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Why an MRI costs $1,080 in America and $280 in France
201–210 of 223 posts
Re: Why an MRI costs $1,080 in America and $280 in France
#202Earlier quoted context omitted.
> Although it dovetails with the well worn narrative on HN, this comparison fails due to the level of care. The context is purely the model of provision; level of care isn't addressed. > Second, some of the development of MRI technology happened in Britain. Most was performed in the U.S. Who is paying for the cost of development of this and other new technology and drugs? It's often not the people in places like Cana…
>The context is purely the model of provision; level of care isn't addressed. Exactly. The level of care is not addressed, therefore you can call the US a backwater and hence receive upvotes.
Exactly what, exactly?
Re: Why an MRI costs $1,080 in America and $280 in France
#203Earlier quoted context omitted.
First of all: "the United States is Cambodia or Burkina Faso or rural India, with access to a doctor available if you can pay the bill out-of-pocket" Although it dovetails with the well worn narrative on HN, this comparison fails due to the level of care. Also, from the article comments: "There are just a couple problems. In 2009, the French Society of Radiology equipment in France was critically undermining care, an…
> Although it dovetails with the well worn narrative on HN, this comparison fails due to the level of care. The context is purely the model of provision; level of care isn't addressed. > Second, some of the development of MRI technology happened in Britain. Most was performed in the U.S. Who is paying for the cost of development of this and other new technology and drugs? It's often not the people in places like Cana…
"This marketing spend is disproportionately targeted at the US, as it's one of the few countries which permits heavy marketing of prescription drugs directly to normal people."
By few, you mean two, soon to be one. The US and New Zealand, and New Zealand has passed legislation to phase it out.
The US will be the only country in the world where you can be advised of your potential need for a prescription drug not by a medical professional, but by an actor on a television screen.
Re: Why an MRI costs $1,080 in America and $280 in France
#204Earlier quoted context omitted.
MRI specifically is overused and kind of crappy in Japan. In the rest of the world, the standard is for a 1-3T MR study; in Japan, you get a lot of 0.5 and even lower (0.2T! wtf) MR studies. They're used for a lot of health screenings, whereas in the rest of the world they're more often used for actual problems.
I call bullshit on your first point--that MRIs are "overused" in Japan. MRIs aren't something that can really be overused. Unlike CT scans, or pretty much any non-MRI method of imaging the inside of the body, they don't harm the patient. Even though you are right that many of the MRI machines in Japan are lower-resolution cheaper models, that is largely because there are way more MRI machines here, and they are used…
"The doctor flatly refused -- MRIs were only available after physical symptoms had developed. Of course, at that point, the available treatments for a flare-up of MS are less effective at preventing long-term neurological problems. (Happily, I am back in Japan now.)"
There's your mistake. You didn't see a doctor who owned (or who had bought a share in) an MRI machine. Those doctors are 4.2 times more likely to refer patients for MRI than doctors who don't.
Re: Why an MRI costs $1,080 in America and $280 in France
#205Earlier quoted context omitted.
Medical research spending in the US is approximately $500/person/year. The medical cost gap between the US and other countries is approximately $3,500/person/year. R&D spending simply does not account for for anything close to the huge discrepancy in costs.
You're missing the point. High prices for drugs, procedures, and medical devices in the United States are what makes their development financially feasible. Without the American market, the expected payoff to new medical technologies would be much lower, so it's reasonable to believe that fewer would be commercialized. Americans bear the bulk of these costs, which are passed along in the price of their treatments, be…
I don't think I am missing the point.
Medical R&D in the US amounts to about $100 billion/year. (I misremembered a slightly higher number previously, but the ballpark is the same.) Meanwhile, the US is spending in the neighborhood of $1 trillion/year more on health care than if spending were on the same level as a typical European country. Yes, I understand that those R&D costs get baked into medical costs, but they simply don't account for the vast majority of the discrepancy.
If the US system cost the same as a typical European system with the exception of US R&D spending on top, the discrepancy would only be around 10% of what it actually is.
Re: Why an MRI costs $1,080 in America and $280 in France
#206Earlier quoted context omitted.
I'm confused, could you name a situation in which this wouldn't be the case? The profits that an insurance company makes are the amount it charges for its services minus the amount that it pays out, it seems that reducing the amount they pay out would necessarily increase profits. I'm not aware of any insurance companies that charge on a cost-plus basis, and the insurance companies can't just charge companies as much…
One situation: if they believe that their competitors will follow suit. Unless an insurance company concocts a way to lower costs that isn't easily replicable , they have little incentive to do so. Otherwise, they're just triggering a race to the bottom.
By this logic, no company in any industry should attempt to reduce costs in an easily replicable way. Since the world doesn't behave that way, there must be something wrong with your logic.
Re: Why an MRI costs $1,080 in America and $280 in France
#207Earlier quoted context omitted.
I don't live in the US, but India does have a health care system fairly similar to the US. The biggest difference is it has less red tape than the US, and insurance companies play a minor role. Most people pay out of pocket and comparison shop. Costs here did vary significantly for the surgery - the dirty hospital was 0.9-1.5lac (depending on general ward vs private room, etc), the place where I had it done was about…
> The biggest difference is it has less red tape than the US, and insurance companies play a minor role. If true, you are glossing over a pretty substantial difference between the two systems.
I'm not so much glossing it over as emphasizing it. The Indian healthcare system is like the US healthcare system, except people are not insulated from the price. As a result, people shop around.
I.e., Nitramp is wrong, people are capable of shopping around, all they need is incentive to do so.
Re: Why an MRI costs $1,080 in America and $280 in France
#208Earlier quoted context omitted.
It's not difficult to figure out what happens to a marketplace when you remove the competition with government mandate. America's health care system has been hyper regulated for decades. You can't even shop across state lines effectively. We have the worst of both systems. We have enough government interference to drive up prices through restriction of competition, bad regulation, bad mandates; and we have government…
Of course, all of the countries with good health care have more regulation, not less. (Yes, even in Switzerland.) Do you know of any countries with minimal health care regulations and good outcomes? I suspect they don't exist, because the preconditions of a functioning free market do not exist for health care consumption (rational consumers, symmetry of information, consumer choice, etc.)
Of course, all of the countries with good health care have more regulation, not less.
All you've identified is that rich nations have good health care regardless of how much regulation they have. This is hardly surprising - the evidence suggests that once health care exceeds a certain minimum level, it has little effect on health outcomes.
Incidentally, the Indian health care system is excellent and less regulated than the US one. I'm very lucky that I blew out my back in over here rather than in the US. I didn't come over here as a medical tourist (my startup is in Pune), but I strongly recommend that more people consider it.
Granted, the vast majority of people here are too poor to use the health care system effectively, but that's not the fault of the system.
Re: Why an MRI costs $1,080 in America and $280 in France
#209Want to get our costs down to competitive levels? 85% of all healthcare costs in America are for those over the age of 65. America has the leading health care system for the elderly. We pay for 80 year olds to have surgeries that they can't get in Canada or France. Nobody wants to talk about it though, because it's not a nice thing to say, that grandma is buying six extra months at a price of a million in treatment.…
My grand-parents, at 86 and 87, recently had multiples surgeries: eyes, hips, pacemakers... They are quietly approaching the bionic state. Those are costly procedures, taking place in public hospitals without any extra. Yay for socialized medecine ! Which brings me to my question : what kind of surgeries can't you get at 80+ years old in France ?
There aren't any. The parent to this thread doesn't know what they're talking about. :)
It's just a way that the media/government gets people to accept their poor health care situation: it's better! and you couldn't get it anywhere else! The high costs? That's just the way things are, never mind these examples in every other developed country in the world.
All of this is bullshit.
Re: Why an MRI costs $1,080 in America and $280 in France
#210Earlier quoted context omitted.
You're missing the point. High prices for drugs, procedures, and medical devices in the United States are what makes their development financially feasible. Without the American market, the expected payoff to new medical technologies would be much lower, so it's reasonable to believe that fewer would be commercialized. Americans bear the bulk of these costs, which are passed along in the price of their treatments, be…
Yeah America makes the whole medical R&D, right. Seriously.
Gotta love the level of idiocy in this entire thread. Americans are being really (and irrationally) delusional here, without any data to back up anything being said.