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View Full Version : 90% of ambulances dispatched in Tokyo are for non emergencies



Maciamo
Oct 8, 2004, 15:11
Chauffeur ambulances drain funds (2nd article) (http://www.japantimes.co.jp/cgi-bin/getarticle.pl5?fd20040928tc.htm)


"My wife is about to have a baby. We need you to come over here." Within seconds of the 119 emergency call, a three-member ambulance crew was alerted and then dispatched to the caller's home in Tokyo.
But upon arrival, the crew didn't find a hysterical wife in labor with an equally hysterical husband at her side. Instead, a very calm couple was waiting at their door, overnight bags in hand.

"The due date is tomorrow," the husband cheerily explained. "Her labor pains haven't started yet, so we'd like you to get us to the hospital tonight."

And so the ambulance crew duly chauffeured the couple to the hospital.

"Well that was fun," said the wife as she disembarked from the vehicle at the end of the journey. "These ambulances really are spacious inside." And with that, the couple entered the hospital, not even bothering to thank the crew for the free lift.

This "emergency call," believe it not, was fairly typical. In the Tokyo metropolitan region, more than 90 percent of calls for ambulance assistance are for nonemergencies, according to statistics from the city's fire department. Ambulance crews find themselves spending the bulk of their shifts with such unnecessary tasks as escorting home salarymen too drunk to walk or kids with sprained wrists, rather than dealing with life-threatening injuries.


Shukan Post figures the same trend exists throughout the country -- in 2003, ambulances were dispatched 4.8 million times.
...
Maintaining a squadron of ambulances is an expensive business. The price of each fully equipped vehicle runs to around 200 million yen. The costs of employing a three-member crew for each one are even more astronomical.

The Tokyo Metropolitan Government puts the cost of each ambulance dispatch in the city at around 45,000 yen.

So does the math: With 660,000 dispatches a year, more than 90 percent of which are unnecessary, taxpayers' money is being squandered annually to the tune of 25 billion yen a year -- and that's just in Tokyo. Yet unless the national habit of dialing for ambulances for less than serious situations can broken, the waste will continue.

Make the count. If 90% of the 4,8 million nationwide dispatches were for nonemergencies, like in Tokyo, the cost of unnecessary dispatches would amount to 200 billion yen per year in wasted tax-payers money. The problem is that ambulances are free and people tend to abuse as they have little idea that each dispatch cost the nation 45,000yen.

Considering that the average salary (based on the GDP per capita) in Japan is about 3 million yen a year, and that the equivalent tax rate is 10%, each citizen pays in average 300,000yen in taxes on salary each year. 200 billion yen of wasted tax equals to about 666,000 people whose total taxes are wasted in chauffeuring drunk salarymen home or other nonemergencies.

I think there should be penalties for calling an ambulance for a non emergency. Or there should be a pick-up service for elderly people who can't walk for their weekly or monthly visit to the hospital and can't afford a taxi. That pick-up service would be a minibus taking all the nonemergency patients to the hospital, without all the equipment and crew of a regular ambulance, so as to reduce costs. This service could even be charged at a reasonable rate (like public transportation), and heavier penalties (eg. 10,000yen) should then be imposed on those who try to abuse the free emergency ambulance service.

Jungle Boy
Oct 8, 2004, 16:08
Nice job with the math Maciamo. It really is alot of wasted money. And I agree they need to make reforms. The way it is now is just ridiculous.

Tateishi
Oct 8, 2004, 17:19
Damn, and in Australia it's $500Aus, aprox 40000yen, to call out an ambulance.

thomas
Oct 8, 2004, 17:33
A similar article was published in the printed edition of the Daily Yomiuri on Sept. 11, saying that the Tokyo Metropolitan Goverment now mulls charging for ambulance services.


According to the Tokyo Fire Department, ambulance crew members have found on their arrival that some people who called for an ambulance were just lonely or did not want to go to hospital alone. In such situations, the crew members returned to their station without taking the caller to hospital, a department official said.

In one case, a man in his 50s called for an ambulance because he was to be hospitalised and needed to go to a specific hospital by 9 a.m. The ambulance crew arrived to find the man was in no distress, but was waiting for them, holding a paper bag full of clothes and other necessities. In another case, a woman in her 20s called for an ambulance over a toothache because she did not know of any dental clinics that were open at night.

During the cherry blossom and year-end seasons, the number of people who call for ambulance increases, with many of them drunk from consuming too much alcohol at parties.
:auch:

In my country local communities charge for unrequired calls for fire brigade and ambulance services.

thereisnospoon
Oct 8, 2004, 19:03
We have a similar problem in the UK with people calling the emergency services for very inane reasons. Such as, lost remote controls, broken nails etc.

senseiman
Oct 9, 2004, 00:02
I'm kind of surprised, but at the same time I had kind of figured something like that must be the case. An ambulance with its sirens blaring and lights flashing is pretty much a daily occurence in my neighborhood, yet I don't think I've ever seen anyone actually have an accident or anything.

It pisses me off big time. A couple of years ago I was in a bike accident, fell off and hit the asphalt pretty bad, shattering my elbow (which is an exceptionally painful place to break a bone FYI). As I was lying on the sidewalk in pain my wife who was with me said "I'll call an ambulance." But I was thinking "Well, my life isn't in danger and the bone isn't sticking through the skin or anything, so maybe I don't really need an ambulance. If there was a serious accident somewhere and the ambulance couldn't respond because they were taking me to hospital I would feel terrible." So I told her to just call a cab.

Only problem was it was 9:00 at night, so after we got in the cab (which took about 15 min. to get there) we had to go to 3 hospitals until we could find one that was open, and then they just sent me to yet another hospital (and we had to get another cab because we had sent our first one on its way) because they didn't deal with broken bones. It was about 2 hours after my accident before I got medical attention and I was in pretty major pain by that time.

If I had known that 90% of the A## holes who call for ambulances don't even need them, needless to say I wouldn't have bothered.

Kamisama
Oct 9, 2004, 02:21
I wonder if traffic in japan gets so bad sometimes, that you have to call an ambulance to get you to an area because you can't get there in a day. Or perhaps the stress of traffic would bring the woman to labor earlier. Quite the interesting article.

Maciamo
Oct 9, 2004, 10:01
I'm kind of surprised, but at the same time I had kind of figured something like that must be the case. An ambulance with its sirens blaring and lights flashing is pretty much a daily occurence in my neighborhood, yet I don't think I've ever seen anyone actually have an accident or anything.

Same for me in Tokyo. I did see one or two real accident, but no match to the ambulance passing everyday or twice a day. On the other hand, it could be people having a heart attack inside a building or something else we can't see from outside.


But I was thinking "Well, my life isn't in danger and the bone isn't sticking through the skin or anything, so maybe I don't really need an ambulance. If there was a serious accident somewhere and the ambulance couldn't respond because they were taking me to hospital I would feel terrible."

I thought exactly like you before reading the article. I wouldn't bother calling an ambulance even for a broken arm, etc. if it was not an emergency (i.e. something life-threatening) But now that I know I live in a country of selfish and stingy people...


I wonder if traffic in japan gets so bad sometimes, that you have to call an ambulance to get you to an area because you can't get there in a day. Or perhaps the stress of traffic would bring the woman to labor earlier.

No, nothing like that. I found that there were relatively few traffic jams in Tokyo compared to the average European cities, probably because roads are much wider (4 lanes in each direction, against 1 in normal European cities).
Anyway, car drivers usually step aside to let the ambulance through, and it's quite easy again because of the wide roads. Even with a car on each of the 4 lanes, there is more empty space in total (between each of the 4 cars) than there would be on a 1 lane street, where stepping on the pavement is the only solution, and sometime not enough. I have in fact never seen an ambulance having troubles making its way through the traffic in Tokyo.

DoctorP
Oct 9, 2004, 10:40
If I remember correctly in the U.S. you are charged for the ambulance ride! Especially since many of the ambulances are operated by private companies. Usually this cost is offset by your insurance company, but I would guess that keeps the non-emergency use down to a minimal. I would have never expected Japanese to do something like this...very creative...but pisses me off too!

Lina Inverse
Oct 9, 2004, 10:53
Here in Germany, abuse of the emergency call (for non-emergency situations) is strictly punished. Not only the abuser has to pay all the costs of the dispatch, but also an additional fine, so it can easily amount to 500 (68275 Yen) and more.
They need such a regulation there as well - people will think twice before they waste about 70,000 Yen of their money for a non-emergency.

Maciamo
Oct 9, 2004, 11:37
If I remember correctly in the U.S. you are charged for the ambulance ride!

That doesn't surprise me as hospital or visits to the doctors are not free (paid by the National Healthcare) in the US and other ultraliberal countries like Australia or China.

However in Europe and Japan medical care is heavily subsidized by higher taxes. In some countries like the UK or Spain, healthcare is completely free. In others like France or Japan, about 70-80% is paid by the national health insurance.

I am not sure if ambulances are free in all European countries, but usually they are, due to the government's policy to support health care.

PopCulturePooka
Oct 9, 2004, 11:58
In Australia you can opt to be an Ambulance subscriber, which means a bit of your salary (a REALLY tiny amount) is yanked out each week towards the Ambo's. Then if you need an ambulance you're fine. No charge.

But if you aren't a subscriber you're screwed. The bucks you gotta pay are quite big.

Oh and people covered by private health are generally covered for ambulance as well.


That doesn't surprise me as hospital or visits to the doctors are not free (paid by the National Healthcare) in the US and other ultraliberal countries like Australia or China.

However in Europe and Japan medical care is heavily subsidized by higher taxes. In some countries like the UK or Spain, healthcare is completely free. In others like France or Japan, about 70-80% is paid by the national health insurance.

I am not sure if ambulances are free in all European countries, but usually they are, due to the government's policy to support health care.
Australian healthcare is generally free for most people if covered by Medicare.

Jungle Boy
Oct 9, 2004, 13:19
Are Japanese more frail than Western or European people? Like mentally? Because I too have known of people who have broken arm's, leg's ect and refuse to call an ambulance. Instead they either get a ride, or take a cab. It seems that in Japan they call an ambulance for the dumbest things, while we tough it out.

Maciamo
Oct 9, 2004, 14:22
Australian healthcare is generally free for most people if covered by Medicare.

Yes, if you are on Medicare, but eventhough you have to pay the doctor and medicare reimburse you on your (Australian) bank account. The point is if you didn't subscribe to medicare or do not have an Austrlian bank account, you have to pay the full price. I went twice to the doctor in the few months I stayed in Australia. Both times they charged me about 70AUS$ (about 50US$ or 5,500yen) for a 2 minute visit, and both times just to be told that I could buy cold/flu medicines without prescription at the chemist.

In contrast, I accompanied my wife twice to the hospital in Europe (UK and Spain) and she didn't have to pay either time, eventhough she was Japanese and not even resident in Europe (and we weren't married at the time). She also had a medical check (including blood test) at the doctor in Belgium and didn't have to pay anything either. It's just free for anybody in some countries.

Even in Japan, with the Japanese National Health Insurance, I (and my wife) had to pay 10,000yen for the annual medical check and about 3,000 to 5,000yen for a visit to the doctor for a cold. Sometimes I wonder what this Japanese National Health Insurance covers - not even ambulances as they are free for non-insured people or short-time visitors as well (I think).

Kamisama
Oct 9, 2004, 15:11
That's cool, people wasting the governments money. It's their way of rebelling against such stupid civil laws. People are screwing with the government like it screws with them. I see justice!!

Maciamo
Oct 9, 2004, 17:18
That's cool, people wasting the governments money. It's their way of rebelling against such stupid civil laws. People are screwing with the government like it screws with them. I see justice!!

That is NOT the government's money. There is no such thing. Everything comes from taxes. Then what "stupid civil laws" are you referring to ?

PopCulturePooka
Oct 9, 2004, 23:47
Yes, if you are on Medicare, but eventhough you have to pay the doctor and medicare reimburse you on your (Australian) bank account. The point is if you didn't subscribe to medicare or do not have an Austrlian bank account, you have to pay the full price.
Really?

Don't think so.

I've never paid a cent to a doctor in Australia. I give them my Medicare card and badda bing badda boom. Thats all there is.

digicross
Oct 22, 2004, 13:31
Heck, if a school kid didn't managed to finished his or her homework (or worse, the bully's homework that if isn't finished he or she will kill you or fatally injured you), that's an emergency to him or her no matter what other people said.



As for the couple with baby, drunk people, sprained wrist, and so on.

Well... Like I said, some people have their own definition. Maybe the problem isn't because of these people 'misused' the service, but the fact this kind of service existed in the first place.



As for wasted money.

Well... Money is cheap anyway. Besides if some people think the money is wasted, why bother to provide such service in the first place anyway?

But here's a way to reduce the number of 'unnecessary' calls, make them pay for every call their make, even for the life threatning ones. I'm sure that the number of ''unnecessary' calls will be reduced.

What about the cost? Heck, if there're life threatning emergencies, cost doesn't matter. Besides, even the mob (that includes the whole healthcare system, especially private ones) knows that you couldn't milk money out of a broke person. Not to mentioned that things will always have a way of sorting things out.



As for "Everything comes from taxes."

Everything comes from taxes, that were collected from the people and then owned by the government. The money is owned by the government, that's the truth, no matter how much some people said that it's 'the people's money'.

Heck, when most people paid their taxes, they don't expect it to come back from the government (either in financial form, goods, services, and so on). That's what it's always been for the last few thousands of years, and that's what it will be now. Of course, there will always provocation toward people by some people to demand more and more from their government.

For that, the answer is "Give Caesar what is Caesar's!"

Of course, there's always the Pharisees (separatists) around to provocate the people to goes against the government.

Anyway. If you think that tax is not mandatory, just try not paying tax for a few months. I'm sure that the police car, the fire engine and the ambulance will arrive at your place faster than if you were to call them by yourself.



As for "what "stupid civil laws" are you referring to ?"

I think he mean by laws that somehow were authorized eventhough everyone (including the people in the government) do want the laws to be authorized. The question is, if everyone don't the laws to be authorized, then who want the laws to be authorized in the first place?

Heck, all people just want to do what their want (which varies from person to person), disregard what some people said about caring for the community, in the end, what people care is what they want, sure some people want the happiness of others, but it's still what their want ("'I' want the happiness of others" for example). For a good lesson of selfishness in a good way (Yes, being selfish can be a good thing), it should be noted Mary got a very selfish trouble maker kid who is a Messiah, he could teach you a thing or two about being selfish in a good way, he's currently absent for the moment though.

All people need are just guidelines to organize themself so that things will worked nicely, where everyone gets what they want. Unfortunately, these days everytime there's a guideline that worked with everyone, it's thrown out.

Why? Because it will cause harmony among the people, and 'they' don't like that ('they' owned every government). Much like that 'they' don't like on how the people don't care about the taxes the people give to the government.



As for "Sometimes I wonder what this Japanese National Health Insurance covers"

Doh! The money is used for the free ambulance calls of course! That's right, somewhere out there, there are people using the money that were taken from you.

Maybe the problem isn't that the ambulance couldn't provide for the actual life threatning cases.

Maybe the real problem is that people were upset that somethere out there, there are people spending their money for stuff they deemed unnecessary.

PaulTB
Oct 22, 2004, 16:44
Each person has a different term for "emergency".
Yeah, and there are lots of different definitions of 'dumbass'.

PopCulturePooka
Oct 22, 2004, 16:52
No people are upset Digicross because people in LEGITITMATE emergency and life threatening situations are being put at great risk because abulances they can use are being used to ferry LAZY IDIOTS around like a free taxi service.

Thats one big problem.

stephenmunday
Nov 1, 2004, 16:11
The fact that most of the time ambulances are not traveling to or from real emergencies would probably explain why they seem to be the only vehicles on the road that actually keep to the speed limit... Or is it just the case that the Mikawa area of Aichi where I live really does have the worst drivers in Japan?