Uber, the car ride-summoning service powered by a smartphone app, has been in the healthcare news for a number of reasons over the last few months. Most of the coverage has been positive, including how it’s faster than an ambulance. There have even been people who have been shot and called Uber instead of an ambulance.
The honeymoon of Uber as an ambulance alternative and the realities of servicing the ill has officially ended. Fortune.com is reporting that a NYC Uber driver refused a ride to a woman in labor, and then still charged them $13.00 for his time. From the article:
Instead of taking David Lee and his wife to the hospital, the Uber driver balked because the expectant mother retched on the sidewalk. He informed them he would lose $1,000 a day if Lee’s wife became sick in the car and, what’s more, told them no other driver would accept a woman in labor as a passenger.
There are two things that are relatively humorous to me about this whole thing. The first is that the driver didn’t want the woman vomiting in his car because he would lose $1,000 a day. Vomit, contrary to popular belief, is not that hard to clean up. Sure there may be a lingering scent from it, but that’s what those little green cardboard pine trees are for. Second, other Uber drivers not only accept pregnant women as passenger but sometimes they get naming rights and choose to name the baby after Uber. The company even has it’s own promotional onesie for babies born in Uber cars.
To add insult to the injury of not being deserving enough for a ride in a precious Uber, the driver also reportedly charged the couple $13.00 for his time. This is actually something that got me thinking and I think this Uber driver may be on to something that may revolutionize EMS. Could you imagine if ambulances were able to charge for their time instead of whether or not they actually transported? That is SUCH a novel idea!
Oh, wait. It isn’t.
The problem is that ambulances are reimbursed on a fee for service model. The service an ambulance actually renders is primarily transportation, the whole clinical patient care aspect is a sidenote when reimbursement is involved. Without actual transportation, the largest payor in healthcare will not provide you reimbursement. Since the largest payor in healthcare won’t do it then the other payors generally follow suit. You may be wondering why you can’t just bill the largest payor and then go after them for the money, right? That’s because the largest payor happens to be the United States Government through it’s Medicare and Medicaid programs. There are some instances where services do recover funds for doing RMAs, but those are rare when you look at the big picture.
While I am against the refusal of service (especially since Uber is going to be one of the ways that healthcare costs are curbed from a transportation perspective) I am definitely pro-charging for time.