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(Washington Post)   Why does an MRI cost $1,800 in the United States and $280 in France? Because American hospitals and doctors simply charge more. Viva non-socialized health insurance   (washingtonpost.com) divider line 259
    More: Obvious, American Hospital Association, United States, health insurance, pharmaceutical industry, Uwe Reinhardt  
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3236 clicks; posted to Politics » on 15 Mar 2013 at 2:48 PM (1 year ago)   |  Favorite    |   share:  Share on Twitter share via Email Share on Facebook   more»



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2013-03-15 11:30:34 AM  
There was an interesting thread on FARK earlier in the week that discussed how the American style health insurance system makes it almost impossible to tell how much things actually cost, force healthcare providers to charge individuals and small insurers more to make up for undercharging large insurers who have more power to dictate prices and creates huge overhead because of all the time and people it takes to deal with the bullshiat.

We need transparency in healthcare 1.What providers charge needs to be publicly available. 2. performance of providers needs to be publicly available and there needs to be a national, government sponsored health insurance that provides a baseline level of care and fair pricing. Either a single payer system that everyone is enrolled in and people can then buy supplemental insurance if they want it or a medicare type plan available to everyone as an alternative to private insurance.
 
vpb [TotalFark]
2013-03-15 11:33:01 AM  
That's what capitalism is all about.

"Whatever the market will bear" just doesn't work when it comes to health care.
 
2013-03-15 11:46:00 AM  
Ok, go to France and get your MRI.  What? You don't want to go all the way to France for an MRI?  France smells bad, you say?  Well then pony up, mister!
 
2013-03-15 11:46:32 AM  
It takes more lube to get the average American inside the bore.
 
2013-03-15 11:56:59 AM  

Voiceofreason01: We need transparency in healthcare 1.What providers charge needs to be publicly available. 2. performance of providers needs to be publicly available and there needs to be a national, government sponsored health insurance that provides a baseline level of care and fair pricing. Either a single payer system that everyone is enrolled in and people can then buy supplemental insurance if they want it or a medicare type plan available to everyone as an alternative to private insurance.


Hospitals will bill insurance companies whatever they can get away with...http://reason.com/reasontv/2012/11/15/the-obamacare-revolt-okl ahoma-do ctors-fi
 
2013-03-15 12:09:37 PM  
Liability
 
2013-03-15 12:14:09 PM  
At that price differential, you could fly to France, get an MRI, spend a day in the Louvre or whatever there is to do in France and have the French doctor send the results back to the US.

Or maybe just finish up treatment in France.
 
2013-03-15 01:09:53 PM  

slayer199: Hospitals will bill insurance companies whatever they can get away with...http://reason.com/reasontv/2012/11/15/the-obamacare-revolt-okl ahoma-do ctors-fi


The point is that for all we hear from politicians about how we need to do this or that to "fix" healthcare the truth is that the insurance based system that we've created is broken and needs to be changed at a fundamental level in order to be viable. Cutting out "waste" in the system or tweaking tort law isn't going to do it.
 
2013-03-15 01:15:52 PM  
MRI in Canada:  free if you wait for it (it isn't urgent) or about $500
 
2013-03-15 01:18:57 PM  

Voiceofreason01: There was an interesting thread on FARK earlier in the week that discussed how the American style health insurance system makes it almost impossible to tell how much things actually cost, force healthcare providers to charge individuals and small insurers more to make up for undercharging large insurers who have more power to dictate prices and creates huge overhead because of all the time and people it takes to deal with the bullshiat.

We need transparency in healthcare 1.What providers charge needs to be publicly available. 2. performance of providers needs to be publicly available and there needs to be a national, government sponsored health insurance that provides a baseline level of care and fair pricing. Either a single payer system that everyone is enrolled in and people can then buy supplemental insurance if they want it or a medicare type plan available to everyone as an alternative to private insurance.


Doctors should have set prices on a menu.  Like McDonalds.
 
2013-03-15 01:19:10 PM  
As an uninsured person, my medication would cost me $800 if I bought it in the US but only $130 by ordering from Canada.
 
2013-03-15 01:20:09 PM  

Voiceofreason01: slayer199: Hospitals will bill insurance companies whatever they can get away with...http://reason.com/reasontv/2012/11/15/the-obamacare-revolt-okl ahoma-do ctors-fi

The point is that for all we hear from politicians about how we need to do this or that to "fix" healthcare the truth is that the insurance based system that we've created is broken and needs to be changed at a fundamental level in order to be viable. Cutting out "waste" in the system or tweaking tort law isn't going to do it.


So...adding more people to the current insurance system might not solve the problem?  The hell you say.
 
2013-03-15 01:21:14 PM  
I_C_Weener:
Doctors should have set prices on a menu.  Like McDonalds.

yes actually they should. It beats the hell out of them charging whatever they think that you(or your insurance company) can afford. It would also give doctors an edge in fighting back against being cheated by insurance companies.
 
2013-03-15 01:21:46 PM  

Happy Hours: At that price differential, you could fly to France, get an MRI, spend a day in the Louvre or whatever there is to do in France and have the French doctor send the results back to the US.

Or maybe just finish up treatment in France.


Not so much anymore. My wife and I just bought tickets to Paris and they ran us about 4k for 2. That was buying them through Air France in France; the same tickets purchased domestically ran at about $3500 - 4500, each.

Just a few years ago we were able to get the same tickets for about $800. I don't know what the fark happened in the past two years to justify this rape, but nowadays travel to Europe is becoming something that only the ultrarich will be able to afford.
 
2013-03-15 01:23:34 PM  
There's a "F*cking MRIs, how do they work?" charge attached in the US
 
2013-03-15 01:24:58 PM  
Well, in short, it works like this.

Person A gets into a car accident.  Broken rib causes a lacerated spleen, leads to surgery, 4 day stay in the hospital, and a bill of $100,000.  Person A has no health insurance, makes minimum wage, and because of that could only afford bare minimum coverage car insurance.  The person who hit them was uninsured.  Person A cannot have any hope of paying their bill.  So they are forced to declare bankruptcy due to no fault of their own.  The side effect of this of course is a high chance that person's life is ruined, but we'll leave that aside for now.

The hospital will get nothing back on that bill.  So, they distribute it to the next 1000 people who come in by generally increasing the cost of their bills by $100 through various methods such as overpriced acetaminophen.  Eventually Person B will come in and be in a similar situation to Person A, so the hospital will be forced to eat that bill too, and pass on another $100 to everyone who comes in with health insurance.

This is what Republicans call a perfectly working system, and it is what we have today.  That's why health care is so expensive.
 
2013-03-15 01:25:12 PM  
Because medical devices, research and pharmaceuticals conduct business in the US because that's where the profits and lax regulations exist.  So Americans help pay for it.
 
2013-03-15 01:25:59 PM  

catmandu: As an uninsured person, my medication would cost me $800 if I bought it in the US but only $130 by ordering from Canada.


Arizona woman charged $83,000 for two injections that would cost $200 in Mexico.
 
2013-03-15 01:26:05 PM  

catmandu: As an uninsured person, my medication would cost me $800 if I bought it in the US but only $130 by ordering from Canada.


But of course the drug companies worked with their buddies in Congress to stop you from doing that under the false rationale of "GASP! Drugs bought in Canada are unsafe and could kill you! We're stopping you for your own good!"
 
2013-03-15 01:28:01 PM  

GAT_00: Well, in short, it works like this.

Person A gets into a car accident.  Broken rib causes a lacerated spleen, leads to surgery, 4 day stay in the hospital, and a bill of $100,000.  Person A has no health insurance, makes minimum wage, and because of that could only afford bare minimum coverage car insurance.  The person who hit them was uninsured.  Person A cannot have any hope of paying their bill.  So they are forced to declare bankruptcy due to no fault of their own.  The side effect of this of course is a high chance that person's life is ruined, but we'll leave that aside for now.

The hospital will get nothing back on that bill.  So, they distribute it to the next 1000 people who come in by generally increasing the cost of their bills by $100 through various methods such as overpriced acetaminophen.  Eventually Person B will come in and be in a similar situation to Person A, so the hospital will be forced to eat that bill too, and pass on another $100 to everyone who comes in with health insurance.

This is what Republicans call a perfectly working system, and it is what we have today.  That's why health care is so expensive.


If that was the only reason then per capita it would average out. But it doesn't. The US per capita healthcare cost is three times most other first world countries.
 
2013-03-15 01:28:01 PM  
My Mother-In-Law needed 8 dental crowns.  In Canada they are $2,500 a pop and in China they are about $500 each.   She had one done in Canada (through her plan as the 1 year maximum).   Traveled to China for the other 7 , made it a trip.

Dental cost $17, 500 versus $3,500.  She saved a fortune.  A few months later one of the crowns failed - the Canadian one.  Over 5 years later, and the Chinese crowns are fine.
 
2013-03-15 01:35:25 PM  

Voiceofreason01: There was an interesting thread on FARK earlier in the week that discussed how the American style health insurance system makes it almost impossible to tell how much things actually cost, force healthcare providers to charge individuals and small insurers more to make up for undercharging large insurers who have more power to dictate prices and creates huge overhead because of all the time and people it takes to deal with the bullshiat.

We need transparency in healthcare 1.What providers charge needs to be publicly available. 2. performance of providers needs to be publicly available and there needs to be a national, government sponsored health insurance that provides a baseline level of care and fair pricing. Either a single payer system that everyone is enrolled in and people can then buy supplemental insurance if they want it or a medicare type plan available to everyone as an alternative to private insurance.


Do you have a link? I'd love to read it.
 
2013-03-15 01:43:29 PM  

Flint Ironstag: If that was the only reason then per capita it would average out.


Why?  Person B is already paying an inflated cost when they declare bankruptcy, so when Person C has to do so, their cost now includes A and B, and so on and so forth.  Just because they couldn't pay it doesn't mean they weren't billed for it.
 
2013-03-15 01:44:25 PM  

Voiceofreason01: There was an interesting thread on FARK earlier in the week that discussed how the American style health insurance system makes it almost impossible to tell how much things actually cost, force healthcare providers to charge individuals and small insurers more to make up for undercharging large insurers who have more power to dictate prices and creates huge overhead because of all the time and people it takes to deal with the bullshiat.

We need transparency in healthcare 1.What providers charge needs to be publicly available. 2. performance of providers needs to be publicly available and there needs to be a national, government sponsored health insurance that provides a baseline level of care and fair pricing. Either a single payer system that everyone is enrolled in and people can then buy supplemental insurance if they want it or a medicare type plan available to everyone as an alternative to private insurance.


Yeah, I saw a news report on this. The same procedure can cost 20 different prices, depending how you want to pay, because insurance companies "negotiate" prices. In some cases people with no insurance were able to pay thousands of dollars less than people with insurance for the same procedure since the prices weren't jacked up so the insurance company/hospitals could make a big profit. The whole health care/insurance industry in the US is one big corrupt sick scam.
 
2013-03-15 01:44:34 PM  
AnotherBluesStringer:
Do you have a link? I'd love to read it.

sorry. I looked but couldn't find it.
 
2013-03-15 01:45:18 PM  

basemetal: Liability


Do they not have liability in the other countries?
 
2013-03-15 01:53:45 PM  
i23.photobucket.com
 
2013-03-15 01:53:53 PM  

make me some tea: basemetal: Liability

Do they not have liability in the other countries?


When you take the profit out of the insurance picture, lawsuits become less of an issue.  Medical lawsuits in Canada are not that common.

Imagine if Fire Departments were private and were paid with private insurance.  Overnight you would start a lawsuit industry on fire malpractice.  It is the nature of having something as a profit making business versus a best effort service based on good will and professionalism.
 
2013-03-15 01:55:04 PM  

mrshowrules: make me some tea: basemetal: Liability

Do they not have liability in the other countries?

When you take the profit out of the insurance picture, lawsuits become less of an issue.  Medical lawsuits in Canada are not that common.

Imagine if Fire Departments were private and were paid with private insurance.  Overnight you would start a lawsuit industry on fire malpractice.  It is the nature of having something as a profit making business versus a best effort service based on good will and professionalism.


You make a very valid point.
 
2013-03-15 01:55:48 PM  

mrshowrules: make me some tea: basemetal: Liability

Do they not have liability in the other countries?

When you take the profit out of the insurance picture, lawsuits become less of an issue.  Medical lawsuits in Canada are not that common.

Imagine if Fire Departments were private and were paid with private insurance.  Overnight you would start a lawsuit industry on fire malpractice.  It is the nature of having something as a profit making business versus a best effort service based on good will and professionalism.


Addendum: Liability insurance for doctors in Canada is 1/10th the cost as the US.
 
2013-03-15 01:56:46 PM  
I think a major cause of the expense of health care in the US is due to the liability insurance (which is obscenely expensive) that doctors are required to have; since we have such a sue-happy society. The US needs Tort Reform but it will never happen because the Government is primarily made up of lawyers.
 
2013-03-15 01:58:29 PM  
Because THE WORLD'S GREATEST HEALTH CARE is expensive.  Duh.
 
2013-03-15 01:59:52 PM  

Voiceofreason01: We need transparency in healthcare


Honestly? No we don't. It won't help. If you need a medical procedure, you need a medical procedure. Being told that your appendectomy is going to cost $13,000 does absolutely nothing - you need the surgery. You can't say "the price is too high, I refuse to pay". You'll die.

The problem with health care costs isn't transparency. It's bargaining power. Patients don't have any.
 
2013-03-15 02:00:46 PM  

GAT_00: Flint Ironstag: If that was the only reason then per capita it would average out.

Why?  Person B is already paying an inflated cost when they declare bankruptcy, so when Person C has to do so, their cost now includes A and B, and so on and so forth.  Just because they couldn't pay it doesn't mean they weren't billed for it.


If the price was already inflated then this cannot be the reason that prices are inflated.
 
2013-03-15 02:03:04 PM  

Flint Ironstag: GAT_00: Flint Ironstag: If that was the only reason then per capita it would average out.

Why?  Person B is already paying an inflated cost when they declare bankruptcy, so when Person C has to do so, their cost now includes A and B, and so on and so forth.  Just because they couldn't pay it doesn't mean they weren't billed for it.

If the price was already inflated then this cannot be the reason that prices are inflated.


I can't decide if you're trolling because you refuse to accept the real reason for inflated health care costs or are a new level of incredibly dense.
 
2013-03-15 02:04:00 PM  
BTW, as I posted (far too late) in the earlier thread, the UK has private health care and private health insurance alongside the NHS.

Reasons to go private (apart from purely cosmetic work which is all private unless there is a medical reason, like plastic surgery after an accident for example) are usually to get treated quicker for routine work and to have a nicer private room and better food. The quality of treatment is usually the same and is often done by the same surgeons and often in the same theatre.

And private health care seems to be far cheaper than in the US. For one they don't have to cover ER and emergency ambulances since the NHS will take care of that very well. Secondly they can't charge outrageous fees because then people will just wait and get treated in the NHS. Bupa, the biggest private healthcare provider, is still very profitable but they have to keep their prices reasonable because the NHS is a viable alternative, even if you have money. When a Formula One driver was badly injured in testing last year she was taken to the nearest NHS A+E and treated there. I dare say they sprung for a private room but the quality of treatment wouldn't have been much different.

Drugs like courses of antibiotics or painkillers if prescribed are covered by a fixed prescription charge, currently just under £8, about $12, for the course. If you are unemployed or on various welfare schemes then they are free.  A family member is diabetic and his medication is totally free.

We pay higher taxes than the US, plus a National Insurance tax that pays for welfare and the NHS, but per capita our healthcare costs about a third of that of the US per capita, with broadly similar results, so it works out cheaper overall. Some cancer survival rates are higher in the US but that's about it.
For most of us we take for granted the freedom of just being able to go and see a doctor any time, even just as a precaution if we feel a few minor possible symptoms, without ever having to consider the financial cost, no matter if we have a job or not. That alone must provide huge benefits since early diagnosis and treatment can make a huge difference with so many illnesses.
 
2013-03-15 02:06:05 PM  

ferretman: I think a major cause of the expense of health care in the US is due to the liability insurance


and you'd be wrong. I'm not going to provide links since Google will give you dozens of results. But most famously Texas passed pretty comprehensive tort reform a couple years ago and it hasn't affected healthcare costs.
 
2013-03-15 02:06:35 PM  

GAT_00: Flint Ironstag: GAT_00: Flint Ironstag: If that was the only reason then per capita it would average out.

Why?  Person B is already paying an inflated cost when they declare bankruptcy, so when Person C has to do so, their cost now includes A and B, and so on and so forth.  Just because they couldn't pay it doesn't mean they weren't billed for it.

If the price was already inflated then this cannot be the reason that prices are inflated.

I can't decide if you're trolling because you refuse to accept the real reason for inflated health care costs or are a new level of incredibly dense.


So what is the real reason? The only explanation you have posted in this thread is that because some people can't pay their bill has to be be paid by everyone else.

I pointed out that if that was the sole reason then per capita it would average out. In reality it doesn't. In reality the per capita cost in the US is three times everywhere else.
 
2013-03-15 02:09:20 PM  

vpb: That's what capitalism is all about.

"Whatever the market will bear" just doesn't work when it comes to health care.


I was told that the free market would solve this problem and everything would be efficient and cheap.
WHAT HAPPENED?!!!!
 
2013-03-15 02:10:14 PM  

Lionel Mandrake: Because THE WORLD'S GREATEST HEALTH CARE is expensive.  Duh.


strange, I thought the worlds greatest healthcare was cheap. World's greatest is just not in the US.
BWahahahahahahahahaahahah
 
2013-03-15 02:10:31 PM  

mrshowrules: When you take the profit out of the insurance picture, lawsuits become less of an issue.


TFA: "Two of the five most profitable industries in the United States - the pharmaceuticals industry and the medical device industry - sell health care. With margins of almost 20 percent, they beat out even the financial sector for sheer profitability. The players sitting across the table from them - the health insurers - are not so profitable. In 2009, their profit margins were a mere 2.2 percent. That's a signal that the sellers have the upper hand over the buyers."

According to TFA, insurance profit margins are quite thin--about 2.2%.  That's why the study suggests its not about the insurance providers but rather health care providers themselves. Is that inaccurate?
 
2013-03-15 02:12:50 PM  

GAT_00: This is what Republicans call a perfectly working system, and it is what we have today.  That's why health care is so expensive.


if only there were another method of paying for healthcare
some kind of universal system where everyone is covered.
 
2013-03-15 02:14:58 PM  

Flint Ironstag: We pay higher taxes than the US, plus a National Insurance tax that pays for welfare and the NHS, but per capita our healthcare costs about a third of that of the US per capita, with broadly similar results, so it works out cheaper overall.


A fair amount of Americans are aware of and this; we're pretty pissed off that we're not mature enough to institute a similar mixed public /private system. We were told we couldn't have a "public option" because no private sector business could compete. Just like (ahem) no one possibly could compete with the USPS so there is no such thing as FedEx, UPS or DHL. (ahem)
 
2013-03-15 02:15:49 PM  

grokca: It takes more lube to get the average American inside the bore.


No kidding.  That shiat is $30 per ounce at Walgreens.
 
2013-03-15 02:17:41 PM  

Somacandra: Flint Ironstag: We pay higher taxes than the US, plus a National Insurance tax that pays for welfare and the NHS, but per capita our healthcare costs about a third of that of the US per capita, with broadly similar results, so it works out cheaper overall.

A fair amount of Americans are aware of and this; we're pretty pissed off that we're not mature enough to institute a similar mixed public /private system. We were told we couldn't have a "public option" because no private sector business could compete. Just like (ahem) no one possibly could compete with the USPS so there is no such thing as FedEx, UPS or DHL. (ahem)


Yeah, Bupa, the UKs biggest private healthcare company, is very profitable and successful, despite competing against the NHS. It's main selling points are skipping waiting lists, nice private room and better food. And most Bupa memberships are paid for by employers as a perk, since cover costs far less than private insurance in the US.
 
2013-03-15 02:17:50 PM  
OK say you've got $15000 in medical costs for yourself in a given year. And fark it all, you've got cancer.

Well each business involved in medical needs to make a profit off of you.

Corporation A is an insurance company.
Corporation B is an hospital.
Corporation C is a pharmaceutical company.

You've been paying $200 per month for health insurance. Let's assume they don't jack the shiat out of your health insurance when they find you have cancer. You pay $2400 a month for medical costs. Now the insurance company has to profit, right? So they take $50 of that per month, or $600 a year that is just raw 'profit'. Insurance is like the greatest scam ever.

You: $2400
Them: $600

You're paying for hospital stay. Well this isn't a goddamn charity, the hospital needs to profit (I have no idea WHY, since it's job should be only helping you, but it does. Oh and it wants a new hospital wing to treat highly infectious superbugs because our nation overuses antibiotics, so under the covers they want you to pay for it.) Now, wouldn't you know, there are also all these deadbeats who get cancer who don't even pay for it, or old people the government pays jack sh*t for, so someone's gotta pay for it. Oh and insurance companies negotiate prices, those farks, taking money out of the hospital's mouth. So they charge you $4600 for various services, even though it only costs them about $800 to really treat you. (The insurance company, angels that they are, will get you later in high premiums so the money can snowball.) In the end the hospital makes about $3800 in 'profit' off of you.

You: $4600
Hospital "profit": $3800

Company C developed a great drug that will kill the cancer, and has some side effects that will probably also kill you. Whatever. Only like 100,000 people in the country get this particular cancer, and it cost them like 2 billion to make, so they charge you $8000 a year for it. It actually only costs them about 2 dollars to make the actual drug, but you know, research costs and everything because heaven forbid you get that drug from Canada. Let's just round down to 0.

You: $8000
Pharma "makes": $8000.

Now you just paid the full $15000, of which about $12400 was either pure profit, or to pay for research costs or "deadbeats" - these btw are not really profits but just hidden costs that jack up the overall costs.

You're probably better off not having insurance and eating better food each year so you have a much higher likelihood of not getting cancer. But then you get old and shiat, and no one wants to die. So you're paying for the research people who make drugs that make you less likely to die, you pay for the deadbeats who don't pay for anything, you pay for the insurance companies that unless they are run by monkeys will never, EVER lose money...in the end, healthcare is a great scam. And you pay for it because you or everyone around you eats crap.
 
2013-03-15 02:25:58 PM  

bdub77: OK say you've got $15000 in medical costs for yourself in a given year. And fark it all, you've got cancer.


Time to sit down and calmly set yourself on fire in front of the Capitol building? Public self-immolation has a way of drawing local media out.
 
2013-03-15 02:32:01 PM  

Flint Ironstag: o what is the real reason? The only explanation you have posted in this thread is that because some people can't pay their bill has to be be paid by everyone else.

I pointed out that if that was the sole reason then per capita it would average out. In reality it doesn't. In reality the per capita cost in the US is three times everywhere else.


Ok, let me be more simple.  US health care costs are the result of a spiraling effect.  Each year, some people are not able to pay their bills, resulting in those losses being passed onto everyone else.  This happens every single year.  As the cost of a bill has increased from year to year, the cost that cannot be paid also increases.  This means the costs next year are increased again.  This continues every single year.

I have no idea how you cannot grasp this.  It's a domino effect.  If inflation means a 3% increase year to year, new equipment a 2% increase, and unpayable bills a 5% increase, other countries would see a 5% increase because they have responsible systems designed to make sure medical care can be paid.  We see a 10% increase.  That means over 10 years, a $100 cost would go to $163 for the rational systems, but $259 here.

The numbers are arbitrary, but I can't see how I can make this clearer.
 
vpb [TotalFark]
2013-03-15 02:34:48 PM  
Somacandra:

According to TFA, insurance profit margins are quite thin--about 2.2%.  That's why the study suggests its not about the insurance providers but rather health care providers themselves. Is that inaccurate?

Well, many insurance companies had to send out checks when the provision requiring that at least 80% of premiums be spent on health care.
 
2013-03-15 02:35:17 PM  

ferretman: I think a major cause of the expense of health care in the US is due to the liability insurance (which is obscenely expensive) that doctors are required to have; since we have such a sue-happy society. The US needs Tort Reform but it will never happen because the Government is primarily made up of lawyers.


Tort reform: because the vaunted American Individual (peace and blessings be upon him) is so stupid that he is easily hoodwinked by lawyers into handing out large verdicts.
 
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