person would have to pay 2 insurances to get private services. Also single payer really means there is only 1 insurance, so yes, it bans all other insurances.

> It’s about acknowledging that a) it is cheaper for everyone if people with no money go to the doctor early, because a GP is 1k% less expensive to society than a hospital bed runout. This is one of the reasons healthcare in single payer countries is ~50% per capita.

There are multiple issues why healthcare in the US is more expensive than "single payer systems", and preventative medicine is a small part.

> people without money don’t deserve to die because they are poor and should have basic treatments, even when it is their own fault they are poor and make bad decisions.

Is this moral line of yours defined by the country? Because if you want to save people's lives, single payer systems are very expensive. Its a lot better to open immigration and bring poor people from abroad.

Even the right to life and liberty requires the government to have people work at jobs to maintain security. Other than an-caps, even the most rabid libertarian thinks the government should provide national security.

Isn't that all forced "slave labor" by this same argument?

This is an unrealistic absolutist argument in any realistic view of the modern world with actual governments especially given the extreme excess of resources on earth to provide everyone with good medical care.

“Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care…”[1]

[1] Article 25 UN Declaration of Human Rights

The right to acquire it or the right to get it from someone else?

The right to it even if you are mentally ill, broke, bad at decision making or all of the above.

My point is definitely that you have an obligation to provide society funding for healthcare even if they don’t pay. Just like the military will defend them even if they don’t pay, or a firefighter will put out their house.

> The right to it even if you are mentally ill, broke, bad at decision making or all of the above.

The right to be provided something is the right to take from someone else. There is no escape to this, its a right that infringes on the right of others.

Theft cannot be a human right, and i would strongly reject anyone that defends such a thing, including the UN.

I understand now, when firefighters save homeless people, the homeless people are stealing from others.

This thread is going nowhere, you clearly value money more than the health of people less fortunate than you. Systemic poverty and sick people, who cares right.

I value liberty above everything else, partly because without liberty everything else also goes away.

You mention a trade-off with money and health, but the very idea of taking from some to give another is a violent expression. You might justify to yourself that is fine to rob and murder for the sakes of others. Others will think the same way.

Liberty for privileged people like yourself not born with disability or systemic poverty. Thanks for proving my point.

I’m no longer participating in this thread, and won’t read any replies.

Hot dog, there's a cheaper ER 30 minutes from here!

I can certainly imagine situations when I would choose waiting another 30 minutes over paying an extra $10k... Can't you?

Ooh, THIS one reuses sharps and passes the savings on to me!

Yeah, but this one provides free mosswort and radium supplements with all limb reattachments!

Communism would have all ERs equally shitty and expensive [to the taxpayer]. Is that all that better?

I mean, your argument holds true for everything. And yet, look around us and compare to any instance of communism on various extents. Capitalism is always better.

> I mean, your argument holds true for everything. And yet, look around us and compare to any instance of communism on various extents. Capitalism is always better.

Modern mixed economies are better, but there is a reason capitalism as a system (rather than a component of another system) died sooner than Soviet-style communism, to the extent that we now unironically call mixed economies with large socialized elements “capitalism”.

Among mixed economies, it's not the more strongly capitalist ones that have the most efficient, effective, or publicly popular health care systems, either.

You can stay off our communist roads then.

Enjoy bartering and purchasing your way across private property to something distant. (Yeah, fat chance you actually hold to your criticisms.)

Bartering? You dont need to State to exchange money :S

This is a very cool dichotomy you've presented me with.

Damn this was a crude comment.

I can't imagine a human right more fundamental than health care. What good is freedom of speech or assembly or trade to a dead person?

Patients in distress are usually not very able to make distinctions between hospitals based on pricing or really any other factor apart from perhaps proximity. This key point seems to not be addressed by any of the standard libertarian takes.

Edit: Also, I grew up in a country (India) where healthcare was definitely part of the market economy. And what that meant (and still does) was that people with money get high quality immediate care, and those without get shafted. That's what the market does to healthcare.

Oh, they do have a choice:

Pay up for the nearest facility, IF you have the funds to do so.

Or die.

> False. Healthcare is not a human right, but the insane inflation of healthcare costs would be avoided by removing a large portion of the regulation surrounding it.

....So it can only be for the rich.

Insurance is simple - you have a group pool their risk together so that everyone's protected.

Yet, when we try to discuss making an insurance pool the size of the country, for everyone, people like you go all "not a right".

When I see "not a right", I read into it as "Fuck you I got mine".. when there is plenty to go around for everyone.

> If hospitals actually had to compete to get patients, based on affordability, among other factors, healthcare would be far cheaper

Citation needed: prices are NOT linked to how much thing is, but how much the market will bear. Stating falsehoods to cover up your intent is disgusting. We know how c(r)apitalism works. We're rejecting that. Tried it, didn't work. Reiterating for better.

> private charity/need-sharing would take the place of insurance.

Uh huh. So non-christians need not apply? I know how this plays out... This is a citizenry issue, for the whole country. And you end up wanting to make it a fractured "small group" issue. People fall in cracks, and you don't care. Some "mythical" group will fix it.

> This is what libertarian and 'eliminate regulation' types want.

This statement is incorrect. Libertarians want competition in the emergency medical transport industry. If someone can offer a better service and at a lower cost, then that service should be an option.

All other things being equal, if it takes an ambulance 20 minutes to arrive on scene versus a ride share that takes 5 minutes, which is preferred? Granted ambulances provide more than simply transporting someone to a hospital, but those services could easily be applied under legal alternatives and done in a safe, effective, and efficient manner.

The libertarian argument is that it should not be illegal to let the market provide alternatives.