6 ms·

Just curious why are MRI and CT machines so expensive? They are the ultimate tool for debugging the human body. Shouldn't they be very affordable?

by nojvek 10y ago

nordify 10y ago
Scans do not need to be crazy expensive. In Finland, unsubsidized, undiscounted and no questions asked, just pay prices for scans from a private health company are 258€. Expensive, yes. Crazy expensive, no.
- masklinn 10y ago
  During the ACA runup a few years back, japanese neck MRI were quoted below $100.
  - tim333 10y ago
    You can get the scans in India for ~ $50-$100 if you're out that way https://www.medifee.com/tests/mri-scan-cost/ https://www.medifee.com/tests/mri-scan-cost/ https://blog.labsadvisor.com/2016/05/28/ct-scan-cost-in-delhi-ncr/ https://blog.labsadvisor.com/2016/05/28/ct-scan-cost-in-delh...
tominous 10y ago
Your comment is basically Anselm's ontological argument. Very strange to see it applied to medical imaging!
wyager 10y ago
Cost inflation in the US is huge due to a combination of red tape, CYA, customers with good insurance subsidizing people with bad/no insurance, and many other factors. There's no simple answer, unfortunately. No one is entirely sure why medical costs are so high in the US. It doesn't appear to be any one factor that people commonly blame. Fundamentally, they don't need to be expensive; via private medical tourism, you can get any sort of scan at a fraction of the US cost.
- throwawaydbdksn 10y ago
  The problem is everyone gets paid too much. Our doctors salaries are far out of line with most countries , we have the strictest drug pricing laws in the world, and people love to sue. We also have a significant portion of the population paying no medical bills while the rest is overcharged to compensate. On top of that our health insurance is full of middle men like "PBM's" that do nothing but raise costs. The combo means docs, drugs, treatment, and insurance are all more costly. A fix is hard to come by but would work something like this. 1)subsidize the cost of medical school increasing supply of MDS 2)pass laws to protect physicians from frivolous lawsuits or at least limit damages. 3)disallow drug companies from advertising, ban rampant kickbacks to doc's that prescribe their drugs 4)ban anti competitive practices that prevent insurance companies from negotiating prices directly with manufacturers. 5) provide healthcare centers of last resort(the ER) compensation for patients unable to pay. My last point is state specific and really controversial but it's based on what I've personally seen. States with a lot of illegal immigrants spend an enormous amount for healthcare at the ER for these people. Around 1/4 of the people that came into the ER I was familiar with were likely illegal and over 90% either gave a fake name or never paid. The majority of those costs are passed on to those with insurance. I lived in an area with probably 3% of the population were undocumented. Since the ER is healthcare of last resort they are forced to treat you even if you give them completely false info with no intention of paying. Illegal immigrants know this and preferentially go to the ER because they get treated without probing questions or need to pay. They also already have fake ID's in most cases so giving one to the hospital isn't a big deal. This enomous cost gets buried because it's politically unpopular to say and because the hospital just raises prices in everyone else to compensate.
  - csydas 10y ago
    Alternatively, increased free clinics for basic healthcare (flu, checkups, non-emergency procedures) could eliminate a large percentage of wasted effort and time. Free regular checkups just a few times a year would catch so many issues before they became big expensive issues and it would eliminate the use of the ER as a general physician visit. We're already paying out crazy amounts for doctors time and for expensive visits, might as well make the basic health checks free. No need to bring insurance in on matters like just having a doctor write "you have the flu. Rest 4 days and take this" when the entire operation is 15 minutes for a quick culture.
patrickg_zill 10y ago
I was quoted prices that varied by almost ten times when I was looking for a CT scan. An independent lab, owned by the head of radiology at a hospital in another County, was $268 USD if paid at time of service, cash or credit card. He used to have several locations, but the other hospital bought out all the locations near them. And closed them almost immediately.
- mistermann 10y ago
  And this is just one of the many problems with the US medical system, even if it went to a single payer system taking the individual off the hook, the cost of delivery is completely out of control due to (in my opinion) a lack of "proper" capitalism. Perhaps any acquisitions in the field of medicine should be subject to antitrust laws?
  - hellohappy1234 10y ago
    They are the subject of antitrust laws. Hospital mergers are often blocked due to this very issue
rcxdude 10y ago
They are hugely complex pieces of kit, manufactured in relatively low volumes and requiring lots of specialized materials and development. Not an easy thing to cost-reduce. (That said, each scan has very low marginal cost).
- BostonEnginerd 10y ago
  I agree that they're highly complicated, but they're made in surprisingly large volumes. There are 5,564 hospitals in the US, and each one will likely have several. A manufacturer will probably ship 500 units/year. This is decent enough volume where you can drive good cost reductions.
hellohappy1234 10y ago
I think there is an important point for people to remember: The cost of a procedure, like a CT scan, is not the cost of the procedure. The amount you are getting charged is the Chargemaster rate. The Chargemaster rate is the same no matter who you are, the different is what people pay from the chargemaster bill. Let's say you are given tylenol and the charge master is $50. The reason why this is so high is because medicare will then say that they pay , say, 20% the chargemaster rate, and thus elderly patients pay $10. This is why elderly patients are seen as great patients for revenue: They all actually can pay something, even if its only a fraction of the chargemaster. A gold plated insurance patient will pay Medicare+30%, and thus the gold plate insurance pays $20. The patient with no insurance then is also billed $50 because they don't have an agreement with the hospital. Thus, what likely happens is that they pay $0 and goes bankrupt, or more likely, these patients don't have any net worth at all. This creates a weird situation where the homeless, destute, and people with no net worth essentially get infinitely free healthcare. These patients tend to be very high volume healthcare users (homeless patients that take $5000 ambulance rides as taxis because they know they will never actually pay a penny, despite having millions of dollars of charges.). This is what the Affordable Care act tried to prevent: by making people pay something, you were actually decreasing costs for all because you remove free riders who present the majority of sunk costs in the healthcare system. Very few people if ever pay for the full cost of a procedure or chargemaster. The chargemaster is a negotiation tactic. Not a final bill. That is why a CT Scan costs thousands of dollars. Because everyone knows you'll only end up paying a fraction of that if you have insurance. And if you pay cash, its only a few hundred bucks, because thats how much people get paid anyways. Source: I'm an ER Doc.I do research in healthcare and billing
- cli 10y ago
  What do, for example, tourists pay? When I buy a plane ticket to the US, there is travel insurance, but I have never needed to use it and do not know how it would work.

Just curious why are MRI and CT machines so expensive? They are the ultimate tool for debugging the human body. Shouldn't they be very affordable?

by nojvek 10y ago

Just curious why are MRI and CT machines so expensive? They are the ultimate tool for debugging the human body. Shouldn't they be very affordable?

nordify 10y ago

Scans do not need to be crazy expensive. In Finland, unsubsidized, undiscounted and no questions asked, just pay prices for scans from a private health company are 258€. Expensive, yes. Crazy expensive, no.

masklinn 10y ago
During the ACA runup a few years back, japanese neck MRI were quoted below $100.
- tim333 10y ago
  You can get the scans in India for ~ $50-$100 if you're out that way https://www.medifee.com/tests/mri-scan-cost/ https://www.medifee.com/tests/mri-scan-cost/ https://blog.labsadvisor.com/2016/05/28/ct-scan-cost-in-delhi-ncr/ https://blog.labsadvisor.com/2016/05/28/ct-scan-cost-in-delh...

tominous 10y ago

Your comment is basically Anselm's ontological argument. Very strange to see it applied to medical imaging!

wyager 10y ago

Cost inflation in the US is huge due to a combination of red tape, CYA, customers with good insurance subsidizing people with bad/no insurance, and many other factors. There's no simple answer, unfortunately. No one is entirely sure why medical costs are so high in the US. It doesn't appear to be any one factor that people commonly blame. Fundamentally, they don't need to be expensive; via private medical tourism, you can get any sort of scan at a fraction of the US cost.

throwawaydbdksn 10y ago
The problem is everyone gets paid too much. Our doctors salaries are far out of line with most countries , we have the strictest drug pricing laws in the world, and people love to sue. We also have a significant portion of the population paying no medical bills while the rest is overcharged to compensate. On top of that our health insurance is full of middle men like "PBM's" that do nothing but raise costs. The combo means docs, drugs, treatment, and insurance are all more costly. A fix is hard to come by but would work something like this. 1)subsidize the cost of medical school increasing supply of MDS 2)pass laws to protect physicians from frivolous lawsuits or at least limit damages. 3)disallow drug companies from advertising, ban rampant kickbacks to doc's that prescribe their drugs 4)ban anti competitive practices that prevent insurance companies from negotiating prices directly with manufacturers. 5) provide healthcare centers of last resort(the ER) compensation for patients unable to pay. My last point is state specific and really controversial but it's based on what I've personally seen. States with a lot of illegal immigrants spend an enormous amount for healthcare at the ER for these people. Around 1/4 of the people that came into the ER I was familiar with were likely illegal and over 90% either gave a fake name or never paid. The majority of those costs are passed on to those with insurance. I lived in an area with probably 3% of the population were undocumented. Since the ER is healthcare of last resort they are forced to treat you even if you give them completely false info with no intention of paying. Illegal immigrants know this and preferentially go to the ER because they get treated without probing questions or need to pay. They also already have fake ID's in most cases so giving one to the hospital isn't a big deal. This enomous cost gets buried because it's politically unpopular to say and because the hospital just raises prices in everyone else to compensate.
- csydas 10y ago
  Alternatively, increased free clinics for basic healthcare (flu, checkups, non-emergency procedures) could eliminate a large percentage of wasted effort and time. Free regular checkups just a few times a year would catch so many issues before they became big expensive issues and it would eliminate the use of the ER as a general physician visit. We're already paying out crazy amounts for doctors time and for expensive visits, might as well make the basic health checks free. No need to bring insurance in on matters like just having a doctor write "you have the flu. Rest 4 days and take this" when the entire operation is 15 minutes for a quick culture.

patrickg_zill 10y ago

I was quoted prices that varied by almost ten times when I was looking for a CT scan. An independent lab, owned by the head of radiology at a hospital in another County, was $268 USD if paid at time of service, cash or credit card. He used to have several locations, but the other hospital bought out all the locations near them. And closed them almost immediately.

mistermann 10y ago
And this is just one of the many problems with the US medical system, even if it went to a single payer system taking the individual off the hook, the cost of delivery is completely out of control due to (in my opinion) a lack of "proper" capitalism. Perhaps any acquisitions in the field of medicine should be subject to antitrust laws?
- hellohappy1234 10y ago
  They are the subject of antitrust laws. Hospital mergers are often blocked due to this very issue

rcxdude 10y ago

They are hugely complex pieces of kit, manufactured in relatively low volumes and requiring lots of specialized materials and development. Not an easy thing to cost-reduce. (That said, each scan has very low marginal cost).

BostonEnginerd 10y ago
I agree that they're highly complicated, but they're made in surprisingly large volumes. There are 5,564 hospitals in the US, and each one will likely have several. A manufacturer will probably ship 500 units/year. This is decent enough volume where you can drive good cost reductions.

hellohappy1234 10y ago

I think there is an important point for people to remember: The cost of a procedure, like a CT scan, is not the cost of the procedure. The amount you are getting charged is the Chargemaster rate. The Chargemaster rate is the same no matter who you are, the different is what people pay from the chargemaster bill. Let's say you are given tylenol and the charge master is $50. The reason why this is so high is because medicare will then say that they pay , say, 20% the chargemaster rate, and thus elderly patients pay $10. This is why elderly patients are seen as great patients for revenue: They all actually can pay something, even if its only a fraction of the chargemaster. A gold plated insurance patient will pay Medicare+30%, and thus the gold plate insurance pays $20. The patient with no insurance then is also billed $50 because they don't have an agreement with the hospital. Thus, what likely happens is that they pay $0 and goes bankrupt, or more likely, these patients don't have any net worth at all. This creates a weird situation where the homeless, destute, and people with no net worth essentially get infinitely free healthcare. These patients tend to be very high volume healthcare users (homeless patients that take $5000 ambulance rides as taxis because they know they will never actually pay a penny, despite having millions of dollars of charges.). This is what the Affordable Care act tried to prevent: by making people pay something, you were actually decreasing costs for all because you remove free riders who present the majority of sunk costs in the healthcare system. Very few people if ever pay for the full cost of a procedure or chargemaster. The chargemaster is a negotiation tactic. Not a final bill. That is why a CT Scan costs thousands of dollars. Because everyone knows you'll only end up paying a fraction of that if you have insurance. And if you pay cash, its only a few hundred bucks, because thats how much people get paid anyways. Source: I'm an ER Doc.I do research in healthcare and billing

cli 10y ago
What do, for example, tourists pay? When I buy a plane ticket to the US, there is travel insurance, but I have never needed to use it and do not know how it would work.