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

washingtonpost.com

41–50 of 223 posts

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

#41

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.

Not necessarily, if the person running the machine or the person screening the results has to be a trained medical professional. In those cases, due to monopoly and other concerns, we'd have a supply bottleneck which would increase price given increased demands.

I don't however know if you have to be medically trained to use a MRI machine, or interpret the results

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

#42

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…

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

Of course there is plenty of good medical stuff coming from many countries other than the USA. The market for medical care world wide is way larger outside the USA too. Finally, much medical research is multi national and collaborative.

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

#43
post #40
post #36

Earlier quoted context omitted.

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. I…

Thanks for the correction on Vietnam - I double checked and wasn't able to find another instance of mangling, but since you said "for example", I imagine there are others I missed.

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

#44

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.

In order to have access to an MRI scan you need to have a machine that's geographically close. If the nearest machine is 100 miles away the bar on what will justify a scan goes way up compared to if a machine is an elevator ride away. Buying more machines costs more money.

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

#45

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.

Increased demand drives costs up, not down.

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

#46
FWIW, its roughly $100 or even less in India.

Granted, the quality of medical care varies by a lot in India, but there are places and doctors in India who are so good, that if I am sick, all I want to do is take a flight back home...

The lack of health insurance in general in India ( now, it is being sold to a growing section of the population ) has meant that prices are comparitively lower ( though, they are really rising these days ).

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

#47

Earlier quoted context omitted.

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.

Not necessarily, if the person running the machine or the person screening the results has to be a trained medical professional. In those cases, due to monopoly and other concerns, we'd have a supply bottleneck which would increase price given increased demands. I don't however know if you have to be medically trained to use a MRI machine, or interpret the results

One obviously has to be trained to use the MRI machine, and that person is local. But the interpretation is even now not done on site.

Low bandwidth costs mean that it can be done halfway around the world.

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

#49

Earlier quoted context omitted.

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.

Most medical procedures are not emergent. It's hard to shop around for emergency care, but shopping around for everything else is pretty straightforward. We have strong experimental evidence that when people are not insulated from price, they shop around and consume less medicine with no measurable effect on their health. http://www.rand.org/health/projects/hie.html

I agree that much of the general public is insulated from price, however a few personal observations: (Note: I worked for 8 years for a state insurance company and my wife has been a nurse practitioner for 12 years)

People don't "shop" for healthcare the same way they shop for televisions or other consumer products. In fact the overwhelming majority tend not to all. Either someone like me at their insurance company picks a primary care physician for them, or they pick one from a list based on simple factors like someplace convenient, seems like it's a good part of town, etc. Unless the doctor is so unbelievably terrible, it's extremely unlikely they will switch. My wife, who is frustrated by many aspects of our healthcare system, attributes much of this to the complete and utter lack of medical literacy possessed by the general population. The average person simply has no idea how modern medicine works on any substantial level, so they have little to no basis for making an informed decision about their care or provider. When you are sick, even with something routine and non life-threatening, you don't think "Hmm I could go see the doctor today because I feel awful, but I think I'll price shop for a day or two beforehand." Even people with strong financial incentive, i.e., people with limited means, don't do this. If a child or loved one is involved you're even less likely to start thinking about dollars over medicine.

I do agree that most patients have no accurate understanding of the real cost of their care, and that more education in that department certainly can't hurt, but no matter how you slice it, that cost is simply much higher than it is in other developed societies, and that is a serious problem that needs to be addressed.

Edit: Something I wanted add: I know in a community like HN, many will be of the sentiment that if you fail to educate yourself about a product or service, you borderline deserve the consequences. I agree with this in most respects. However, taken to it's logical conclusion, that would require me to become an expert on everything under the sun. I have no idea how the plumbing in my home works, or how to do anything but routine maintenance on my car. It's not that I lack the interest to learn about these things, it's simply that there aren't enough hours in the day to plausibly accomplish this. When faced with the need of a professional expert, I have to use a little common sense mixed in with any superficial knowledge I do have, and trust that there is a system in place that prevents me from being totally screwed price wise.

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

#50
post #35

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.

So France and Germany have some non-price rationing mechanism. Whatever mechanism they have, it causes them to half less than half as many MRI's (per capita) than the US.

http://www.oecd-ilibrary.org/docserver/download/fulltext/811...

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