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The Cost of an ACL Injury

calv.info

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Re: The Cost of an ACL Injury

#111

Post by reeses »

jonknee wrote: post #92
ricree wrote: post #89

Earlier quoted context omitted.

>If you take the device fresh and something isn't right you can claim it was defective. If it was used for another operation who is to say when something happened to it? There's something on the order of 100,000 ACL tears per year. Even with no reuse, it seems odd that economies of scale can't get that well below $900.

Economies of scale have nothing to do with medical billing in the US. For example, IV bags of saline don't cost $100 in the real world (more like $1).

This becomes readily apparent with medical care for animals. Your vet will send you home with bags of Ringer's, line, and a bunch of cannulae for $50.

It's not as simple as insurance alone driving the cost, but having a throat to choke if something goes wrong does contribute to it.

As has been mentioned elsewhere, random overhead is covered in weird places, as well.

Re: The Cost of an ACL Injury

#112

Post by pyre »

jacoblyles wrote: post #97
pyre wrote: post #64

Earlier quoted context omitted.

That's because in Libertarian Utopia everyone of importance will be independently wealthy, and those who aren't, deserve to be trampled by the others. /sarcasm

Libertarians have been complaining about the USA's complicated health bureaucracy for decades. Hell, they've written dozens of books about it. It doesn't take a genius to find perverse incentives in US medical pricing schemes. But don't let me get in the way of your 30 seconds of hate...

I've met plenty of people whose political views on health care were along the lines of:

  Person 1: "You should pay for your own care"
  Person 2: "What if you are poor and can't?"
  Person 1: "Sucks to be you."
With the possible addendum of:

  Person 1: "But charity organizations will cover
             the costs for those that can't pay,
             because then I can choose of my own
             will to put money towards the cause."
  Person 2: "What if not enough people donate?"
  Person 1: "Well, it sucks to be poor."
[I'll note that "sucks to be you" as an answer could probably be translated as, "I have not thought out my position that far, and I don't like you challenging my views, so I'll give you a short and curt answer."]

Re: The Cost of an ACL Injury

#113

Post by sp332 »

chudi wrote: post #39
dbuxton wrote: post #9

This is absolutely shocking to me. Had my ACL replaced in the UK privately about 8 years ago (no health insurance, paid out of pocket). Total cost was £3000 (+ £600 for initial scan). I could have got it done for free on the NHS but it would have messed up my term time at university. Like the OP I had meniscal tearing too so more or less directly comparable. (Although obviously 8 years is probably a long time in medi…

I got my ACL replaced in Argentina and the cost including rehab was about U$S 3000 having one of the best insurance companies (about 120 U$S a month). If I wanted to use the public care, it could probably cost almost nothing. It always amazed me that in the US the health of a person is not a right and if you get hurt doing anything you have to pay huge fees.

How can you guarantee the health of a person? Doesn't that incentivize risky activities? If someone else will pay to stitch you up if you get injured, or cover your drugs if you get sick, or keep you going in your old age if you make terrible long-term lifestyle choices: wouldn't that skew the overall population toward cheaper, more convenient, or more fun decisions at the expense of the state?

Re: The Cost of an ACL Injury

#114

Post by dclowd9901 »

rayiner wrote: post #82
dbuxton wrote: post #9

This is absolutely shocking to me. Had my ACL replaced in the UK privately about 8 years ago (no health insurance, paid out of pocket). Total cost was £3000 (+ £600 for initial scan). I could have got it done for free on the NHS but it would have messed up my term time at university. Like the OP I had meniscal tearing too so more or less directly comparable. (Although obviously 8 years is probably a long time in medi…

Medical liability costs are about $55 billion in the U.S., or about 2.4% of overall costs: http://www.hsph.harvard.edu/news/press-releases/medical-liab... . There are debates about how much "defensive medicine" adds to the cost, but those aren't all that relevant here since the costs presented are exclusive of additional tests, etc.

Overall costs: 2.291 Trillion

$7,638 per person per year. That just can't be right. I and 90% of the people I know haven't made a significant trip to the dr or hospital in years. Where the fuck is that money going?

Re: The Cost of an ACL Injury

#115

Post by aidenn0 »

DanBC wrote: post #30

So, I have a few questions. > Going in, I had anticipated that doctors would take the lion’s share of the costs. I was surprised when the facilities ended up being the dominant cost; over 40% of the total. Is that because you're paying for the cost of nurses here, rather than breaking that cost out elsewhere? > This centimeter-wide cutting machine cost $900 according to the price sheet. That seems to be a bit much. I…

The easiest way for insurance companies to drive costs down is to find technicalities to not have to pay at all for the most costly ~.5% of their customers and stick them with the bill.

Re: The Cost of an ACL Injury

#116

Post by rayiner »

dclowd9901 wrote: post #114
rayiner wrote: post #82

Earlier quoted context omitted.

Medical liability costs are about $55 billion in the U.S., or about 2.4% of overall costs: http://www.hsph.harvard.edu/news/press-releases/medical-liab... . There are debates about how much "defensive medicine" adds to the cost, but those aren't all that relevant here since the costs presented are exclusive of additional tests, etc.

Overall costs: 2.291 Trillion $7,638 per person per year. That just can't be right. I and 90% of the people I know haven't made a significant trip to the dr or hospital in years. Where the fuck is that money going?

Sick people, rather than people who are not sick, are responsible for the majority of healthcare spending: News at 7.

See: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1361028 (Table 3). 80% of your lifetime healthcare expenditures will be after age 40.

Re: The Cost of an ACL Injury

#117

Post by chm »

For the sake of clarity:

Tendons link muscle to bone; Ligaments link bone to bone;

He tore a ligament, and it was replaced with a ligament, not a tendon.

Re: The Cost of an ACL Injury

#118

Post by rdl »

kenrikm wrote: post #62
calvinfo wrote: post #48

Earlier quoted context omitted.

You're right, there is a discrepancy and I didn't think to put it in the article. I couldn't find the doctor's charges on-hand, but the total cost for the facilities/drugs/equipment was $48,851.82. The insurance ended up paying $14,742.88 of that post-adjustments.

$14,742.88 is the real cost since hospital are running off of the income from what insurance actually pays. if average people were able to pay the "insurance adjusted price" for most things they would not need insurance for most things.

I'd rather just let any citizen/taxpayer pay the medicare or medicaid rate for a medical procedure out of pocket if he wishes. That's even lower than the insurance negotiated rate, and hospitals/doctors would have every right to exclude all medicare/medicaid patients if they want (many private doctors do, but generally hospitals don't, since they depend on the volume from medicare, and there are some other benefits for residencies).

Re: The Cost of an ACL Injury

#119

Post by jonknee »

reeses wrote: post #111
jonknee wrote: post #92

Earlier quoted context omitted.

Economies of scale have nothing to do with medical billing in the US. For example, IV bags of saline don't cost $100 in the real world (more like $1).

This becomes readily apparent with medical care for animals. Your vet will send you home with bags of Ringer's, line, and a bunch of cannulae for $50. It's not as simple as insurance alone driving the cost, but having a throat to choke if something goes wrong does contribute to it. As has been mentioned elsewhere, random overhead is covered in weird places, as well.

And human medical procedures that aren't typically covered by insurance. LASIK for example, imagine what laser eye surgery would cost if it was billed like an ACL reconstruction. Instead you have to pay yourself and doctors compete, the entire bill (at a nice place) ends up being what a couple of ACL knives cost.

Re: The Cost of an ACL Injury

#120

Post by rogerbinns »

defen wrote: post #42
twoodfin wrote: post #21

Earlier quoted context omitted.

The fraction of patients without insurance but with enough cash and motivation to fly to the UK purely to seek savings on medical treatment has got to be fairly tiny. My impression is that medical tourism from the U.S. is not typically for cost savings, but rather because particular procedures are either completely unavailable (experimental stem cell treatments) or could require long wait times (liver transplants). I…

> The fraction of patients without insurance but with enough cash and motivation to fly to the UK purely to seek savings on medical treatment has got to be fairly tiny. Well, if my options are to spend 60 grand on an ACL repair in the U.S., or significantly less than that on a first-class ticket to London, some serious fun, and an ACL repair...I know which one I would choose.

Those weren't your options. As with most things health related in the US, someone else was paying (the "insurer" in this case). Given the choice between you paying $2,400 in the US (and the insurer paying an amount you don't see or care about), or you going to the UK and paying 3,000GBP plus accommodation and tickets, I'll bet you pick the former.

It is in the insurer's interest for you to go somewhere cheaper as it saves them (not you) money. There are various press articles about this happening such as this 2009 article http://usatoday30.usatoday.com/news/health/2009-08-22-medica...

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