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Dial 1298 My son always wants to watch motorbikes on the telly. While watching an old episode of motorcycle adventurer Charley Boorman traveling through India by various means, I took note of Charley’s description of the ambulance service in Mumbai. He said that until recently there were no ambulances, so a group of entrepreneurs set up a service.
It is called Dial 1298 and it provides scheduled and emergency medical transportation. Even the poor are catered for:
The principle of cross subsidy is used wherein:
- Full charge to a patient going by choice to a private hospital.
- Subsidized charge to BPL (Below Poverty Line) patient going by choice to a government / municipal hospital.
- Free service to accident victims, unaccompanied, unconscious individuals and victims of mass casualty incidents.
One of their investors is Accumen Fund, who say: “We use philanthropic capital to make disciplined investments – loans or equity, not grants – that yield both financial and social returns.”
All good, voluntary stuff. Socialists hate it.
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When I came across >>this<< military surplus ambulance for sale, I found myself wondering how one would go about setting up a private emergency response ambulance in the UK.
There have been several instances of the UK ambulance services leaving people to die due to bureaucracy or indifference.
In those cases having a private competitor you could call who will make you their top priority (with post hoc easy payment plans) and who has state of the art equipment would be a welcome alternative.
But the more I thought about it, the more I was sure that there are almost certainly massive regulatory hurdles designed to stop you from doing things exactly like this.
There are private ambulance services of one kind or another in most poor cities of reasonable size where there are significant numbers of government bureaucrats / middle class people / expats / tourists. (Sometimes these will be “medical evacuation services”, when there is no decent hospital in the city). Regardless of what local laws and regulations say, a way will be found for such things to exist, because the politicians and bureaucrats and well connected will be a significant part of the customer base. Whether the general population will gain any benefit at all from their existence is going to depend on circumstances and how they are run. In somewhere like India, the answer is probably “a little”, which is not unrelated to the fact that it is a freer place than most poor countries.
If I understand correctly, “top priority” could be as simple as carrying you through the doors of the emergency department rather than leaving you lying in the ambulance.
I’d be willing to pay for an ambulance that will at least try to not kill me, wouldn’t you? 😉
That’s not to say the gub’ment ambulances are all terrible, but their performance frequently is.
India is a classic clash between the hard work and thoughtfulness of ordinary people, and the endless regulations and subsdidies of the government.
The regulations of the “Permit Raj” strangle private action.
And the subsidies (such as the new ideas for “free” educaition) undermine voluntary alternatives.
As for the latest idea of cash-for-votes (sorry the Economist magazine idea for “income support” in India) it will bankrupt the country.
Sadly, as so often, I can not think of a way of fighting these destructive policies without falsely seeing “against the poor”/
This is the problem – the terrible problem.
And it true of every country.
By the way – rolling back regulations is less incredibly difficult than rolling back welfare schemes.
After all the Permit Raj was partly rolled back in India (some years ago – and with good results).
But rolling back welfare programs is even harder.
“When I came across >>this<< military surplus ambulance for sale, I found myself wondering how one would go about setting up a private emergency response ambulance in the UK."
You would probably get sued to death if not prosecuted. Just like how if you beat up a burglar you will probably end up in prison while a police officer who does exactly the same thing won't. Your legal rights are supposedly the same and if you had the money to fight it all the way may end up so in practice, but the system is heavily biased toward letting powerful organisations do what they've always done and against anything that seems strange or disconcerting. See Rex v Haddock.
On this ambulance thing – sounds great, but what's to stop me setting up Bloodsucker Capitalists Ambulance Ltd that offers voluntary transfer to private hospitals without a cross subsidy? That would undercut this provider and eliminate their base for cross subsidy.
Michael writes: “Whether the general population will gain any benefit at all from their existence is going to depend on circumstances and how they are run. In somewhere like India, the answer is probably “a little”, which is not unrelated to the fact that it is a freer place than most poor countries.”
But Dial 1298 does seem to be specifically run as a general service for the general population. They say they offer services to “below poverty line” people at a discount. Also see here. They are going into slums and training people in first aid, marketing to slum-dwellers and hoping to station ambulances near slums. “We are offering the ambulance service on a no profit, no loss basis, which is considerably cheaper than the cost to other, more affluent areas in Mumbai.”
That sounds like more than “a little” benefit. Of course whether it is successful and what is really happening, I have no idea. But that seems to be the aim.
mdc: “what’s to stop me setting up Bloodsucker Capitalists Ambulance Ltd that offers voluntary transfer to private hospitals without a cross subsidy? That would undercut this provider and eliminate their base for cross subsidy.”
Good point. And yet there it is; for now; apparently.
If you have excess capacity, as one should do with such a service, one can offer some of that capacity to those unable to afford it and still break even or even make a profit.
Many drug companies offer reduced price plans for the less-well-off. Why should they not? The drugs themselves are cheap to produce, the majority of cost being in the research. That is not affected by such plans and is positive publicity for the drug companies (and I’m sure delivers a fairly solid tax write-off)