Forgive the long comment, and this is very US centered and doesn’t apply to every area in the US. EMS systems vary broadly between states and even municipalities within states…

To put some of that in perspective:

• A new ambulance costs about $250-$400k depending on the type.
• The heart monitors we use are somewhere in the area of $10k-$25k a piece. That’s ONE piece of the equipment that we use, and they need maintenance and replacement every so often.
• There’s all the other equipment, and restock of medical items. Even if something doesn’t get used it has to be on the truck and has to be replaced when it’s outdated.
• Fuel is expensive. The last agency I worked for spent about $400k - $500k a year just on fuel.
• There’s insurance - auto insurance, liability insurance, workman’s comp, etc.
• Keeping an EMS certification active requires ongoing continuing education credits. We take classes constantly to stay current and to be able to renew our cert, which in some states costs money just to renew. I’ve spent hundreds just to be able to work, both in con ed classes and certs. Some agencies will help pay for this cost, and many provide free con ed classes for their providers. This costs money.
• There’s building costs, rent, electric, etc.
• Ongoing vehicle maintenance (ambulances break a LOT)
• administrative costs, and so many more I haven’t listed

And that’s all before you get into paying anyone for their work. You aren’t paying thousands of dollars for YOUR ambulance ride. You’re paying for the fact that the ambulance existed to respond to your emergency in the first place. Many agencies don’t get taxpayer money, and if they do, it’s minimal. My last agency had townships paying them $2k a year to provide 24-7 ambulance service with paid providers. That doesn’t even cover fuel, let alone anything else.

Is it absolutely bullshit that people should have to be bankrupted to pay for an ambulance bill? 100% No one should have to worry about money when they’re having an emergency.

If you don’t like it, advocate for a municipal tax. If every household paid something like $75-$100 a year you could have the best EMS service with well trained, well paid providers using the best, most up to date equipment available and you would never have to worry about an ambulance bill. The places that implement those taxes generally either don’t bill at all or bill insurance and only take what insurance pays them, there’s no balance billing of the patient.

But no one wants extra taxes, even if it could save them thousands of dollars, and for some reason people come out and support funding for the fire departments and the police departments and no one wants to advocate for support and funding for EMS, so instead you get this mess where EMS is somehow expected to hold itself together and be a profitable enough business to self sustain. You end up with a system where providers are underpaid, have to work 70+ hour weeks to survive (and thus are incredibly burnt out and exhausted - you really want a provider who has worked 70 hours in 5 days on 10 hours of total sleep making life or death decisions?), the good providers head to places where they can get better pay, the equipment and ambulances are old and being held together by sheer will of the providers, and patients still have insane bills.

Patients should not fund EMS. Government should fund EMS. It’s a service, not a business, but under the current system in most places, it has to be a business if you want to be able to call 911 and have someone there to respond.

I work in EMS. My advice to students and brand new EMTs is always the same: don’t freak out when your patient is in cardiac arrest. Those are the easy calls. I have to keep people alive and if someone is crashing in front of me I have to figure out why and what I can try to do to stop it so they don’t die. The ones that are already in cardiac arrest aren’t getting any more dead, and the only outcomes are that we improve on that or we don’t. We can’t make them worse. Dead is the most stable condition.

Edit: That said, one of my favorite things about working in EMS is that I don’t have to care about “medically necessary” or insurance companies. If I think my patient needs a treatment and it’s in my protocol to give it, I give it. I don’t have to ask for an insurance company’s approval or get a payment method from my patients, I just get to help people.

Oh good, it wasn’t just me.

I had a tattoo I wanted for years. I was like well it’s going to be really expensive and I shouldn’t spend the money on it while I have these expenses coming up. A few years and a divorce later, well, I really want this tattoo, but I have student loans and a car loan and it would be really irresponsible of me to pay for a tattoo instead of putting extra money towards those. Yes I could work a bunch of OT to pay for it, but if I work a bunch of OT then I should take that money and put it towards becoming debt free. Maybe when I pay them off I’ll get it. Then it hit me that I won’t have my loans paid off until I’m in my 40s, even at the rate I’m going (making double payments every month).

Tattoo was finished yesterday. I could have paid off one of my loans with what it cost, but fuck it’s absolutely beautiful. The artist is a painter who tattoos and it legit looks like a painting on my skin.

When I’m gaming my cat will sit on my desk and grab my cheek with his paw to let me know he wants pets. If I don’t stop and give him pets or don’t give him the required amount of pets it escalates from him gently petting my cheek (hey you idiot, I want you to do THIS to ME), to him petting me with claws out, to him slapping me on the face, to angry headbutts.

If he doesn’t want pets but just wants to be with me he’ll just curl up in my lap with his head in the crook of my elbow and stare up at my face until he falls asleep. I love him so much, he’s the absolute best cat.

It didn’t turn into a fight, we both thought it was hilarious. He was like wait, is it really purple, then we both laughed about it a bunch and I looked up the color blind tests with the numbers hidden in colored dots and he realized that he could see the numbers in most of them but there were a few that he had to ask me if there really was anything there or if it was just plain dots to mess with people. Afterwards there were times he would start arguing with me about colors again and I’d make a comment about my grey sweater and then we’d both just end up laughing.

My ex used to argue with me about colors all the time. It was odd. Then one day he told me he really liked my grey sweater. I was like I don’t own a grey sweater. He said yes you do, and pulled it out of my drawer. It was my light purple sweater. That’s how we found out he was slightly color blind.

I had a TENs machine. I also have endometriosis (after suffering for over 20 years found a surgeon willing to do surgery, gods bless her for giving me a chance to live). When I was still with my ex I used it as a simulator to try to show him what my pain felt like. He was on the floor screaming and couldn’t straighten his legs or stand up because of the pain and I was just standing there chilling and hadn’t even hit the lowest threshold of my normal everyday pain limit, let alone the pain I felt when I had my period. I was like now do you understand why I’m exhausted and depressed all the time and hate my life?

Well one died for good, and the other pretended to die and then came back later to claim all the glory and credit

I’m a really fast reader and I had a slowish day at work yesterday. I read The Colour of Magic start to finish yesterday morning and really enjoyed it. I’m almost finished with The Light Fantastic now.

I think I’ve got about 5 reads in ;) I tend to find books I like and reread them way too many times. I’ve got about 9 or 10 reads of The Witcher novels and am trying to resist pulling them out again.

“I found god/in the sound/of your factories burning down/now I sleep so sound”

Yes, I’m not sure why they deleted their comment, it was still a good suggestion and I appreciate it.

I forgot I read this series! I absolutely loved the first half, by the last half I just felt like I was only finishing it because I had invested too much time in it. I hated the way the women characters developed at the end, it felt very “men writing women”. It was so gross. I also hated how dialogue heavy the last few books were, the plotline dragged hard.

I have read the Hobbit! I was so excited for the movies and when the first one came out I almost cried in the theater. I made myself watch the second one but never did watch the third one. The book is good enough.

Depends. I’ve realized that people aren’t really looking for an answer beyond being acknowledged, so “hey”, “hey, how are you?” or a simple return of the greeting lets them know that you hear them and are completing the social contract. If they follow up or if it’s asked in a context where I think they want an answer sometimes I just say “here” or “breathing” and that gets the point across.

Dang, that’s rough. It sucks that neighbors can really affect your quality of life so much. My first apartment was great the first 2 years and then I had an unemployed couple move in below me and all they did 24/7 was sit outside under my windows and heat/ac unit and smoke and it filled my apartment with smoke (I’m really sensitive to smoke and get horrible migraines from it), talk loudly, and have really loud sex at all hours of the day (which was amusing but obnoxious). Shortly after they moved in another couple moved into the apartment that had a balcony adjoining ours and they were potheads who were too lazy to take their dog out to use the toilet, so they just let it out onto the balcony to go right onto the floor. It smelled so bad we couldn’t use ours anymore or open the door to it. I was so grateful when my lease was over and I could GTFO. My neighbors in my current apartment are fantastic and I’m in terror of the day one of them moves. As a long time night shifter sometimes I’m worried that I’m the loud one, I try to be quiet but I’m just nocturnal by nature and I’m on the top floor.

Sound can also travel very oddly. I grew up in a house where my sibling’s bedroom was between my bedroom and my parent’s bedroom. I could have the radio on in my bedroom and turn the volume down so low that you couldn’t make out individual words if you were standing a few feet in front of the radio, and you couldn’t hear it at all in the hallway or my sibling’s room, but somehow in my parent’s room it was obnoxiously loud. I remember one time I had it on just loud enough to hear my music in my room and I went to my parent’s room to talk to them and almost had to yell to be heard over it. I had to use headphones all the time and I couldn’t have private conversations in my bedroom if I didn’t want my parents to hear.

Hey you, you’re finally awake…