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

[DragonStryk72]

saw this article online in the Washington Post, and thought it was quite interesting:



Steve Brill’s massive Time article focused national attention on the price of health-care services in the United States. Sarah Kliff got further data showing an MRI can cost anywhere from $400 to $1,861 in Washington, DC alone. But as startling as the price difference between one hospital and another, or one insurer and another, can be in America, the difference between America and other countries is even more extraordinary. I wrote this piece in March 2012. But it’s worth revisiting now.

There is a simple reason health care in the United States costs more than it does anywhere else: The prices are higher.

http://m.washingtonpost.com/blogs/wonkblog/wp/2013/03/15/why-an-mri-costs-1080-in-america-and-280-in-france/


I find it interesting that all the huge debates and nonsense going on with Obacare and universal health care, and really the problem is just prices. We charge at rates that would be called price gouging in any other industry, but no one calls attention to it to any significant degree. Why not? Because, at the hospital, they don't have to price for customers, but insurance companies. then the insurance companies break the costs down as needed for their premiums, and individuals only learn of the costs when things have already gone wrong.

We talk about healthcare reform, but we don't ever seem to talk about fixing the price problems.

[Thunderknuckles]

saw this article online in the Washington Post, and thought it was quite interesting:


I find it interesting that all the huge debates and nonsense going on with Obacare and universal health care, and really the problem is just prices. We charge at rates that would be called price gouging in any other industry, but no one calls attention to it to any significant degree. Why not? Because, at the hospital, they don't have to price for customers, but insurance companies. then the insurance companies break the costs down as needed for their premiums, and individuals only learn of the costs when things have already gone wrong.

We talk about healthcare reform, but we don't ever seem to talk about fixing the price problems.
I have some ideas on why it costs so much but it is really irrelevant. The system is fundamentally broken and unsustainable.
I live in SoCal. I have insurance through my employer. The cost is about 2/3 of my friggin' mortgage per month and the big insurance companies want to up premiums another 20%!
I told my wife, by next year there's no point. I'll drop the insurance. With the money I pocket I can easily pay for for serious injuries. If something really bad happens, then we sign up for Obamcare, since they have to take pre-existing conditions, and pay for it that way. I simply can't justify paying nearly $1,000 a month on health insurance for us. Neither my wife nor I have ever even broken a bone in our bodies in over 4 decades of life and God willing, neither will my children. Assuming no major problems, that's $120,000 back in my pocket over 10 years, assuming current prices remain stagnant which is a pipe dream. So, lets just call it at least $500,000 back in my pocket over 10 years.

[DragonStryk72]

I have some ideas on why it costs so much but it is really irrelevant. The system is fundamentally broken and unsustainable.
I live in SoCal. I have insurance through my employer. The cost is about 2/3 of my friggin' mortgage per month and the big insurance companies want to up premiums another 20%!
I told my wife, by next year there's no point. I'll drop the insurance. With the money I pocket I can easily pay for for serious injuries. If something really bad happens, then we sign up for Obamcare, since they have to take pre-existing conditions, and pay for it that way. I simply can't justify paying nearly $1,000 a month on health insurance for us. Neither my wife nor I have ever even broken a bone in our bodies in over 4 decades of life and God willing, neither will my children. Assuming no major problems, that's $120,000 back in my pocket over 10 years, assuming current prices remain stagnant which is a pipe dream. So, lets just call it at least $500,000 back in my pocket over 10 years.

um, not to crap on your day further, but you do realize that under obamacare, you taking a huge financial hit for being uninsured. its not healthcare or insurance, its a mandate to have some.


If the system is fundamentally broken, then we should overhaul that system.

[Kathianne]

um, not to crap on your day further, but you do realize that under obamacare, you taking a huge financial hit for being uninsured. its not healthcare or insurance, its a mandate to have some.


If the system is fundamentally broken, then we should overhaul that system.

The 'penalty,' what the SCOTUS now calls a 'tax' is much less than the cost of insurance. Personally, I think it's a way for the government to get out of paying refunds to the working poor. Those who cannot afford to take Obamacare or even their employers plans. Their 'penalties' will mean no refund.

[DragonStryk72]

The 'penalty,' what the SCOTUS now calls a 'tax' is much less than the cost of insurance. Personally, I think it's a way for the government to get out of paying refunds to the working poor. Those who cannot afford to take Obamacare or even their employers plans. Their 'penalties' will mean no refund.

Sigh... that's a whole other ball of wax.

In any event, I do think we could do as some other countries are doing, and have the insurers and caregivers sit down to negotiate prices, with the government sending it back to them if its determined to be gouging, or stepping in to fix a price if they can't or won't agree. Pretty simple, and sticks to regulating a very necessary form of commerce.

[fj1200]

We talk about healthcare reform, but we don't ever seem to talk about fixing the price problems.

I think, but could easily be wrong here, that other countries use a lower resolution MRI which would be less expensive, and just as good in most situations, but regulations here mandate the higher resolution equipment. I'll have to try and find something later.

[PostmodernProphet]

what most people don't realize is that the laws regulating insurance companies provide that they make annually adjust their premiums to compensate for benefits they pay out and add a "profit" based on a maximum percentage of paid benefits......

so for example, if the cost of an MRI is $200 they may set premiums to cover the $200 plus an additional 7%..$14...or, if the hospital charges $1000 they can raise the premium to recover the $1000 plus $70......same transaction.....they receive one bill, they pay one bill......but they receive $70 instead of $14......until recently, the patient never even found out how much the bill was......and until recently, most didn't even know how much the insurance premium was, their employer paid it.....and the employer simply deducted it from their taxes......

and we wonder how we got where we are today......

until recently, there was no one on either side of the transaction who had any desire to keep the cost lower, only a desire to keep the cost higher.....

[Robert A Whit]

saw this article online in the Washington Post, and thought it was quite interesting:





I find it interesting that all the huge debates and nonsense going on with Obacare and universal health care, and really the problem is just prices. We charge at rates that would be called price gouging in any other industry, but no one calls attention to it to any significant degree. Why not? Because, at the hospital, they don't have to price for customers, but insurance companies. then the insurance companies break the costs down as needed for their premiums, and individuals only learn of the costs when things have already gone wrong.

We talk about healthcare reform, but we don't ever seem to talk about fixing the price problems.

The price problem is easy to fix.

1. Stop using insurance for more than a select few problems.
2. Stop having government pay for medical problems other than extreme problems.

A. Prices should be transparent; quoted first.

I can elaborate should somebody wish the market to win out on prices. But so long as they support high prices, solutions will not be listened to.

[Little-Acorn]

There is a simple reason health care in the United States costs more than it does anywhere else: The prices are higher.

Wow.

I am in awe.

I have to wonder: How many years of college did this Ezra Klein person go to, to enable him to figure that out? :bow2:

[Little-Acorn]

BTW, could those high prices possibly be, because while France transfers massive amounts of tax money from the few wealthy people left in that country, to the hospitals to hide the fact that MRIs there cost as much as they do here... the U.S. simply makes a law forcing hospitals to pay everything themselves, even for people who cannot pay, and so American hospitals double or triple the prices of every procedure to pay for the large numbers of people who pay zero?

In both cases, government is forcing people who earn money, to give it up to pay for those who don't for whatever reason. They just do it in different ways, to either hide or reveal what the real cost is.

[Robert A Whit]

I have some ideas on why it costs so much but it is really irrelevant. The system is fundamentally broken and unsustainable.
I live in SoCal. I have insurance through my employer. The cost is about 2/3 of my friggin' mortgage per month and the big insurance companies want to up premiums another 20%!
I told my wife, by next year there's no point. I'll drop the insurance. With the money I pocket I can easily pay for for serious injuries. If something really bad happens, then we sign up for Obamcare, since they have to take pre-existing conditions, and pay for it that way. I simply can't justify paying nearly $1,000 a month on health insurance for us. Neither my wife nor I have ever even broken a bone in our bodies in over 4 decades of life and God willing, neither will my children. Assuming no major problems, that's $120,000 back in my pocket over 10 years, assuming current prices remain stagnant which is a pipe dream. So, lets just call it at least $500,000 back in my pocket over 10 years.

Well said.

In general, the youth are not sick. They have sniffles of course, but they don't suffer heart problems, cancer, etc. Those are the problems of those who are towards the twilight of life.

A key is to make it pay for the young to have funds on hand to afford proper health care.

Remember that Bush wanted health savings accounts.

BS to that said Democrats.

We can't have the public actually able to afford health care Democrats brayed.

Bear in mind, things that get lower priced are lower because you know up front the cost, you were able to set funds aside for what you want, and when the deal was good, you struck.

Free enterprise will save health care. Only by tossing out the false ideology of democrats.

[jimnyc]

It's cheaper in France because they don't need to make money to offset the money they spend on their massive and powerful military? :poke:

[Nukeman]

Just because a hospital "charges" a amount they NEVER get PAID that amount.. You folks are forgetting that in most instances the biggest and largest payer for medical expenses is the federal govt through CMS or the Center for Medicaid/Medicare Services. These guys are the reason prices are high... Plain and simple. Medicare pays approx 0.24 cents on the dollar so in your scenario of a MRI costing 1080.00 in the US and 200.00 in France. Well do the 3rd grade math and figure it out if we get 0.24 cents on the dollar that comes out to $259.00 so we ARE in line with what France pays.. This whole thing is such a pile of BS it's laughable..

Want to bring down prices SET PRICES nationally quite making it regional and quite paying pennies on the dollar if they did that and set a flat fee than that is what would be charged.

Do you have any idea how much time we spend on figuring out PCR's (percentage cost reduction) from the Fed just to see how much they are going to pay..

Oh by the way that same organization that also oversees Medicaid, they pay 0.04 cents on the dollar guess what that means?? They pay 40.00 dollars for an MRI with a list price of 1080.00 Do you get it that the FEDERAL GOVT are the ones who are solely responsible for the high cost that they bitch about!!!!

You cant make this stuff up!!! It really is a simple fix, but no one wants to listen to "the people" especially our elected officials.....

[Nukeman]

I have some ideas on why it costs so much but it is really irrelevant. The system is fundamentally broken and unsustainable.
I live in SoCal. I have insurance through my employer. The cost is about 2/3 of my friggin' mortgage per month and the big insurance companies want to up premiums another 20%!
I told my wife, by next year there's no point. I'll drop the insurance. With the money I pocket I can easily pay for for serious injuries. If something really bad happens, then we sign up for Obamcare, since they have to take pre-existing conditions, and pay for it that way. I simply can't justify paying nearly $1,000 a month on health insurance for us. Neither my wife nor I have ever even broken a bone in our bodies in over 4 decades of life and God willing, neither will my children. Assuming no major problems, that's $120,000 back in my pocket over 10 years, assuming current prices remain stagnant which is a pipe dream. So, lets just call it at least $500,000 back in my pocket over 10 years.

Keep in mind if you are a CASH PAYING customer ALWAYS speak with the billing office about a reduction in cost or rate. For every dollar that is taken up front it is worth almost 200 in claims.

You should be able to negotiate down to a minimum of 50% cost if not down to 30%.. They make more money by you paying cash at 30% than billing an insurance company 100% and getting the negotiated price and arguing over resubmits and denials!!!!

[Robert A Whit]

Keep in mind if you are a CASH PAYING customer ALWAYS speak with the billing office about a reduction in cost or rate. For every dollar that is taken up front it is worth almost 200 in claims.

You should be able to negotiate down to a minimum of 50% cost if not down to 30%.. They make more money by you paying cash at 30% than billing an insurance company 100% and getting the negotiated price and arguing over resubmits and denials!!!!

A very good example of the market setting prices.

We do it for cars, why not health care?

We do not purchase an insurance policy to purchase a car or a home.

So why hand money to a middle man or the Feds whose major role is to increase costs and make it harder to afford a doctor?

We insure the loss of a home, but not the purchase of a home.

And guess what home insurance costs?

CHEAP

Believe it or not, insurance on even an expensive home is very cheap.

WHY?

Insurance prices are cheap because insurance firms know your chances of making a claim over your home are very low. The risk is so low they don't need to charge much on a very expensive home.

[tailfins]

Keep in mind if you are a CASH PAYING customer ALWAYS speak with the billing office about a reduction in cost or rate. For every dollar that is taken up front it is worth almost 200 in claims.

You should be able to negotiate down to a minimum of 50% cost if not down to 30%.. They make more money by you paying cash at 30% than billing an insurance company 100% and getting the negotiated price and arguing over resubmits and denials!!!!

Have you actually tried this or have you just read about it? In providing assistance to some who don't speak English, I have noticed that once it goes into collections, it's harder to get the prices down. I helped a guy trying to negotiate the bill down. They wouldn't go lower than 70%. He decided to pay zero and take the ding on his credit.

[Robert A Whit]

Have you actually tried this or have you just read about it? In providing assistance to some who don't speak English, I have noticed that once it goes into collections, it's harder to get the prices down. I helped a guy trying to negotiate the bill down. They wouldn't go lower than 70%. He decided to pay zero and take the ding on his credit.

I have done this and it works.

[Nukeman]

Have you actually tried this or have you just read about it? In providing assistance to some who don't speak English, I have noticed that once it goes into collections, it's harder to get the prices down. I helped a guy trying to negotiate the bill down. They wouldn't go lower than 70%. He decided to pay zero and take the ding on his credit.
Once it goes to collections that is money in the rears... NOT UP FRONT. That is the distinction!!! This is a common practice for CASH PAYING customers if they are willing to pay the full negotiated amount up front or day of service it can be reduced by 50-70%..

The reason your "friend" couldn't get it negotiated down below 70% is because he was already delinquent and is being taken to collections. He's lucky they reduced it at all... By that point they have already tried to work with them prior to getting collections involved...... Thus the reason for HIGH cost..

Been in health care for over 20 years

[Robert A Whit]

Once it goes to collections that is money in the rears... NOT UP FRONT. That is the distinction!!! This is a common practice for CASH PAYING customers if they are willing to pay the full negotiated amount up front or day of service it can be reduced by 50-70%..

The reason your "friend" couldn't get it negotiated down below 70% is because he was already delinquent and is being taken to collections. He's lucky they reduced it at all... By that point they have already tried to work with them prior to getting collections involved...... Thus the reason for HIGH cost..

Been in health care for over 20 years

The Surgeon that did surgery on my heart looked just like your avatar. LOL

[NightTrain]

We were told yesterday that an MRI will cost us $4k here in Alaska.

Carry on.

[Robert A Whit]

We were told yesterday that an MRI will cost us $4k here in Alaska.

Carry on.

$250 in CA at Clear health. Might pay you to take a decent vacation and save money too.