Why an MRI costs $1,080 in America and $280 in France

[MindMover]

There is a simple reason health care in the United States costs more than it does anywhere else: The prices are higher.

That may sound obvious. But it is, in fact, key to understanding one of the most pressing problems facing our economy. In 2009, Americans spent $7,960 per person on health care. Our neighbors in Canada spent $4,808. The Germans spent $4,218. The French, $3,978. If we had the per-person costs of any of those countries, America’s deficits would vanish. Workers would have much more money in their pockets. Our economy would grow more quickly, as our exports would be more competitive.

http://www.washingtonpost.com/blogs/ezra-klein/post/why-an-mri-costs-1080-in-america-and-280-in-france/2011/08/25/gIQAVHztoR_blog.html?wprss=linkset

Interesting stats on the numbers......

[midnight]

1. Remove the middle man, I mean the Insurance Co.

[Initech]

5. Also get advertising out of it.

I read something where it said that a reason why our health care costs so much is because companies like Kaiser and AEtna spend a metric fuck-ton of money every year advertising. Take that out of the equation and costs would drop dramatically.

[BOHICA12]

58. BUT Advertise the prices so people can compare.

One MRI versus another, one blood work versus another, let folks choose.

[crimsonblue]

6. doctors themselves are much to blame for high costs

In BFE Kansas, an ENT (Ear Nose Throat) physician can bill insurance upwards of $10k for a 45 minute surgery to clear a deviated septum. A Dermatologist can bill insurance $2k to remove a precancerous mole. An anesthesiologist can bill insurance more than $5k to administer anesthesia, which can legally be performed by a nurse anesthetist for 1/10 the cost. The doctors are the ones holding the chips, not the non-profit insurance industry that most Americans use.

[lumberjack_jeff]

7. There's blame to go around

But yeah, the AMA shares a big chunk of it.

[shcrane71]

8. Insurance companies can refuse to pay inflated prices. That somewhat helps in keeping consumers,

I mean patients, from getting fleeced. The uninsured have no choice but to pay the inflated costs unless they want to have their credit ruined -- which often happens.

Of course, insured people will often be sent to through several unnecessary procedures and tests in order to increase profits.

[tblue37]

30. My daughter is almost a quarter million dollars in debt for medical school.

As long as we allow our young professionals to go so deeply into debt to get trained for careers, we will have to expect them to need to earn enough money to pay off those debts. Other countries subsidize the training of such essential professionals.

[eridani]

31. +10,000

My husband got a root canal in the Netherlands for $25 in 1996. Of course the government paid for his professional education, and also controlled prices on his inputs.

[Rosa Luxemburg]

53. Doctors in the USA are basically businessmen (and women)

they like you to be ill

[Rosa Luxemburg]

54. and dentists like you to have bad teeth

it's all about moneymaking

[cbdo2007]

17. Doctor rates for non-insurance people are higher than insurance people - dramatically.

[Kablooie]

49. I found the opposite.

When I lost my insurance due to unemployment the doctor had a special lower fee I could pay.

[bornskeptic]

50. Then why is the per person cost in Germany lower than in Canada?

Almost everyone in Germany has insurance from a private insurer.

http://economix.blogs.nytimes.com/2009/04/17/health-reform-without-a-public-plan-the-german-model/
http://www.allhealth.org/briefingmaterials/CountryProfiles-FINAL-1163.pdf

It's not the fault of the insurance companies that MRIs cost over $1000. Things aren't exactly cheap for Medicare either. The federal government appropriates over $500 billion annually to cover about 47 million Medicare enrollees. That's about $900 per enrollee per month, which is far higher than the cost of covering those in the same demographic group in the insurance-based systems in France, Germany, Switzerland, and the Netherlands. Medicare enrollees are still faced with substantial out of pocket costs unless they can afford a couple hundred a month for supplemental coverage.

[izquierdista]

2. Yes, but......

If American doctors were paid like French doctors, would they be able to hang out at country clubs that make the Chateau de Versailles look like a bungalow?

[aint_no_life_nowhere]

20. The film Sicko interviewed a British doctor who was making about $150,000 a year under socialized

medicine. He wasn't a businessman in a white smock as many American doctors are. But he owned a new Audi, a million dollar home and lived a very comfortable lifestyle. He didn't get into medicine to get super rich, but to serve.

[Honeycombe8]

29. I read somewhere, tho, that France is having trouble finding enuf qualified doctors.

They go to other countries for the money, and students don't pursue a medical career because the money's not good enough.

Don't know if that's true, but that's what I read a couple of years or so ago.

[CreekDog]

35. where did you read this?

we expect a little more than that.

[crimsonblue]

3. I could bore you with the economics of health care..

but to suffice to say, the costs of medical care are distributed across a wider range of people in universal health care systems.

[crimsonblue]

4. Plus...

how long do you wait to have to get an MRI in Canada or France? How long do you have to wait to get arthroscopic knee surgery?

[KT2000]

9. I had to wait 2 months in the US

because the insurance company took that long to approve it.

[Yooperman]

13. I was refused care by my insurance company....

My father died of colon cancer...my doctor ordered a colonoscopy when I turned fifty....

The insurance company refused it saying I didn't have any symptoms so they denied my care.

My brother was dying from brain cancer and they refused to pay for his admittance to a nursing facility to care for him in his final days... saying he could live at home. We as a family had to fork over $2000.00 so the facility would take him in.

Presently our co-pays are getting so high I can't afford to see a specialist that I need to see.

Damn insurance companies... we need them OUT OF THE EQUATION! Period.

YM

[crimsonblue]

16. at one prominent hospital in Canada, average wait time for knee surgery is 109 days.

http://www.pnhp.org/news/2009/june/response_to_the_sena.php

[dflprincess]

22. And in the U.S. if you don't have the cash or the insurance

you will wait until you die.

[shcrane71]

48. And in the US, you'll die a miserably, painful death for not having insurance.

Literally, on skid row.

[CreekDog]

37. anecdotal

also you don't post any data about US wait times.

i think you're concern trolling this issue.

[haele]

41. And that is different from my mother's six-month wait how?

There are four major hospital systems in town, and the one my GP works through has an average of a 3-4 month waiting list to see any one of the 15 dermatologists in that system; for my insurance to cover the visit to the dermatologist, my GP has to "agree"with my need to see that specialist for,say, a worrisome mole that has been growing on my leg.
Three months to four months to see a specialist and be covered by your insurance for that visit.

That's American medical insurance.

At least in Canada, you won't finally get to see the specialist and then find out the procedure isn't covered or was denied by your insurance company after the fact. You know up front how much it's going to cost.

Haele

[SOS]

44. Wait times worst in US and Canada, other nations much better

[iverglas]

55. I hope people actually read your link re Canadian wait times

Last edited Sun Mar 4, 2012, 08:51 PM - Edit history (1)

The context is:

Posted on June 25, 2009
Response to the Senator accusing Canada of having "staggering" wait times from Canadian Surgeon and Hospital Executive Dr. David Zelt

By Dr. David Zelt
The Kingston Whig Standard
6/24/09

Dr. David Zelt, chief of staff and vice-president, medical administration, at Kingston General Hospital, sent the following reply to McConnell.

and what he said was:

Your researchers have taken data and interpreted it incorrectly, with the result that your information is inaccurate.

Your statement to the Senate: “Today, the average wait time for (hip replacement) surgery at KGH is about 196 days.” In fact, our actual average hip replacement wait time is 91 days — less than half of what you stated.

Your statement to the Senate: “What about knee replacements? Well, at Kingston General, the average wait time is 340 days, or almost a year from the moment that the doctor says you need a new knee.” In fact, our average wait time for knee replacements is 109 days.

Three months' wait for a surgery for a non-life-threatening condition, from referral to surgery? When it is available to every resident of the province on equal footing? Is someone actually concerned about this?

I took my partner to the ER just before midnight on a Saturday night a couple of years ago because symptoms he was describing sounded to me like a retinal detachment. I was right. After two hours there and very complete examination, he was told to report to the eye clinic at the hospital in our city that is the designated in-patient eye surgery facility the next morning. He was admitted and had to wait all day for the surgery, because on a Sunday only two ORs were operating and he got bumped by every car accident and emergency caesarian section that came along. All in all, it was about 19 hours from ER arrival to surgery. It was emergency surgery, needed immediately to preserve his eye, and it was done immediately, and the wait time was mainly associated with it happening at midnight on a Saturday.

More from your link:

Your statement to the Senate: “And for cardiac bypass surgery, patients in Ontario are told they may have to wait six months for a surgery that Americans can often get right away.” In fact, the median wait time for cardiac surgery in Ontario is 16 days (32 days at KGH).

That is the median time. Half waited longer, half waited less time. Again, if the situation is an emergency, it is treated as such, and surgery is essentially immediate.

I'm wondering what your point was, too.

As I sit here with my third cast on the leg I broke just over three weeks ago, having had attention (ambulance, three consults, 3 sets of xrays, plaster cast) first in the ER, then a consult week later to decide whether to have surgery, then the surgery a week later to install a plate and screws and put on another temporary cast, then a consult a week later to examine the wound and replace the cast, then this week another set of xrays and maybe one of those air cast things ...

I was really quite pissed about spending nearly 8 hours in the ER the first time. Apparently I made the mistake of breaking my leg the same day half the city broke or dislocated something; two life-threatening orthopaedic emergencies, even (whatever they might be), I was told when I finally got pissy, while I and everybody else were waiting. And frankly I'm pissed about the two-week wait for surgery, when I was told at the ER it would be within a week. But really.

So far it has cost me $45 for a medically-necessary ambulance trip (waived if I were low-income or otherwise eligible), several taxi fares, and a total of maybe $50 for prescriptions. And a little under $100 for a private wheelchair rental for two months. I'll have a few more taxi fares for a few more hospital visits before it's over. So, about $400 out of pocket all told, all for incidentals.

I paid $750 last year for Ontario health insurance, at tax time, because I'm high-income. (That's the second-highest level; the previous year I paid the top rate, $900. The scale ranges from 0 for low-income to $900; people receiving social assistance and seniors also receive drug coverage.)


editing to note: I have these out of pocket expenses because I'm self-employed and do not purchase any supplemental insurance. If I worked for the government or an employer of any significant size, I would have private supplemental group insurance which would cover my prescriptions, taxis and wheelchair rental, possibly with some sort of annual deductible which would not be significant.

[smaug]

10. Right winger mythology, again

Quit watching Faux Noise -- it makes you stoopid. That is, if you aren't a troll.

The wait is the same as in the US - as someone pointed out, insurance company bean counters in an outsourced compaigne (yes, the Dutch spelling) will put you off on receiving necessary treatment in order to maximize short term corporate profit.

Government bureaucracies can be pressured by elected representatives. Corporate bureaucracies only respond to profit. Which do you prefer, one you can get results from calling your elected officials, or one that you had no chance of influencing, even if you are a shareholder?

[crimsonblue]

18. thanks for the ad hominem and straw men....

How about you look at scientific studies and news reports.

http://www.bbc.co.uk/news/health-12964360

http://www.nejm.org/doi/full/10.1056/NEJM199410203311607


Please don't let my facts get in the way of your hysterical need to be correct.

[CreekDog]

38. Please explain what you mean by "hysterical"?

examples too.

[anneboleyn]

25. Exactly, smaug (and I love your name - Smaug is awesome, and wicked witty) Benedict Cumberbatch

is supposed to play (or rather perform the voice of) Smaug in the film version of The Hobbit. We love him.

[KeepItReal]

12. Way to catapult the propaganda

Eom

[crimsonblue]

19. What propaganda?

Please see the links I provided downstream which support my assertations.

[Chemical Bill]

23. Do patients in Canada or France wait for an MRI...

if it is an emergency?

Do patients in France or Canada have to wait for cancer, heart attack treatment, or even CPR?

Conversely, will a MRI bill cause anyone in Canada or France to go bankrupt from medical bills? Have many people died while waiting for arthroscopic knee surgery in Canada or France?

Bill

[blublu]

34. not long

I've never had to wait for an MRI and its never cost me an Euro. There is also a a clinic in northern Paris that specializes in all problems concerning knees, many sportsmen and general population use this clinic. I was unemployed during my stay at the clinic and it still only cost me "les Frais de sejour" (price of food,clean linen and general upkeep) which cost me about 10 Euros a day.

[CreekDog]

36. The waits are longer in the US for such surgeries for people without health coverage

longer than any universal system.

oh and that's 47 million people.

[NashvilleLefty]

40. Wait times? Cherry-pick much? How about the bottom line:

Life expectancy is longer in Canada, and its infant mortality rate is lower than that of the U.S.

http://en.wikipedia.org/wiki/Comparison_of_the_health_care_systems_in_Canada_and_the_United_States

[Gabi Hayes]

11. how about 3500? I had four in one year, and they all cost

at least that much, not inluding the neurologist's interp

[anneboleyn]

24. I was going to say the same. MRIs are at least 3,500 and more...

Many MRIs are in the 5,000 range (and as you note the interpretations cost a fortune -- the radiologists charge 1,000, and the cost is even more for specific specialists' interpretations)

[Brother Buzz]

27. $3500 is like the manufacturers suggested retail price

I've had over a dozen in the last five years and have NO health insurance. I shopped around out of necessity. I found the prices fluctuate a lot and the OP is pretty spot on. The best I can do is just over $1000 including the radiologist's reading. The $3000 E-ticket ride MRI was on the biggest, baddest, fastest, highest resolution machine that emitted the lowest radiation, or so they told me.

[Lint Head]

14. They do one MRI then charge per view which is nothing more than virtual unbundling of

the digital image. It's like selecting and cropping a Photoshop image a total rip off.

[backscatter712]

15. TL;DR - Price gouging.

Look at the supply & demand curve. Demand is fixed - a customer isn't going to be shopping around or refusing to buy when he/she needs treatment for a heart attack. As a result, the suppliers can charge insanely high prices. Give the suppliers monopoly/oligopoly power, let them restrict the supply, and the prices shoot into the stratosphere.

[crimsonblue]

21. Here's an article for your consideration...

http://www.european-hospital.com/en/article/8808-France_ranks_low_in_Europe_for_MRI_equipment.html

[Sparkly]

52. Nevermind.

[Puzzler]

26. Unless you're including drugs, the Canadian cost is way lower...

... than $4,808. Depending on the person, it's about 1/4 (or less) of that figure for full coverage with ZERO deductions.

FYI, a work friend of mine a few years ago needed open heart surgery (for a valve replacement). He was operated on within 24 hours of admission to emergency.

(For any lurking wingnuts: facts are so inconvenient, eh?)


Puzzler
Victoria, BC
CANADA

[JCMach1]

28. $60-70 in the UAE for an MRI

and no co-pay on that... completely covered by PRIVATE, non-subsidized insurance.

[bvar22]

32. The BIG Difference:

In civilized countries, access to Health Care is a basic RIGHT guaranteed by their governments.

In the USA, access to Health Care is a For Profit Commodity SOLD to Americans for maximum Profit.
The "historic" "reforms" actually PROTECTED and Codified the "Private, For Profit" delivery system.

The only "RIGHT" established by the Affordable Care Act was the RIGHT for Insurance Corporations to
DEMAND payment every year from every single American for an invisible product most will be unable to use.
Adding fuel to the fire, the IRS is now the Collection Agency for the Health Insurance Cartel.

2014 will be an interesting year when America finds out what is really in this bill.
Between 40 Million and 70 Million (estimated uninsured by 2014) already struggling Working Class Americans will be forced to buy Junk Insurance ("Bronze Policies&quot that they won't be able to use due to high co-pays and deductibles.

"Medical Bankruptcy" is a term unknown in civilized countries, but will STILL be Big Business in the USA
even after 2014. Perhaps even BIGGER as MILLIONS Americans actually attempt to access Health Care with their "Bronze" Policies.

[SATIRical]

33. What would be most interesting

Is to see where the additional cost went.

How much do our doctors/administrators/nurses/janitors get paid compared to others. Are they equally qualified?

I'd need to see that information to really understand the differences.

[uppityperson]

39. I bet the janitors are equally qualified. Here's a link to some salaries. Generally make less in Fra

than here in USA, with higher taxes, but also greater benefits (vacation/time off, health care, etc)
France
http://www.worldsalaries.org/france.shtml
Professional Nurse
http://www.worldsalaries.org/professionalnurse.shtml
General Physician
http://www.worldsalaries.org/generalphysician.shtml

[SATIRical]

42. Thanks. So considering

Their nurses make 33% less and the doctors makes less than 50% of what ours make, is that something we should be trying to change.

It explains a large amount of the difference in the price of medical care, but I'm not sure lowering a doctors wages to below our median household income is really the answer.

[uppityperson]

43. The easiest most noticable way to cut outgo is to pay providers less.It's happened to me, as a nurse

Last edited Sun Mar 4, 2012, 04:16 PM - Edit history (1)

many times over the yrs. But. If the goal is to decrease patient care, to overwork nurses so there is a "nursing shortage", that is a good strategy.

There is no nursing shortage. There are and have been plenty of nurses. Again, but...so many have quit the profession because of the combination of over work, over stress, low salaries. Yes, a nurse in a specialized field can have a really decent salary, but for the rest of us? Same thing for many physicians. Specialists can make good wages, but family practice docs? So many clinics are being absorbed into larger groups with the pressure put on to do more, see more, in less time. It ends up being poor medicine and many docs and nurses won't do it.

The cost of health care, esp for things like MRIs is not dependent upon how much nurses and physicians make.

I'd start with for-profit health insurance companies. Regulate them more. Way more.

And look at the managers, from top on down. See who makes what and what they do. What can be shrunk down. A top manager needs an office assistant. They might need an assistant. Next down also needs an assistant. Hey, let's make another position to handle this problem, ok? Now they need an assistant also, or...they can share with the others so let's overwork that person.

Look at all those nurses. Patients and families see them working. Work nurses work. See the nurses work. Hey, if we cut one of those nurses, spread the patients out between the others, we will save....$900/day! Cool. Work nurses work. See the nurses work. See a patient have a problem and the nurse handle it. See another patient have a problem and the nurse handle it. See a 3rd patient have a problem but what is this? The nurse is busy handling the other 2 problems? Quick nurse! Leave those 2 problems and go call for help from the manager. What? They are not available? And what happened to the 3rd person with the problem? Bad nurse. Bad bad nurse. You need to prioritize! No raise for you. Oh, you also need to know that we aren't making enough money so we are increasing your patient load.

Also realize that in France, you get a lot more benefits for less salary. 5 weeks paid vacation a yr (could be 4, am too tired to look it up but it is a hell of a lot more than we do in the USA), health care, decent patient load, etc.

[SOS]

45. Comparison of four cities

MRI cost:

Dallas TX: $3,624
Detroit MI: $3,461
New York, NY: $2,199
Tokyo, Japan: $160

http://www.npr.org/templates/story/story.php?storyId=120545569
http://www.comparemricost.com/

[Comrade Grumpy]

46. We pay more for poorer outcomes. We need nationalized health care now!

Eliminate the parasitical insurance companies that prey upon the people.

[pitohui]

47. we need a cap on prices pure and simple

if you are uninsured you are sometimes billed MANY TIMES when an insurance company would pay...and it's legal

[glinda]

51. Mom had a stroke. five days and bill for $98000. Now

I see that by cutting off her therapy and throwing her into a nursing home, they stand to make a lot of money all over the place. Profit by abuse of the citizens.

[dflprincess]

56. One thing I've noticed since more people are getting stuck with high out of pocket plans is that

it's a lot easier to get an appointment with my doctor & the waiting room is awfully empty compared to the past. Though I've only been in for the routine screening tests this year that are covered (and even then I wound up fighting with my insurance company to get them to cover the pap smear).

[spanone]

57. i just had one and my co-pay was 280.00