6 ms·

In Canada, my pharmacist is assessing my thyroid hormone level. It's an easy job. I got the blood drawn in the pharmacy for... $15. That part was considered pri

In Canada, my pharmacist is assessing my thyroid hormone level. It's an easy job. I got the blood drawn in the pharmacy for... $15. That part was considered private healthcare. How much would it cost me in US to get a blood sample sent to a clinician for my TSH to be checked?

Bilal_io 4y ago
Not sure what "minimum" means here, but here is some data: https://www.findlabtest.com/lab-test/thyroid-testing/ https://www.findlabtest.com/lab-test/thyroid-testing/ https://health.costhelper.com/thyroid.html https://health.costhelper.com/thyroid.html
tptacek 4y ago
It depends on whether you called your family care doctor or went to urgent care.
- olliej 4y ago
  I mean yes, but also unhelpful. The majority of people aren’t going to urgent care for random checkups. The over reliance on urgent care in the US is a byproduct of a system that means people often have no other option (dr doesn’t take your particular insurance, your insurance doesn’t actually cover checkups, …) and the general cost of preventative care in the US meaning people don’t get things looked at prior to them becoming much bigger problems, where they do become urgent.
  - tptacek 4y ago
    The majority of people should go to urgent care for routine stuff. NPs are just as qualified to do that work as doctors, and have better escalation paths to the doctors. Just so we're clear: "urgent care" doesn't mean "ER".
    - tharne 4y ago
      > The majority of people should go to urgent care for routine stuff Most medical providers would advise against this. Managing someone's health is not the same thing as changing the oil in a car. It's immensely helpful for the medical provider to develop a working relationship with the patient and understand the person's conditions and medications.
      - tptacek 4y ago
        The point of going to your provider's urgent care is that those links are already present. They're all working off the same charts.
        maxerickson 4y ago
        "routine stuff" probably isn't the best term to get people on the same page. You talk about availability in a couple other comments; at my provider, I can usually get an appointment with my PCP within a couple days, vs almost certainly waiting at least 30 minutes at the urgent care. I think the last routine thing I went in for was a sprain evaluation (I wanted advice on strengthening the joint more than I was expecting any immediately useful treatment). There wasn't any urgency there really, and I wanted to discuss it with the doctor. If I thought I needed antibiotics for something I would just go to the urgent care.
        tptacek 4y ago
        Sore throats, fevers, rashes, allergic reactions, sprains, ear congestion, that kind of thing. Most people go to their PCP for these things, and urgent care is perfectly good at doing first line care for all of them; in fact, I've gotten more extensive care at the urgent care clinic than I ever have from a PCP. I won't go to urgent care for a physical.
    - olliej 4y ago
      > Just so we're clear: "urgent care" doesn't mean "ER". Ok, that changes my response quite a bit - because there's a real issue in the US where the set up of the healthcare system means people have to go to the ER, but urgent care is substantially different. However a lot of my points still stand: many urgent cares are associated with specific insurance or medical groups which means they simply aren't available. Additionally urgent care typically comes with a significant increase in costs, ruling them out for most.
deskamess 4y ago
And yet getting an appointment to see a Doctor is a multi-week process (Ontario). The last time I wanted to see my own Doctor was a 3 week wait for in-person and 10 day for a phone. I took the phone option because I had the issue before and wanted some feedback as soon as possible - I did get prescribed the same antibiotics - until then I self treated with OTC hoping it did not make matters worse. However there are many who do not have a provider and the walk-in system is not working effectively - most offices are not taking walk in patients. In Ontario, I think even online health provider systems are off, exacerbating the systemic problems. The rest of the family is losing their Dr in March due to retirement. Right now healthcare in Ontario is free and unavailable (empty store syndrome). The US system has always seemed available, especially Doctor/urgent care visits. Clearly there are procedures that are inaccessible to certain demographics.
- tharne 4y ago
  > And yet getting an appointment to see a Doctor is a multi-week process (Ontario). And there's the rub; in the U.S. you pay for healthcare with your money, and in Canada you pay with your time. There's no such thing as a free lunch.
  - notenoughbeans 4y ago
    You also pay with your money, just through less direct means.
  - stjohnswarts 4y ago
    I've heard this but no one ever cites any relevant studies that shows any such disparity.
    - tharne 4y ago
      You don't need a study. Enough people, myself included, have used the healthcare system multiple countries or have family in other places, that this is mostly common knowledge. That might not satisfy a debate judge, but it's good enough for most of us.
mikem170 4y ago
In most states in the U.S. you can order many tests for yourself, paying cash, no insurance involved. The TSH test you mentioned can be purchased for $49 [0] at the first place I found. Places doing this will coordinate the test appointment for you at a nearby local testing center, the same companies doctors might use, and the testing center would draw the blood sample for you. There's several states that may not allow tests like this to be ordered outside of a doctor visit, for your own good presumably. Using insurance and going through a doctor it can be difficult (understatement!) to find out what something will cost ahead of time. Your insurance may charge you $150 for a sick visit to the doctor, and the doctor may tell you there is no charge for the test, but unless you ask the right questions you won't find out that they are just talking about their part of taking the blood sample and ordering the test, they won't volunteer that there may be third party lab charges, and they and their office staff will have no idea what those charges might be. It can take a lot of time to chase down all the parties involved - your insurance company, the doctor, the lab, for other things maybe a radialogist, an anaesthesiologist, and/or facility charges at a hospital or clinic, medications from pharmacist, and so on, trying to find out what the total bill might be, and there are no guarantees, any of them can tell you one price and bill something different, it might depend on which billing codes are used for each procedure, and you may not get all the bills for months. Doctors have you sign a paper saying you will pay for anything deemed medically necessary, and these third parties will threaten to send you to collections based on that, if you complain. Typical insurance plans have a yearly deductable of several thousand dollars, applicable to non-preventive care, with the idea being to incentivize people to pay attention to the costs for routine care (there's also an out of pocket maximum, perhaps $10-15k per year). But the costs are obfuscated. It's not a free market system, it's a scam, a jobs program for health care administrators (3200% increase from 1975 to 2010) [1]. [0] https://www.testing.com/tests/thyroid-stimulating-hormone-tsh/ https://www.testing.com/tests/thyroid-stimulating-hormone-ts... [1] https://www.athenahealth.com/knowledge-hub/practice-management/expert-forum-rise-and-rise-healthcare-administrator https://www.athenahealth.com/knowledge-hub/practice-manageme...
- runnerup 4y ago
  GP said the TSH test was available for $15 in Canada. I found it also for $15 [0] in the USA as well as for $50 [1]. I also believe you can sometimes pay out of pocket for things like x-rays / MRI's in the USA and get them for surprisingly "affordable" rates (trivially affordable to those making >$100,000/year USD, utterly out of reach for kitchen workers). Sometimes though, the diagnostic facilities with the MRI machines will require a prescription, but that's nt mandated by law. 0: https://www.discountedlabs.com/thyroid-stimulating-hormone-tsh https://www.discountedlabs.com/thyroid-stimulating-hormone-t... 1: https://www.privatemdlabs.com/lab_tests.php?q=tsh&view=search_results https://www.privatemdlabs.com/lab_tests.php?q=tsh&view=searc...

Bilal_io 4y ago

Not sure what "minimum" means here, but here is some data: https://www.findlabtest.com/lab-test/thyroid-testing/ https://www.findlabtest.com/lab-test/thyroid-testing/ https://health.costhelper.com/thyroid.html https://health.costhelper.com/thyroid.html

tptacek 4y ago

It depends on whether you called your family care doctor or went to urgent care.

olliej 4y ago
I mean yes, but also unhelpful. The majority of people aren’t going to urgent care for random checkups. The over reliance on urgent care in the US is a byproduct of a system that means people often have no other option (dr doesn’t take your particular insurance, your insurance doesn’t actually cover checkups, …) and the general cost of preventative care in the US meaning people don’t get things looked at prior to them becoming much bigger problems, where they do become urgent.
- tptacek 4y ago
  The majority of people should go to urgent care for routine stuff. NPs are just as qualified to do that work as doctors, and have better escalation paths to the doctors. Just so we're clear: "urgent care" doesn't mean "ER".
  - tharne 4y ago
    > The majority of people should go to urgent care for routine stuff Most medical providers would advise against this. Managing someone's health is not the same thing as changing the oil in a car. It's immensely helpful for the medical provider to develop a working relationship with the patient and understand the person's conditions and medications.
    - tptacek 4y ago
      The point of going to your provider's urgent care is that those links are already present. They're all working off the same charts.
      - maxerickson 4y ago
        "routine stuff" probably isn't the best term to get people on the same page. You talk about availability in a couple other comments; at my provider, I can usually get an appointment with my PCP within a couple days, vs almost certainly waiting at least 30 minutes at the urgent care. I think the last routine thing I went in for was a sprain evaluation (I wanted advice on strengthening the joint more than I was expecting any immediately useful treatment). There wasn't any urgency there really, and I wanted to discuss it with the doctor. If I thought I needed antibiotics for something I would just go to the urgent care.
        tptacek 4y ago
        Sore throats, fevers, rashes, allergic reactions, sprains, ear congestion, that kind of thing. Most people go to their PCP for these things, and urgent care is perfectly good at doing first line care for all of them; in fact, I've gotten more extensive care at the urgent care clinic than I ever have from a PCP. I won't go to urgent care for a physical.
  - olliej 4y ago
    > Just so we're clear: "urgent care" doesn't mean "ER". Ok, that changes my response quite a bit - because there's a real issue in the US where the set up of the healthcare system means people have to go to the ER, but urgent care is substantially different. However a lot of my points still stand: many urgent cares are associated with specific insurance or medical groups which means they simply aren't available. Additionally urgent care typically comes with a significant increase in costs, ruling them out for most.

deskamess 4y ago

And yet getting an appointment to see a Doctor is a multi-week process (Ontario). The last time I wanted to see my own Doctor was a 3 week wait for in-person and 10 day for a phone. I took the phone option because I had the issue before and wanted some feedback as soon as possible - I did get prescribed the same antibiotics - until then I self treated with OTC hoping it did not make matters worse. However there are many who do not have a provider and the walk-in system is not working effectively - most offices are not taking walk in patients. In Ontario, I think even online health provider systems are off, exacerbating the systemic problems. The rest of the family is losing their Dr in March due to retirement. Right now healthcare in Ontario is free and unavailable (empty store syndrome). The US system has always seemed available, especially Doctor/urgent care visits. Clearly there are procedures that are inaccessible to certain demographics.

tharne 4y ago
> And yet getting an appointment to see a Doctor is a multi-week process (Ontario). And there's the rub; in the U.S. you pay for healthcare with your money, and in Canada you pay with your time. There's no such thing as a free lunch.
- notenoughbeans 4y ago
  You also pay with your money, just through less direct means.
- stjohnswarts 4y ago
  I've heard this but no one ever cites any relevant studies that shows any such disparity.
  - tharne 4y ago
    You don't need a study. Enough people, myself included, have used the healthcare system multiple countries or have family in other places, that this is mostly common knowledge. That might not satisfy a debate judge, but it's good enough for most of us.

mikem170 4y ago

In most states in the U.S. you can order many tests for yourself, paying cash, no insurance involved. The TSH test you mentioned can be purchased for $49 [0] at the first place I found. Places doing this will coordinate the test appointment for you at a nearby local testing center, the same companies doctors might use, and the testing center would draw the blood sample for you. There's several states that may not allow tests like this to be ordered outside of a doctor visit, for your own good presumably. Using insurance and going through a doctor it can be difficult (understatement!) to find out what something will cost ahead of time. Your insurance may charge you $150 for a sick visit to the doctor, and the doctor may tell you there is no charge for the test, but unless you ask the right questions you won't find out that they are just talking about their part of taking the blood sample and ordering the test, they won't volunteer that there may be third party lab charges, and they and their office staff will have no idea what those charges might be. It can take a lot of time to chase down all the parties involved - your insurance company, the doctor, the lab, for other things maybe a radialogist, an anaesthesiologist, and/or facility charges at a hospital or clinic, medications from pharmacist, and so on, trying to find out what the total bill might be, and there are no guarantees, any of them can tell you one price and bill something different, it might depend on which billing codes are used for each procedure, and you may not get all the bills for months. Doctors have you sign a paper saying you will pay for anything deemed medically necessary, and these third parties will threaten to send you to collections based on that, if you complain. Typical insurance plans have a yearly deductable of several thousand dollars, applicable to non-preventive care, with the idea being to incentivize people to pay attention to the costs for routine care (there's also an out of pocket maximum, perhaps $10-15k per year). But the costs are obfuscated. It's not a free market system, it's a scam, a jobs program for health care administrators (3200% increase from 1975 to 2010) [1]. [0] https://www.testing.com/tests/thyroid-stimulating-hormone-tsh/ https://www.testing.com/tests/thyroid-stimulating-hormone-ts... [1] https://www.athenahealth.com/knowledge-hub/practice-management/expert-forum-rise-and-rise-healthcare-administrator https://www.athenahealth.com/knowledge-hub/practice-manageme...

runnerup 4y ago
GP said the TSH test was available for $15 in Canada. I found it also for $15 [0] in the USA as well as for $50 [1]. I also believe you can sometimes pay out of pocket for things like x-rays / MRI's in the USA and get them for surprisingly "affordable" rates (trivially affordable to those making >$100,000/year USD, utterly out of reach for kitchen workers). Sometimes though, the diagnostic facilities with the MRI machines will require a prescription, but that's nt mandated by law. 0: https://www.discountedlabs.com/thyroid-stimulating-hormone-tsh https://www.discountedlabs.com/thyroid-stimulating-hormone-t... 1: https://www.privatemdlabs.com/lab_tests.php?q=tsh&view=search_results https://www.privatemdlabs.com/lab_tests.php?q=tsh&view=searc...