Why an MRI costs $1,080 in America and $280 in France • Hacker News Board

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

#31

Post by prostoalex » Sun, Mar 04, 2012, 5:07 AM UTC

mindcrime wrote: post #20

Can't believe they didn't even mention the Monopoly Protection Certificate racket run by the government in many states: http://en.wikipedia.org/wiki/Certificate_of_need And never mind the huge monopoly granted to AMA certified physicians, in terms of providing medical care. Of course those guys have a huge incentive to keep as many people out of the physician pool as possible. We certainly couldn't allow competition,…

The labor costs would vary from country to country. The article questions the price of a service performed by machine (that supposedly differs very little from country to country).

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

#32

Post by niels_olson » Sun, Mar 04, 2012, 5:08 AM UTC

Just a plug for Paul Starr's The Social Transformation of American Medicine. It's the definitive text on healthcare in America. After that, all the other writing is quaint.

On a separate note, you should have seen the fear on the faces of the retired English couple I saw today when I sent the poor man to the ER. They're here on vacation, he had an MI 15 years ago, ran out of his aspirin a month ago on vacation, now he has had vertigo for a week (stumbling like a drink) and new onset high blood pressure. Never paid a dime for healthcare and I just sent them to the lion's den. I reimbursed them the cost of my office visit, but that will be a drop in the bucket.

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

#33

Post by davidhollander » Sun, Mar 04, 2012, 5:08 AM UTC

jrwoodruff wrote: post #6

rsanchez1 wrote: post #2

Anyone who has insurance doesn't care about the price. They only care about the deductible. When people shop around, they look for the insurance companies that provide the lowest deductibles and stick with them. After that, there's no pressure on the providers to lower prices. The insurance companies in the US don't negotiate lower prices, they just pass on the cost to policy holders in their deductibles. The provide…

I don't know about you, but next time I need an emergency room or surgical procedure, I'm not going to be shopping for the cheapest one. The article addressed this - how do you 'shop around' when you're under anesthesia, and would you really hire the cheapest doctor to diagnose your daughters life threatening ailment? It just doesn't play out in reality.

Yes, most agree that security against unexpected and unpredictable costs, such as emergency room visits and catastrophic illness, is the proper role of insurance.

However, for drugs, chronic treatment, and preventative procedures, costs would much lower if consumers were allowed to shop around and haggle prices without going through insurance. This is why you see certain operations like Lasik, which are elective and not covered by anyone's insurance, becoming highly roboticized and deflating in cost rather than inflating.

http://www.youtube.com/watch?v=3WnS96NVlMI

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

#34

Post by InclinedPlane » Sun, Mar 04, 2012, 5:13 AM UTC

US: 91.2 MRI scans per year per 1,000 population

France: 21.8 MRI scans per year per 1,000 population

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

#35

Post by Vivtek » Sun, Mar 04, 2012, 5:16 AM UTC

rsanchez1 wrote: post #2

Anyone who has insurance doesn't care about the price. They only care about the deductible. When people shop around, they look for the insurance companies that provide the lowest deductibles and stick with them. After that, there's no pressure on the providers to lower prices. The insurance companies in the US don't negotiate lower prices, they just pass on the cost to policy holders in their deductibles. The provide…

I've heard this before. Do you think that Germans or the French end users care about the price? No - they're insured far better than any American without a (D) or (R) after their name. They just _go to the doctor when they're sick_. Period.

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

#36

Post by rfrey » Sun, Mar 04, 2012, 5:19 AM UTC

redwood wrote: post #30

darksaga wrote: post #27

"The question, of course, is why Americans pay such high prices — and why we haven’t done anything about it." This is probably the same reason we've taken close to 40 years to finally try and get off our dependence on foreign oil after Jimmy Carter said we needed to in 1978. Yet, we still pay more than we really should and haven't done anything about it. Why? Lobbyists, too many layers of bureaucracy, special interes…

One note here: we pay less for petrol than any other developing country, which makes it harder for alternatives to make economic sense.

Did you mean "developed countries"? Because I got tired of copying Wikipedia (http://en.wikipedia.org/wiki/Gasoline_and_diesel_usage_and_p...) after:

  Country        US$ / US Gallon
  U.S.           $3.74
  Vietnam        $1.03
  Yemen          $2.76
  Turkmenistan   $0.72
  Tunisia        $3.75
  Trinidad       $2.42
  Taiwan         $3.78
  Syria          $3.15
  Saudi Arabia   $0.49
  Quatar         $0.83
  Puerto Rico    $3.63
  Peru           $3.60
  Panama         $3.14
  Pakistan       $3.46
  Malaysia       $2.31
  Indonesia      $2.23
  Egypt          $1.17

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

#37

Post by baddox » Sun, Mar 04, 2012, 5:29 AM UTC

tzs wrote: post #16

What annoys me as an American about our health care is not that some other countries achieve better outcomes at much lower cost--it is that they do so in so many different ways. For instance, if they all did it by having the government completely run the health care system, with all doctors working for government hospitals and clinics, and being trained in government medical schools, with all costs set by the governm…

> good health care arguably is more important than limited government power

Of course, even that only applies if increasing government power will even improve healthcare (in the long and/or short run), and if increasing government power won't have ancillary negative effects that counter the improvement in healthcare.

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

#38

Post by Aloisius » Sun, Mar 04, 2012, 5:31 AM UTC

InclinedPlane wrote: post #34

US: 91.2 MRI scans per year per 1,000 population France: 21.8 MRI scans per year per 1,000 population

Shouldn't that make the cost in the US go down? After your fixed investment, the only thing you are paying for is the person running the machine.

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

#39

Post by asmithmd1 » Sun, Mar 04, 2012, 5:40 AM UTC

High health care spending is yet another way the US subsidizes other countries. From the article:

"This is a good deal for residents of other countries, as our high spending makes medical innovations more profitable. “We end up with the benefits of your investment,” Sackville says. “You’re subsidizing the rest of the world by doing the front-end research.”

In the past 30 years have you heard of any medical innovation or drugs coming from anywhere other than the US?

Of course the MRI machine was itself invented in the US: http://web.mit.edu/invent/a-winners/a-damadian.html

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

#40

Post by vacri » Sun, Mar 04, 2012, 5:40 AM UTC

rfrey wrote: post #36

redwood wrote: post #30

Earlier quoted context omitted.

One note here: we pay less for petrol than any other developing country, which makes it harder for alternatives to make economic sense.

Did you mean "developed countries"? Because I got tired of copying Wikipedia ( http://en.wikipedia.org/wiki/Gasoline_and_diesel_usage_and_p... ) after: Country US$ / US Gallon U.S. $3.74 Vietnam $1.03 Yemen $2.76 Turkmenistan $0.72 Tunisia $3.75 Trinidad $2.42 Taiwan $3.78 Syria $3.15 Saudi Arabia $0.49 Quatar $0.83 Puerto Rico $3.63 Peru $3.60 Panama $3.14 Pakistan $3.46 Malaysia $2.31 Indonesia $2.23 Egypt $1.17

He did mean developed country. The US pays about two-thirds what Australians do for petrol, who in turn pay about two-third what Europeans do for petrol.

The panic that the US gets itself into when discussing fuel prices is amusing to watch. Australia is a big country with spread out cities like the US (or even more than the US) and similar wage levels, yet we don't have problems with post-paying cash for our fuel. In six weeks of driving around the US west a couple of years ago, I never found a single place where I could post-pay with cash - they were all too afraid of drive-offs. Weird.

Also, you've mangled the statistics - for example, you've used Vietnam's price per litre against the US's price per gallon.