Y'know, having worked CA EMS for years... you live in the mountains of California. Remember? I'm assuming you had to come down the hill to get to the hospital?

Remember that law about having to pull over if there's more than 5 cars behind you on those mountain roads? Ambulances aren't exempt from laws. Especially when driving without lights/siren. which I'm assuming they did, for 2 reasons: they didn't think you were critical (thus the risk of driving that way is higher than the benefit) and a slower ride tends to be a bit more comfortable (but, yeah, it's always bumpy in the back. Trust me). So their driving, as much as it probably sucks for you, does make sense to me.

Pain meds? Might either be: 1) basic EMTs, and don't carry any, 2) protocols won't let them give it without base hospital permission which they didn't get, or 3) they're sadistic bastards. I'm sure you prefer option 3 to be the case, but see if you can't find out which it is - there might be a reason. And sometimes the EMS crew is stuck explaining base hospital's wacky thought process to the patient.

As for the bill, I think the base rate on a basic ambulance in CA is something around $450, paramedic ambulance $550. The mileage they can charge for, equipment (oxygen cannulas, sheets, basically everything they have to throw away).

To get on my soapbox, I think it's utterly absurd that you pay insurance companies out the nose to cover you, then they end up paying only a percentage of the bill and stick you with the rest. Really? doesnt' that totally contradict all those contracts and the POINT of insurance? How much do people blow over months or years that never gets used, they never getting the coverage they expect??? health care is the ONLY field in America where you can get treatment and get away without paying the bill. Seriously - try getting your brakes changed and telling the guy after he finishes that you'll only pay $50, and see what happens. Or walk out of a jewelry store paying 15% of the total cost. It's absolutely absurd.

As per some other comment, absolutely doctors have to practice litigation-mediated medicine. You think most of them know that they don't need blood work, or a CT? But if you don't do it and get sued, well, "everyone" does it, so you're breaching standard of care. And patients get mad if every last thing isnt' done for them. God forbid they go to the ER, wait 8 hours, get one lab drawn, and get told: You have mono. Go home, take some Tylenol, drink lots of fluids. You'll get over it in a couple weeks. The exorbiant costs of health care can probably be traced to 3 reasons: 1) non-payment by consumers, 2) litigation or the threat thereof (I mean, the hospital has to keep lawyers around), and 3) the patients DEMAND high levels of care adn fancy testing. Then don't pay... leading back to number 1... and number 2 when you get down to it.

Off soapbox.

Oh, Todd, I am sorry it took so long to get you to the hospital. But it is a JOB, and there are methods to their madness, and they're hamstrung by buracracy just like the rest of the US.