Local authorities announced a crack down today on what they term “underground ambulances,” or black ambulances, who profit from the illegal long-distance transport of patients in and out of Shanghai. Often shoddily outfitted and misleading to customers, black ambulances pose a serious risk to patients who are ignorant of options and desperate to get home.
Black ambulance operators paper the toilets, corridors and wards of all major hospitals in Shanghai with ads and business cards pushing their supposedly cheaper options for long-distance patient transport to hospitals outside of Shanghai. This service appeals to those who may have come to Shanghai in order to receive better medical treatment, and now wish to return to a hospital in their home town.
The ambulance ads offer such amenities as luxury beds, attendant doctors, on-board oxygen, suction, and stretchers. They wait on standby in nearby neighborhoods, and once called, arrive quickly to the hospital doors, undeterred by hospital security. But from there, the situation gets more shady.
Most black ambulances are unlicensed, or licensed by hospitals in neighboring provinces where standards are lower and outsourcing of ambulance services is more common. There is currently no unified regulatory body overseeing licensing procedures, which results in a slew of risks to patients.
Although plugging such services, many don’t carry on-board attendants, and their sanitation procedures are laughable or nonexistent. While riding in an environment rife with cross-contamination risks, you may also be subjected to cheap industrial oxygen and treatment by untrained paramedics (if there are any in the first place.) If anything were to go wrong en-route, the risks to patient safety are enormous.
Officially licensed ambulances in Shanghai currently number over 500, but only about 10 of these are reserved for out-of-town transport, with more options available on a situational basis. Last year, the number of people requiring such long-distance services was estimated at about 8 per day. In the past, there were far fewer licensed options available and black ambulances were in much higher demand.
So if licensed vehicles can currently meet demand, why the black racket? The most obvious reason is patient ignorance, compounded by the sheer determination of black ambulance operators. Collusion has also been reported between hospital staff and the unlicensed vehicles, with some nurses and doctors pushing their services for a kick back. And of course, there’s the supposed price differences.
But are they actually cheaper? According to one source, no. Black taxi prices were quoted as the same or more than officially licensed vehicles. One price quoted was 2,800 yuan for a 235 km journey. Official ambulances run for anywhere from 8 to 11 yuan per kilometer, which even at the highest estimate would only be 2,585 yuan for 235 km.
Also, because there’s obviously no official payment or receipt system, black ambulances can unexpectedly jack up the price mid-route if you’re not careful (who would you complain to?) leaving you with little option but to agree to the increase and continue on.
This isn’t the first time Shanghai has ratcheted up the pressure on underground ambulances, but hopefully it’s the last. Fines for running an underground ambulance were said today to be at about 30,000 yuan, which oddly has seen a drop from the 100,000 penalty announced last year. But even that failed to deter the practice, and Shanghai has seen the number of black ambulances rise from 20 last year to 30 this year.