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

[Torch]

But Amercians are jetting off to top private tourist hospitals in India and Thailand for example to save money and get usually extraordinary care for that money.

Neither of those destinations are Bulgaria.

And no offense to the health care systems in those two countries, but if I get a cancer diagnosis, I'm calling MD Anderson in Houston or Sloan-Kettering in NYC.

Now, if I wanted a sex change operation, I might consider Thailand. But since I'm not in the market for one of those.... ::)

[Oniya]

Neither of those destinations are Bulgaria.

And no offense to the health care systems in those two countries, but if I get a cancer diagnosis, I'm calling MD Anderson in Houston or Sloan-Kettering in NYC.

Bulgaria might be off the table, but medical tourism is a growing industry.  I know I've seen people on this forum talking about significant operations that they can't possibly afford in the States without winning the lottery, but which would be almost feasible - including airfare and lodging - if they went to another country for the operation. 

[Torch]

Bulgaria might be off the table, but medical tourism is a growing industry.  I know I've seen people on this forum talking about significant operations that they can't possibly afford in the States without winning the lottery, but which would be almost feasible - including airfare and lodging - if they went to another country for the operation.

Oh, I don't disagree. But medical tourism caters to anyone with the cash to spend, not just Americans with the cash to spend.

It would be my guess that well off citizens of countries with socialized medicine are the most frequent customers of private tourist hospitals, rather than wait months for a needed operation.

Most well off citizens of the US are covered by private (i.e. employer sponsored) insurance, and therefore would really have no need to "jet" anywhere for treatment, unless it's something experimental or the like.

[Oniya]

Most well off citizens of the US are covered by private (i.e. employer sponsored) insurance, and therefore would really have no need to "jet" anywhere for treatment, unless it's something experimental or the like.

But there's the sticking point - 'well-off'.  The number of US citizens without health insurance is rising.  Also, the percentage that receive insurance through their employer is falling, either through the benefit not being offered at all, or through employers keeping employees to 'just-below-full-time' hours to avoid having to pay that benefit. 

[Torch]

But there's the sticking point - 'well-off'.  The number of US citizens without health insurance is rising.  Also, the percentage that receive insurance through their employer is falling, either through the benefit not being offered at all, or through employers keeping employees to 'just-below-full-time' hours to avoid having to pay that benefit.

Believe me, if I had a solution for insuring those 50 million tomorrow, I'd offer it up.

Would I be willing to give up my private insurance in order to have every citizen in the US covered by a national health plan? I have to be honest, I'm not sure I'd want to make that choice, especially if it meant risking my children's health and welfare. I'd rather my taxes be raised as long as I can keep the option of private insurance for my family.

And I freely admit that if I were uninsured, I'd feel differently.

[Oniya]

Believe me, if I had a solution for insuring those 50 million tomorrow, I'd offer it up.

Would I be willing to give up my private insurance in order to have every citizen in the US covered by a national health plan? I have to be honest, I'm not sure I'd want to make that choice, especially if it meant risking my children's health and welfare. I'd rather my taxes be raised as long as I can keep the option of private insurance for my family.

And I freely admit that if I were uninsured, I'd feel differently.

I never said that you (or anyone else) should have to give up their insurance.  Frankly, I don't see a problem with leaving in the option for someone to purchase more insurance if they want, but there should be a certain minimum standard of care that is provided in an affordable manner.  The point of the thread is that other countries are providing as good (and sometimes better) care for all of their citizens at a much lower cost.  As was pointed out in the initial post, it's at least partially because there's no regulation about how high a price can be submitted to the insurance companies.

[Torch]

I never said that you (or anyone else) should have to give up their insurance.  Frankly, I don't see a problem with leaving in the option for someone to purchase more insurance if they want, but there should be a certain minimum standard of care that is provided in an affordable manner.  The point of the thread is that other countries are providing as good (and sometimes better) care for all of their citizens at a much lower cost.  As was pointed out in the initial post, it's at least partially because there's no regulation about how high a price can be submitted to the insurance companies.

It was just a rhetorical question I threw out there, I know you didn't suggest it.  :-\

And I agree with you, there should be a minimum standard of care for everyone. As I said, I wish I had a solution, a workable solution that provides basic care to anyone who needs it, and allows for additional options if you can afford it.

[Oniya]

Ah, same page reached. :-)  The rhetorical question just confused me completely.  ^_^>

[TheGlyphstone]

Doctors are the highest-paying profession in the world, Dentists the 3rd, and Lawyers the 4th. The conspiracy theories practically write themselves.

[Torch]

Ah, same page reached. :-)  The rhetorical question just confused me completely.  ^_^>

My fault, I should have clarified. But when I'm typing and I think "rhetorical" in my head, I just assume everyone else can read it that way, too.  :P

[RubySlippers]

Oh, I don't disagree. But medical tourism caters to anyone with the cash to spend, not just Americans with the cash to spend.

It would be my guess that well off citizens of countries with socialized medicine are the most frequent customers of private tourist hospitals, rather than wait months for a needed operation.

Most well off citizens of the US are covered by private (i.e. employer sponsored) insurance, and therefore would really have no need to "jet" anywhere for treatment, unless it's something experimental or the like.

I wish they used this option as elective for all insurance why nitpick even with co-pays the costs could be very high, if they used the same percentages going to India to a first rate tourist hospital it would still save them money most likely and the company in question. And for Medicaid patiants needing expensive life saving care there should be no choice you go to the best and cheapest option on the list that could be being sent abroad for care.

[Callie Del Noire]

But there's the sticking point - 'well-off'.  The number of US citizens without health insurance is rising.  Also, the percentage that receive insurance through their employer is falling, either through the benefit not being offered at all, or through employers keeping employees to 'just-below-full-time' hours to avoid having to pay that benefit.

In the last six months I have offered no less then 9 30 hour a week jobs that should be full time tech positions

[DarklingAlice]

In the last six months I have offered no less then 9 30 hour a week jobs that should be full time tech positions

Which is a, I think, a huge part of the problem. If employers are starting to welch on providing health in insurance due to financial concerns, the government needs to step up. I have had an MRIs and several CT scans over the years and didn't even pay a portion of them because they were covered 100% by the insurance I had through my basic, 40 hour a week, retail job. Ditto the $900 outpatient surgery I had last year, all I paid was a $20 copay. I frankly don't understand the ability of employers to welch on benefits for <40 hr a week employees. Even if they pro-rated benefits with regard to time worked, their workers should still get something. The only time a company should be able to get away with not providing anything is if you work for them as an independent contractor.

The other part of the problem is a bit harder to fix. Americans (and to a lesser extent humanity in general) hate preventative medicine. As someone working in public health and drug discovery this has to be one of the single most frustrating things I have encountered. It seems that the majority of Americans would rather show up with a huge problem at an ER with a crisis than to make use of preventative care and behavior correction to ensure the crisis doesn't happen in the first place. And preventative care is not a luxury affordable only to the rich; every single city I have lived in has a range of underutilized free clinics overflowing with volunteers. Not to mention the horrible rates of patient compliance. But it would probably be easier to fix the insurance situation than to change the nature of people.

[Tiberius]

Darkling, one thing i've come to accept is that, people in general are STUPID you can sit around and scratch your head wondering why people are so dumb all day, or just accept it.

The government just doesn't do enough to help in ways of getting around the general stupidity of people who don't do what is actually sensible for them. I guess its just human nature to be an idiot and make things worse before going to seek treatment.

[DarklingAlice]

@Tiberius:
Despite your attempt to provide yourself as an example of your thesis, I still find such attitudes less than helpful when it comes to either saving lives or writing policy. Simplistic, puerile responses to complex issues tend to be a way to make ourselves feel better about sitting on our ass rather than a way to work towards an actual solution. Thanks though.

[RubySlippers]

Which is a, I think, a huge part of the problem. If employers are starting to welch on providing health in insurance due to financial concerns, the government needs to step up. I have had an MRIs and several CT scans over the years and didn't even pay a portion of them because they were covered 100% by the insurance I had through my basic, 40 hour a week, retail job. Ditto the $900 outpatient surgery I had last year, all I paid was a $20 copay. I frankly don't understand the ability of employers to welch on benefits for <40 hr a week employees. Even if they pro-rated benefits with regard to time worked, their workers should still get something. The only time a company should be able to get away with not providing anything is if you work for them as an independent contractor.

The other part of the problem is a bit harder to fix. Americans (and to a lesser extent humanity in general) hate preventative medicine. As someone working in public health and drug discovery this has to be one of the single most frustrating things I have encountered. It seems that the majority of Americans would rather show up with a huge problem at an ER with a crisis than to make use of preventative care and behavior correction to ensure the crisis doesn't happen in the first place. And preventative care is not a luxury affordable only to the rich; every single city I have lived in has a range of underutilized free clinics overflowing with volunteers. Not to mention the horrible rates of patient compliance. But it would probably be easier to fix the insurance situation than to change the nature of people.

Now that is kind of unfair I'm a diabetic and should be on insulin therapy but just can't afford it, testing supplies and insulin costs to much it would eat up 60% of my inome a month just for those and seeing a doctor is on top of that. The free clinic is at least an option. Same with compliance if the treatment costs more than I can afford if followed through say being released from the hospital what can I do? But for me it comes down to money plain and simple not lack of desire.

As for companies unless there is a contract backed by a good union that cares ,rare, you get what benefits the employers offer or you can quit at least in Florida in fact save for some salaried positions Walmart is offering no one more than 20 hours a week and using temps from agencies for those times they need more work done. You can't order employers to hire people for full time work can you and I fear Obamacare if it kicks in would force them to cut back more hours to get under the window where they must provide care or pay a fine. With the economy they could go to ten hours and get people in to do the work sadly. They don't otherwise have to offer any health care they could drop all programs, raise salaries a bit and say your health is not our problem if you can't work under that then leave, we have lots of people that want the job.

[DarklingAlice]

Now that is kind of unfair I'm a diabetic and should be on insulin therapy but just can't afford it, testing supplies and insulin costs to much it would eat up 60% of my inome a month just for those and seeing a doctor is on top of that. The free clinic is at least an option. Same with compliance if the treatment costs more than I can afford if followed through say being released from the hospital what can I do? But for me it comes down to money plain and simple not lack of desire.

Okay, maybe I have just had the luck to work in the few particular places that do have this, but every single free clinic I have worked in has been able to dispense a month's worth of Metformin, Novalin, and test strips (with a doctor visit) for a suggested donation of $10-15. I think part of the problem is that it is hard for the free clinic system to promote itself. There isn't spare money around to buy billboards when you are trying to keep your patients alive.

[Serephino]

I think it also depends on where you live.  There isn't much access where I live.  There is one free clinic here in town that operates at night one day a week.  Thing is, you have to make an appointment, and they only see 18 patients a night.  The way they do things is really unfair.  You have to call during that day for the appointment.  And if they fill up their appointments that day, will they start booking for the next week?  Nope.  You have to wait until the next day and try your luck again.  My boyfriend tried to get in, but after the third week he gave up.

There is another one about 25 mi away that doesn't require an appointment.  However, you have to pay $75 at the time of the visit.  If you don't have $75 that can be a problem, and that doesn't include medication.  Hell, that's about what my family doctor charges for an appointment, so how does that help anyone?  In this area, if you don't have insurance, preventive care isn't really an option.  It's either get up at the crack of dawn and try your luck at the clinic, or wait until you have a real problem and go to the ER.       

[DarklingAlice]

And you are sure that is the only aid available in your area? Cause we don't exactly live in the most opulent of areas (Dallas, Texas if you are curious) and have multiple general purpose free clinics along with devoted diabetes and HIV clinics. And the free clinics I have worked at average 60-100 patients an evening (though most are only open two to three nights a week). Still, unless you live in the middle of nowhere I would be surprised if there was only one free clinic.

[Serephino]

I live in the middle of nowhere... sort of.  It's a small town, and I'm sure that one clinic is the only one in the area.  There might be others in Johnstown, but none that I could find.  It's a long drive and I don't know the area.

[RubySlippers]

There are only two free clinics covering a part of our county, the county offers a program but they insist on proof of income and medical need earning under $680 a month and I can't prove my income and even if I did I make usually $800 a month so don't qualify for care. Medicaid I meet income levels but am a single adult, but if I get pregnant they would put me into that program but that is not exactly a wise move is it? Or if I purposefully gave myself HIV it would be easy to get help but I will not go there.

Frankly I would move back to Milwaukee if I could they have a huge community health complex that does everything based on ability to pay, but my work base is here and I don't have that kind of money.

But I was just commenting to the comment that patiants don't follow directions and all but in some cases it could be money if your poor eating right and paying for care is often out of the question. And if drugs prescribed cost the people won't buy them and smart ones will demand alternatives.

[Serephino]

I wish I could've gotten my prescription allergy pills.  Maybe then I wouldn't have this stupid sinus infection because the stupid dog is shedding her winter coat. 

[Callie Del Noire]

You know.. my mom told me for a clinic/hospital/facility to put in an MRI..they (the group in question) has to get a 'permission' licenses (or was it usage license) to ensure that it's NEEDED in the area they want to install it.

[Etah dna Evol]

The reason an MRI costs $1,080 in America and $280 in France is because in France they have already paid the other 800 in taxes and furthermore, in America you get the MRI is a few days. In France you might get that MRI next month, or maybe the month after that, depending on how emergent your condition is and what some suit decides. I would rather have my healthcare, expensive as it may be, in the hands of Medical professionals, rather than government bureaucrats.

[Trieste]

If so, then the US is not the way to go, either. Ask any number of Americans who cannot get procedures including cancer treatments and so-called cosmetic surgery because they aren't 'medically necessary'. Funnily enough, their doctors think the procedures are medically necessary. It's the insurance company that defines it otherwise - and insurance companies aren't exactly run by doctors.

You run through the same bureaucracy bullshit in the US as you do in other countries, but in the US you pay more for the privilege.