The Washington Post had a pretty shocking story about ambulance bills. $9,000 for a 40 minute ambulance ride at normal speeds, no siren, no unusual life support measures. What I found striking about the story was less the outrageous pricing than that no one was talking about how the ambulance company’s fees are almost assuredly unenforceable and probably an unfair trade practice.

This ambulance fee situation is an absolutely textbook case of unconscionability. There’s loads of procedural unconscionability: the consumer is an situation in which she has lacks any meaningful choice, being told that she must take the ambulance, and the ambulance never tells the consumer the price of the ride upfront. There’s also plenty of substantive unconscionability: the shockingly high costs—$60/mile!  The unconscionability should be a defense against enforcement of any bill sent by the ambulance company (subject to an offset for quantum merit).

(There might also be duress and undue influence defenses, although the duress and undue influence would be by the hospital, a third-party, rather than by the ambulance company, but the ambulance company surely knows the patients’ situation, so it might be charged with them.)

But it’s not just that there are good defenses against the ambulance bill. By trying to collect such unconscionable fees, the ambulance company might well be engaged in an unfair trade practice.

Now nobody is going to bother taking on a suit for $9,000, but the situation seems amenable to a class action: there are common issues about the overbilling that predominate over any individual circumstances.