You are here

Uber Cuts Ambulance Usage And Health Care Costs Across 766 US Cities

In recent months, it seems like there’s been nothing but bad news for Uber, like having its operating licence revoked in London (“not fit and proper”), concealing a massive cyber-attack, price gauging a passenger $14,000 for a 5-mile ride and reporting a quarterly loss of $1.5 billion. Indeed, the company is becoming almost synonymous with problems. A Bloomberg story three days ago about Airbnb began “With Uber's problems grabbing all the headlines, it's easy to overlook the fact that the other great "sharing economy" company, Airbnb, is also having issues caused by an overaggressive expansion and a tendency to ignore rules”.

For once, a slightly more positive story about Uber has emerged, although there is even an “Uber” downside to this. In brief, researchers have found that when Uber is launched in a city, ambulance usage declines significantly. From The Mercury News.

In what is believed to be the first study to measure the impact of Uber and other ride-booking services on the U.S. ambulance business, two researchers have concluded that ambulance usage is dropping across the country. A research paper released Wednesday examined ambulance usage rates in 766 U.S. cities in 43 states as Uber entered their markets from 2013 to 2015.

Co-authors David Slusky, an assistant professor of economics at the University of Kansas, and Dr. Leon Moskatel, an internist at Scripps Mercy Hospital in San Diego, said they believe their study is the first to explain a trend that until now has only been discussed anecdotally. Comparing ambulance volumes before and after Uber became available in each city, the two men found that the ambulance usage rate dipped significantly. Slusky said after using different methodologies to obtain the “most conservative” decline in ambulance usage, the researchers calculated the drop to be “at least” 7 percent. “My guess is it will go up a little bit and stabilize at 10 to 15 percent as Uber continues to expand as an alternative for people,’’ Moskatel said.

Slusky and Moskatel are submitting their paper to academic journals for peer review. The research was completed independently of Uber. The authors used the company’s public statements to discover when the company entered each market and obtained ambulance usage from the National Emergency Medical Services Information System, or NEMSIS, a national repository for emergency medical services data.

The reason behind the “Uber-effect” is economics. In the US, the Department of Health and Human Services estimates that the price of an ambulance ride to hospital is typically between $600-$1,000. As the Daily Mail noted in “The rise of the Uber ambulance” in April 2017.

Meanwhile, charges for ride-hailing apps charge rarely hit three figures - and customers know the approximate price when they request their ride. Ambulances, by contrast, send bills long after they are used, and often the final amount is unknown until the bill is received.

This chart is from HealthCare.com.

With health care costs having risen so much in recent years, even when people think they need emergency treatment, they increasingly have to weigh-up cost factors before phoning an ambulance. As Slusky told The Mercury News.

“If we want to reduce (health care) spending, we have to find ways to do things cheaper — and that’s in all kinds of situations where you don’t need the most expensive resource. We don’t all need to fly first-class all the time.”

Despite the obvious revenue benefit to Uber, the company was, not surprisingly, keen to distance itself from the idea that calling an Uber driver is a substitute for calling an ambulance.

“We’re grateful our service has helped people get to where they’re going when they need it the most,” said company spokesman Andrew Hasbun. “However, it’s important to note that Uber is not a substitute for law enforcement or medical professionals. In the event of any medical emergency, we always encourage people to call 911.”

While we have some sympathy with Moskatel’s contention that most patients are “pretty good” at assessing how sick they are and how quickly they need to get to hospital. However, there is obviously a risk for patients who suddenly need medical treatment on their way to hospital. Not surprisingly, The Mercury News was able to find an emergency room physician who was strongly against substituting ambulances with Uber rides.

Paul Kivela, president of the 37,000-member American College of Emergency Physicians, said he believes that for those low-risk patients who can’t drive themselves to the emergency room, Uber is a good service. But many people, he said, may not be able to differentiate between a life-threatening emergency and an innocuous medical issue. So, he said, calling 911 is always the safest bet. “A paramedic has the training and the ability to deliver life-saving care en route,” Kivela said. “Where I really have a hard time is believing an Uber driver is going to attend to you.”

Despite the risks, even officialdom sees benefits from the rise of “Uber ambulances”. In April, STAT, a health and medicine news site reported.

Last summer, Washington, D.C., city officials began studying the use of ride-hailing to respond to what they describe as “non-emergency, low-acuity” calls, which accounted for nearly half the city’s 911 calls in 2015, according to a report released in February. “In our research, we found that many of these calls did not require an ambulance,” said District of Columbia Fire and Emergency Medical Services Department spokesperson Doug Buchanan. In fact, he added, it would be better if more people used ride-hailing services instead of an ambulance. “We would love our residents to take that initiative,” he said.

The question of whether to transport someone who is ill to the hospital is a frequent source of debate amongst Uber drivers on forums like uberpeople.net. Many Uber drivers are firmly against it, citing issues like insurance cover, the risk that the person gets worse during the journey, or this.

No way in hell..I am not a medical professional and do not play one on TV