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

[Soodmeg]

Yeah it sucks here in a America as far as keeping healthy. It confusing because every single report for the last 20 years has said that its MUCH cheaper to have preventative care than it is to wait until the person is half dead and needs to be rushed to the hospital yet republicans hate the idea of any type of health changes.

I dont get it....if you disagree fine but what is your gameplan? Oh nothing? Well isnt that great.

I have been uninsured for about 10 years. The biggest problem I see is that it cost about the same amount of money to buy individual non shitty health care with its crazy co pays than it does to rush to the hospital.

Then you have tons of of companies that activity try to make sure they dont have to give health benefits to anyone. Its a lose lose lose.

 

[Clak]

[quote name='crunchb3rry']Cost me $1400 without insurance to get 4 wisdom teeth taken out. How in the world can all the shit they used to do it cost $1400? I've known people that had to go to the hospital for minor shit and were charged $6 for ONE ing aspirin. Yeah, aspirin, the same shit you can buy a hundred of for a couple bucks at the supermarket. Why is the most common medication so overpriced? What reason is there for that other than greed or subsidizing something else by overcharging for minor shit like gauze or a ing TV in your room?

I fell and hurt my neck a while back, everybody said "go to the doctor" and I was like "that would bankrupt my ass." If I'm sick three continuous days my job requires a doctor note, which in order to get would cost more than I'd make for the missed day. A broken arm would literally put me into poverty. I've got a tooth bothering me right now that I know will need a root canal and a crown...that's $1800 without insurance from what I've been told. So I have to save up and my stomach up in the meantime by taking 3-6 ibuprofen every day for months.

I wish it was like the olden days, where you just had to give the doctor a goat and shit was cool. You didn't need a loan or a job that didn't cut you off at thirtysome hours so they didn't have to give you health benefits.[/QUOTE]
They charge prices like that for aspirin in an attempt to recoup costs from people who can't pay. that's what the republitards don't get. They say "You can go to the hospital, they can't refuse you!". What they don't seem to understand is that, 1) They'll save your life, but they aren't do any anything to prevent it from happening again. If you're having a heart attack they'll save you then, but you aren't going to be given preventive meds when you go home. 2) The hospital will recoup the cost of that care by charging the insured out the ass for something simple like aspirin. The uninsured are a big reason why health care is so ridiculously overpriced. We need to get everyone a base level of coverage, but then that's somehow socialism rabble rabble.

 

[BigT]

I've been away for a while, but this is an interesting thread. Here are my takes.

* I agree that costs should be more transparent. I've finished medical school, finished a residency, and am in the middle of a fellowship... and I have no idea what most services cost... outside of basic Medicare codes.

* I agree that insurance serves as a buffer from people seeing true costs. Additionally, it provides a large influx of money into the system, leading to an inflation of costs (same situation as with college and student loans). Overall, this really takes us away from a free market... outside of concierge services, most doctors don't directly compete or set prices. For example, many patients are simply assigned to a doctor. On the other side, as an MD, I can do a great job or a pretty shitty one and still get paid about the same... moreover, due to insurance and HMOs, its not like even doing a good job will get you more money through word of mouth.

* The actual "hospital fees" that get quoted are ridiculous and high. Insurance companies don't pay anything close to that. Only rich foreigners pay that (e.g., I've seen Middle Easterners getting flown in for a specialty procedure... the hospital loves them!)

* A lot of care is wasteful. Lots of surgeries don't show any significant benefit in randomized controlled trials relative to sham procedures. Lots of expensive brand name medications are no better than cheap generics (despite the marketing). Lots of medications only provide marginal benefits or are studied in a small cherry picked population and the results are then extrapolated inappropriately to a broader range of patients. Lots of end of life care is futile and harmful (spending the last weeks of one's life getting poked and prodded, getting central lines placed, getting continuous dialysis, getting placed on pressors, getting intubated, and perhaps resucitaed a couple of times does not look like fun... fill out your advance directives...

* MD salaries are very divergent... it is a weird system that has insulated itself from supply and demand. Basically, MDs are incentivized for doing things, even if those things are not necessarily helpful... that's why cardiologists order a crapload of stress tests, echos, and diagnostic caths... you can always come up with a "reasonable" explanation of why it is needed for billing purposes... talking to patients and coming up with reasonable/conservative approaches that focus on prevention simply take time and lead to a loss of potential earnings. Unlike JD's, MD's do not directly bill by the hour... this is also why most psychiatrists don't do psychotherapy and simply prescribe some combination of antidepressants and antipsychotics...

 

[Trancendental]

[quote name='BigT']I've been away for a while, but this is an interesting thread. Here are my takes.

* I agree that costs should be more transparent. I've finished medical school, finished a residency, and am in the middle of a fellowship... and I have no idea what most services cost... outside of basic Medicare codes.

* I agree that insurance serves as a buffer from people seeing true costs. Additionally, it provides a large influx of money into the system, leading to an inflation of costs (same situation as with college and student loans). Overall, this really takes us away from a free market... outside of concierge services, most doctors don't directly compete or set prices. For example, many patients are simply assigned to a doctor. On the other side, as an MD, I can do a great job or a pretty shitty one and still get paid about the same... moreover, due to insurance and HMOs, its not like even doing a good job will get you more money through word of mouth.

* The actual "hospital fees" that get quoted are ridiculous and high. Insurance companies don't pay anything close to that. Only rich foreigners pay that (e.g., I've seen Middle Easterners getting flown in for a specialty procedure... the hospital loves them!)

* A lot of care is wasteful. Lots of surgeries don't show any significant benefit in randomized controlled trials relative to sham procedures. Lots of expensive brand name medications are no better than cheap generics (despite the marketing). Lots of medications only provide marginal benefits or are studied in a small cherry picked population and the results are then extrapolated inappropriately to a broader range of patients. Lots of end of life care is futile and harmful (spending the last weeks of one's life getting poked and prodded, getting central lines placed, getting continuous dialysis, getting placed on pressors, getting intubated, and perhaps resucitaed a couple of times does not look like fun... fill out your advance directives...

* MD salaries are very divergent... it is a weird system that has insulated itself from supply and demand. Basically, MDs are incentivized for doing things, even if those things are not necessarily helpful... that's why cardiologists order a crapload of stress tests, echos, and diagnostic caths... you can always come up with a "reasonable" explanation of why it is needed for billing purposes... talking to patients and coming up with reasonable/conservative approaches that focus on prevention simply take time and lead to a loss of potential earnings. Unlike JD's, MD's do not directly bill by the hour... this is also why most psychiatrists don't do psychotherapy and simply prescribe some combination of antidepressants and antipsychotics...[/QUOTE]

Great post, we need more honest doctors like you.