16 ms·

A CT scan costs $1,100 in the US – and $140 in Holland

71 points by alweare 7y ago

eucryphia 7y ago
Depends where you shop https://surgerycenterok.com/blog-category/veterinarian-cat-scan-prices/ https://surgerycenterok.com/blog-category/veterinarian-cat-s...
- deleted 7y ago
  [deleted]
nkkollaw 7y ago
Next on Vox: "Magic mushrooms are illegal in the US — but they're legal in Holland".
- bagacrap 7y ago
  I thought it was only truffles that were legal.
- Bubbadoo 7y ago
  Actually, Colorado legalized magic mushrooms earlier this year. Go figure...
themagician 7y ago
It's pretty disingenuous when articles are written about the US healthcare system and they don't talk about methodology for how they determined the price. It's absurd that a methodology is needed, but it is. Is it the average price of the item on the chargemaster? Is it the average price billed to the insurance company? Or is is the average price billed to the patient? Is it the average price for those with insurance, those without, or both? If it's the average price billed between insured and uninsured, is it weighted? And if we are talking about uninsured, is it the average price billed or paid? US healthcare is a disaster, but these kinds of articles are just promo pieces for universal healthcare. Which I guess is the point, but I still find it extremely misleading. I suppose this is what passes for journalism these days though. The only major healthcare provider I know of that posts prices actually charged for most items, publically, is Kaiser. Even then you'd need to know the relative breakdown of plans to determine the average cost paid by the patient. That information may be available, I don't know.
- Aeolun 7y ago
  Normally I think we wouldn't really need 'promo' pieces for universal healthcare, since it's been proven to work literally everywhere (except the US). Hell, even China has some form of universal healthcare.
Shivetya 7y ago
Oh please, cherry pick all you want. Healthcare is expensive in the US because of government, not just the industry. From certificate of need rules to conflicting regulation at nearly all levels and unreasonable coverage requirements that do not take the patient into account. throw in the simple fact the US Congress cannot even be shamed into fixing the Veteran Affairs health system nor the Bureau of Indian Services and people dare suggest we let take more control? fixing US health care will require a lot of work but the first step in fixing it is realizing all the bad players involved and that simply comparing to other systems isn't helping anyone.
- sharkmerry 7y ago
  This seems like whataboutism. is it just veteran care thats broken? Is active duty the same issue? We spend $843 per capita on just Administrative expenses in the US on healthcare. Its like 7-10% of Healthcare expenses. Do we really dare let this waste continue using private companies?
  - dx87 7y ago
    Active duty care is bad as well. A running joke in the military is that "motrin and water" is a miracle cure because it's the only thing you'll get prescribed without a ton of doctor visits. I personally know of two people that were diagnosed with cancer while they were active duty, and both were lucky to survive. One told the doctor he was having severe pain near his abdomen, and instead of doing any sort of examination, they just put him on a 6 month waiting list for hernia surgery. Turns out he had testicular cancer and after the 6 month wait, it had advanced pretty far and he immediately needed to start chemo. They told him he only had a 10% chance of living because the cancer had spread to his lymph nodes during the wait. Another friend kept complaining about headaches and they kept sending him away with motrin, and after a few months they finally did a full exam and they found out he had a brain tumor.
    - hurricanetc 7y ago
      Active duty care varies wildly from post to post. My wife and I experienced spectacular care but I have heard dozens and dozens of horror stories from people who were stationed elsewhere. What is really amazing is that active duty family care is basically magic. USFHP is virtually free and you can go to virtually any private doctor, practice, or hospital you want. It's the impossible dream of what government sponsored health care could be.
erentz 7y ago
Wife recently needed a CT scan of the chest. It was the correct imaging modality for the potential DX in question. An X-ray would be useless as it wouldn’t show the suspected issue. First insurance denied saying we had to have an X-ray first and that X-ray needed to be abnormal in order to justify the CT. But this would just be a waste of time and money since the X-ray is useless for the suspected issue in question, and then it would also undoubtedly caused problems because they would deny the CT when the X-ray wasn’t abnormal. It took 3 hours of my time. About 3 hours of medical assistant time and about an hour of two different doctors time to get this simple 5 minute CT approved. This is all on top of the time of admins at the insurance company. The CT was done and low and behold did show an abnormality. The charge was around $2000 to insurance which was lowered to about $1150 by the negotiated rates. Of which we paid the $115 coinsurance (10%). We asked what the cash price would’ve been to avoid all this, $450. So our 10% coinsurance is actually more like 25% of the real price. And the insurance companies denial and absurd process could only possibly make sense over just always unquestionably paying the cash price if 1 in 3 CTs ordered by doctors in such a scheme was fraudulent. I seriously doubt that would ever be the case. And that’s still ignoring the personnel cost in this example. And the opportunity cost of those personnel not being able to spend that time on actual medical needs of other patients. The system is disgustingly broken in this country, we need to move to a single payer system and get these insurance companies out of the way.
- glennvtx 7y ago
  No we do not. The government has screwed the system up enough, giving this government even more control is a terrible idea. Just stop enforcing monopolies, Force providers to have a clear pricing structure and let market forces deal with it.
  - wmeredith 7y ago
    The market forces did deal with it and created entities large enough to perform regulatory capture and here we are.
    - cheaprentalyeti 7y ago
glennvtx 7y ago
I am in the US and my Ct cost $180, because i bothered to shop around, even a little.
- atombender 7y ago
  Coming from a country with excellent universal healthcare, I find it absurd that you should need to "shop around" for any procedure.
  - exclusiv 7y ago
    For this case, it is silly for a CT. However, for procedures and surgeries, not all doctors are equal. Do you have any choice in your country?
    - atombender 7y ago
      Yes, you can absolutely choose. There's a web site for finding hospitals/clinics for your particular procedure, although your doctor can also refer you directly. The web site tracks the wait time and (often) publicly available quality metrics collected by the health authorities. Travel expenses are covered to some extent if you don't want to use your local options.
glennvtx 7y ago
My CT cost $180 in the US because i bothered to shop around.. I see these articles all the time cherry-picking The only reason healthcare in the US is high is government enforcing monopolies, Giving them more power over healthcare is foolish. If you are the least bit smart you call around, that is the nature of a market.
- Aeolun 7y ago
  When my health is on the line, I do not want to do anything like shopping around. I want the hospital I'm currently at to do the thing for a reasonable rate. Preferably the same rate as every other hospital in the country charges for the same scan.
  - virmundi 7y ago
    The US is too large to have the same uniform price. The cost of materials, rent, and labor vary radically across state lines. Second, for things like CT, they might now be immediate. Therefore you can shop around. For example I had an MRI. $200 after shopping around. Now it wasn’t an emergency, just a check for cancer. Don’t let the assumed to be perfect be the enemy of the good.
    - Data_Junkie 7y ago
      The US is too corrupted with evil politicians to have adequate health care, because you need adequate, healthy people to implement that and we have Donald Trump and his kindred spirits. It's not rocket science, you have to care to make changes, and they simply don't care. Melania said it best.
  - deogeo 7y ago
    Of the cases I heard where people did try to shop around, simply getting price information was nearly if not completely impossible.
  - mindslight 7y ago
    > When my health is on the line, I do not want to do anything like shopping around. How do you obtain food then? Do you not go to grocery stores or restaurants? But talking about just medical services, sure there are many situations where a patient has vanishingly little opportunity to shop around, and applying the market ethic is really just a blessing to price gouge. But there are also many situations that aren't so time critical (like anything that insurance companies currently insist on "authorizing"), where it would be quite easy to shop around if providers had to charge everyone the same price and publish it.
pcurve 7y ago
Let's call it health industrial complex. If you have a white collar job at any one of health care companies in the u.s. (medical health insurance, hospital, pharma, device makers, pharmacy benefits, retail pharmacies, doctors office) you know why healthcare is really expensive in the U.S. There are lots and lots of white collar jobs that are extremely handsomely paid. So many duplication of functions across competing private companies. No good standardization. Surgeons that make well into 7 figures. Thousands of executives making tens of millions of dollars in total comps. Thousands of highly paid IT professionals just at one large healthcare companies. Pharmacists raking in $130-150k. Lawyers and malpractice suits. All #1 in the world. Somebody has to pay for all these rackets.(of which I'm also part of)
bdcravens 7y ago
My wife had a series of CT scans in the ER after a car accident. I noticed that most of them were only paid out at 1/20th of the billed rate. I wonder if the pricing is gaming the accounting, since most people either have some sort of coverage, or can't realistically pay (so the hospital doesn't get the full amount either way)?
m0zg 7y ago
A drug for my kid's IBS costs $1400 in the US and $30 in Russia (and moreover, it's available over the counter there). Same exact drug. Made in Italy, so it's probably cheaper still in Italy. It's not genetic or anything else that would justify a high price - it's a simple antibiotic. Probably costs a dollar a gallon to make. I'm seriously considering finding a good clinic in e.g. Israel where I could pay cash for treatment, and giving up US medical insurance entirely. Thankfully now I can do that without paying a penalty. $15K/yr for a family of 3, with crazy deductibles is kooky. If I get cancer or something, getting treatment in the US would be an insane proposition.
AbortedLaunch 7y ago
Health care in the Netherlands is mostly financed via an income dependent fee collected by the tax authority, supplemented with a fairly minimal mandatory insurance. Assistance for “low” income families is available to help pay this insurance. The per treatment budgets do sometimes cause issues where budget for certain treatments is consumed and patients have to wait to receive treatment.
- bouke 7y ago
  Yes, it’s 6,9% over the total gross of all salaries, paid by the employer. See also: https://www.belastingdienst.nl/wps/wcm/connect/bldcontentnl/belastingdienst/prive/werk_en_inkomen/zorgverzekeringswet/veranderingen-bijdrage-zvw/percentages-zvw https://www.belastingdienst.nl/wps/wcm/connect/bldcontentnl/... (Dutch)
mbrodersen 7y ago
What is the point of the US having the worlds largest GDP when even basic health and education is denied or difficult for large groups of its citizens?
- wincy 7y ago
  I mean it seems bad on paper but my uncle just recently got cancer and despite having no money is now cured. He ended up on disability, but he received prompt treatment. It just sort of works out. My daughter was born when I was unemployed and this actually ended up being better for us, as the private insurance would have had a copay but instead Medicaid applied retroactively and then covered her 8 month NICU stay. Thank you, taxpayers, for supporting my daughters $300,000 a month hospital stay. Maybe some people’s lives get ruined by medical debt but I’ve never met them. People just don’t pay and even mortgage companies just sort of shrug and barely care when you’re getting a loan.
  - dsign 7y ago
    Do you realize how many complicated terms are in your first paragraph? Assuming that everybody can figure out how all those mechanisms work, which is a big stretch, it is terribly stressing to have a medical need of any sort. And I know that because I have family there. Compare it with the single-payer system where I live: it works really well, and I don't need to add financial stress to any doctor visit.
yread 7y ago
One reason also is that the workers in healthcare in the Netherlands are not paid much. As an IT person (clinical programmer, bioinformatician, application specialist,...) there is no way to get above scale 60 in this table https://cao-ziekenhuizen.nl/media/45/download https://cao-ziekenhuizen.nl/media/45/download Most get ~3k some with insane amount of experience get ~4k brutto a month
- adventured 7y ago
  It's the same reason the median radiologist in France will earn $150,000 while radiologists in the US can easily earn four to six times that depending on location. I know a radiologist in the middle of nowhere - one of the poorest states in the US, small city - earning over half a million per year, or roughly 15 times the median full-time income there. In major cities they can get up around a million dollars per year. The healthcare industrial complex racket is a wealth transfer from everybody else to a million people working overly compensated jobs in the healthcare sector, from admin to doctors to nurses to IT workers to insurance salespersons. Everyone complains about the wasted money in the military industrial complex. The healthcare industrial complex is 5x worse when it comes to that, or roughly a minimum of $1 trillion in overspending. The reason there are so few suggesting spending cuts in healthcare, is because there would be a never-ending line of strikes if you attempt to slash pay. The Democrat candidates for President for example all know we have a vast overspending problem in healthcare, they know taxes on the middle class have to go up to match Europe (for the same reason their taxes are so high), and salaries have to go way down in the healthcare field to similarly match Europe, and yet none of them dare say it.
9c8675a8 7y ago
No it doesn't. It proooobably actually costs way more in Holland because of higher taxes and govt fees on everything. Hidden (tho not very well) costs and price.
tsukikage 7y ago
"but the US system has to actually pay for the R&D the rest of the world piggybacks on", goes the standard counter.

71 points by alweare 7y ago

Depends where you shop https://surgerycenterok.com/blog-category/veterinarian-cat-scan-prices/ https://surgerycenterok.com/blog-category/veterinarian-cat-s...

deleted 7y ago
[deleted]

nkkollaw 7y ago

Next on Vox: "Magic mushrooms are illegal in the US — but they're legal in Holland".

bagacrap 7y ago
I thought it was only truffles that were legal.
Bubbadoo 7y ago
Actually, Colorado legalized magic mushrooms earlier this year. Go figure...

themagician 7y ago

It's pretty disingenuous when articles are written about the US healthcare system and they don't talk about methodology for how they determined the price. It's absurd that a methodology is needed, but it is. Is it the average price of the item on the chargemaster? Is it the average price billed to the insurance company? Or is is the average price billed to the patient? Is it the average price for those with insurance, those without, or both? If it's the average price billed between insured and uninsured, is it weighted? And if we are talking about uninsured, is it the average price billed or paid? US healthcare is a disaster, but these kinds of articles are just promo pieces for universal healthcare. Which I guess is the point, but I still find it extremely misleading. I suppose this is what passes for journalism these days though. The only major healthcare provider I know of that posts prices actually charged for most items, publically, is Kaiser. Even then you'd need to know the relative breakdown of plans to determine the average cost paid by the patient. That information may be available, I don't know.

Aeolun 7y ago
Normally I think we wouldn't really need 'promo' pieces for universal healthcare, since it's been proven to work literally everywhere (except the US). Hell, even China has some form of universal healthcare.

Shivetya 7y ago

Oh please, cherry pick all you want. Healthcare is expensive in the US because of government, not just the industry. From certificate of need rules to conflicting regulation at nearly all levels and unreasonable coverage requirements that do not take the patient into account. throw in the simple fact the US Congress cannot even be shamed into fixing the Veteran Affairs health system nor the Bureau of Indian Services and people dare suggest we let take more control? fixing US health care will require a lot of work but the first step in fixing it is realizing all the bad players involved and that simply comparing to other systems isn't helping anyone.

sharkmerry 7y ago
This seems like whataboutism. is it just veteran care thats broken? Is active duty the same issue? We spend $843 per capita on just Administrative expenses in the US on healthcare. Its like 7-10% of Healthcare expenses. Do we really dare let this waste continue using private companies?
- dx87 7y ago
  Active duty care is bad as well. A running joke in the military is that "motrin and water" is a miracle cure because it's the only thing you'll get prescribed without a ton of doctor visits. I personally know of two people that were diagnosed with cancer while they were active duty, and both were lucky to survive. One told the doctor he was having severe pain near his abdomen, and instead of doing any sort of examination, they just put him on a 6 month waiting list for hernia surgery. Turns out he had testicular cancer and after the 6 month wait, it had advanced pretty far and he immediately needed to start chemo. They told him he only had a 10% chance of living because the cancer had spread to his lymph nodes during the wait. Another friend kept complaining about headaches and they kept sending him away with motrin, and after a few months they finally did a full exam and they found out he had a brain tumor.
  - hurricanetc 7y ago
    Active duty care varies wildly from post to post. My wife and I experienced spectacular care but I have heard dozens and dozens of horror stories from people who were stationed elsewhere. What is really amazing is that active duty family care is basically magic. USFHP is virtually free and you can go to virtually any private doctor, practice, or hospital you want. It's the impossible dream of what government sponsored health care could be.

erentz 7y ago

Wife recently needed a CT scan of the chest. It was the correct imaging modality for the potential DX in question. An X-ray would be useless as it wouldn’t show the suspected issue. First insurance denied saying we had to have an X-ray first and that X-ray needed to be abnormal in order to justify the CT. But this would just be a waste of time and money since the X-ray is useless for the suspected issue in question, and then it would also undoubtedly caused problems because they would deny the CT when the X-ray wasn’t abnormal. It took 3 hours of my time. About 3 hours of medical assistant time and about an hour of two different doctors time to get this simple 5 minute CT approved. This is all on top of the time of admins at the insurance company. The CT was done and low and behold did show an abnormality. The charge was around $2000 to insurance which was lowered to about $1150 by the negotiated rates. Of which we paid the $115 coinsurance (10%). We asked what the cash price would’ve been to avoid all this, $450. So our 10% coinsurance is actually more like 25% of the real price. And the insurance companies denial and absurd process could only possibly make sense over just always unquestionably paying the cash price if 1 in 3 CTs ordered by doctors in such a scheme was fraudulent. I seriously doubt that would ever be the case. And that’s still ignoring the personnel cost in this example. And the opportunity cost of those personnel not being able to spend that time on actual medical needs of other patients. The system is disgustingly broken in this country, we need to move to a single payer system and get these insurance companies out of the way.

glennvtx 7y ago
No we do not. The government has screwed the system up enough, giving this government even more control is a terrible idea. Just stop enforcing monopolies, Force providers to have a clear pricing structure and let market forces deal with it.
- wmeredith 7y ago
  The market forces did deal with it and created entities large enough to perform regulatory capture and here we are.
  - cheaprentalyeti 7y ago

glennvtx 7y ago

I am in the US and my Ct cost $180, because i bothered to shop around, even a little.

atombender 7y ago
Coming from a country with excellent universal healthcare, I find it absurd that you should need to "shop around" for any procedure.
- exclusiv 7y ago
  For this case, it is silly for a CT. However, for procedures and surgeries, not all doctors are equal. Do you have any choice in your country?
  - atombender 7y ago
    Yes, you can absolutely choose. There's a web site for finding hospitals/clinics for your particular procedure, although your doctor can also refer you directly. The web site tracks the wait time and (often) publicly available quality metrics collected by the health authorities. Travel expenses are covered to some extent if you don't want to use your local options.

glennvtx 7y ago

My CT cost $180 in the US because i bothered to shop around.. I see these articles all the time cherry-picking The only reason healthcare in the US is high is government enforcing monopolies, Giving them more power over healthcare is foolish. If you are the least bit smart you call around, that is the nature of a market.

Aeolun 7y ago
When my health is on the line, I do not want to do anything like shopping around. I want the hospital I'm currently at to do the thing for a reasonable rate. Preferably the same rate as every other hospital in the country charges for the same scan.
- virmundi 7y ago
  The US is too large to have the same uniform price. The cost of materials, rent, and labor vary radically across state lines. Second, for things like CT, they might now be immediate. Therefore you can shop around. For example I had an MRI. $200 after shopping around. Now it wasn’t an emergency, just a check for cancer. Don’t let the assumed to be perfect be the enemy of the good.
  - Data_Junkie 7y ago
    The US is too corrupted with evil politicians to have adequate health care, because you need adequate, healthy people to implement that and we have Donald Trump and his kindred spirits. It's not rocket science, you have to care to make changes, and they simply don't care. Melania said it best.
- deogeo 7y ago
  Of the cases I heard where people did try to shop around, simply getting price information was nearly if not completely impossible.
- mindslight 7y ago
  > When my health is on the line, I do not want to do anything like shopping around. How do you obtain food then? Do you not go to grocery stores or restaurants? But talking about just medical services, sure there are many situations where a patient has vanishingly little opportunity to shop around, and applying the market ethic is really just a blessing to price gouge. But there are also many situations that aren't so time critical (like anything that insurance companies currently insist on "authorizing"), where it would be quite easy to shop around if providers had to charge everyone the same price and publish it.

pcurve 7y ago

Let's call it health industrial complex. If you have a white collar job at any one of health care companies in the u.s. (medical health insurance, hospital, pharma, device makers, pharmacy benefits, retail pharmacies, doctors office) you know why healthcare is really expensive in the U.S. There are lots and lots of white collar jobs that are extremely handsomely paid. So many duplication of functions across competing private companies. No good standardization. Surgeons that make well into 7 figures. Thousands of executives making tens of millions of dollars in total comps. Thousands of highly paid IT professionals just at one large healthcare companies. Pharmacists raking in $130-150k. Lawyers and malpractice suits. All #1 in the world. Somebody has to pay for all these rackets.(of which I'm also part of)

bdcravens 7y ago

My wife had a series of CT scans in the ER after a car accident. I noticed that most of them were only paid out at 1/20th of the billed rate. I wonder if the pricing is gaming the accounting, since most people either have some sort of coverage, or can't realistically pay (so the hospital doesn't get the full amount either way)?

m0zg 7y ago

A drug for my kid's IBS costs $1400 in the US and $30 in Russia (and moreover, it's available over the counter there). Same exact drug. Made in Italy, so it's probably cheaper still in Italy. It's not genetic or anything else that would justify a high price - it's a simple antibiotic. Probably costs a dollar a gallon to make. I'm seriously considering finding a good clinic in e.g. Israel where I could pay cash for treatment, and giving up US medical insurance entirely. Thankfully now I can do that without paying a penalty. $15K/yr for a family of 3, with crazy deductibles is kooky. If I get cancer or something, getting treatment in the US would be an insane proposition.

AbortedLaunch 7y ago

Health care in the Netherlands is mostly financed via an income dependent fee collected by the tax authority, supplemented with a fairly minimal mandatory insurance. Assistance for “low” income families is available to help pay this insurance. The per treatment budgets do sometimes cause issues where budget for certain treatments is consumed and patients have to wait to receive treatment.

bouke 7y ago
Yes, it’s 6,9% over the total gross of all salaries, paid by the employer. See also: https://www.belastingdienst.nl/wps/wcm/connect/bldcontentnl/belastingdienst/prive/werk_en_inkomen/zorgverzekeringswet/veranderingen-bijdrage-zvw/percentages-zvw https://www.belastingdienst.nl/wps/wcm/connect/bldcontentnl/... (Dutch)

mbrodersen 7y ago

What is the point of the US having the worlds largest GDP when even basic health and education is denied or difficult for large groups of its citizens?

wincy 7y ago
I mean it seems bad on paper but my uncle just recently got cancer and despite having no money is now cured. He ended up on disability, but he received prompt treatment. It just sort of works out. My daughter was born when I was unemployed and this actually ended up being better for us, as the private insurance would have had a copay but instead Medicaid applied retroactively and then covered her 8 month NICU stay. Thank you, taxpayers, for supporting my daughters $300,000 a month hospital stay. Maybe some people’s lives get ruined by medical debt but I’ve never met them. People just don’t pay and even mortgage companies just sort of shrug and barely care when you’re getting a loan.
- dsign 7y ago
  Do you realize how many complicated terms are in your first paragraph? Assuming that everybody can figure out how all those mechanisms work, which is a big stretch, it is terribly stressing to have a medical need of any sort. And I know that because I have family there. Compare it with the single-payer system where I live: it works really well, and I don't need to add financial stress to any doctor visit.

yread 7y ago

One reason also is that the workers in healthcare in the Netherlands are not paid much. As an IT person (clinical programmer, bioinformatician, application specialist,...) there is no way to get above scale 60 in this table https://cao-ziekenhuizen.nl/media/45/download https://cao-ziekenhuizen.nl/media/45/download Most get ~3k some with insane amount of experience get ~4k brutto a month

adventured 7y ago
It's the same reason the median radiologist in France will earn $150,000 while radiologists in the US can easily earn four to six times that depending on location. I know a radiologist in the middle of nowhere - one of the poorest states in the US, small city - earning over half a million per year, or roughly 15 times the median full-time income there. In major cities they can get up around a million dollars per year. The healthcare industrial complex racket is a wealth transfer from everybody else to a million people working overly compensated jobs in the healthcare sector, from admin to doctors to nurses to IT workers to insurance salespersons. Everyone complains about the wasted money in the military industrial complex. The healthcare industrial complex is 5x worse when it comes to that, or roughly a minimum of $1 trillion in overspending. The reason there are so few suggesting spending cuts in healthcare, is because there would be a never-ending line of strikes if you attempt to slash pay. The Democrat candidates for President for example all know we have a vast overspending problem in healthcare, they know taxes on the middle class have to go up to match Europe (for the same reason their taxes are so high), and salaries have to go way down in the healthcare field to similarly match Europe, and yet none of them dare say it.

9c8675a8 7y ago

No it doesn't. It proooobably actually costs way more in Holland because of higher taxes and govt fees on everything. Hidden (tho not very well) costs and price.

tsukikage 7y ago

"but the US system has to actually pay for the R&D the rest of the world piggybacks on", goes the standard counter.