Explain like I’m European.
In: Other
Because you live in a country with a corrupt, profiteering healthcare system that is seen as a bit of a failure for a supposedly developed nation and laughing stock by most Europeans.
I had an MRI last year, didn’t pay for it other than through my taxes.
– Paying off the initial cost of the machine
– Paying the salaries of the doctors, nurses, technicians, radiologists and other hospital staff
– The hospital needs to make a profit
– Because they can charge thousands
Hospital’s chargemaster billing is approximately 7x-10x their actual costs, while insurance companies demand discounts of about 65-85% off the chargemaster price. If you don’t have insurance and offer to settle up with cash, hospitals will “magnanimously” offer 50% discounts, which still charges insurance-less patients about double what insurance companies negotiate.
The cost of an MRI scan is not just in completing the scan itself, but also the technicians time in preparing the patient and operating the machine, but perhaps most significantly, the radiologist’s interpretation of the results.
Perhaps a dirty little secret is that many doctors will simply read the radiologist’s interpretation, without even looking at the pretty pictures. Get your doctor to show you the pictures and point out the features that support the interpretation.
MRI machines have high maintenance costs too. They have liquid helium to cool the magnets. They use a lot of power. Also, the operator has overhead – a whole building to keep clean and lighted, insurance for that building, admin staff, elevators and parking lots and restrooms. They have computers and lots of expensive software for viewing images, telephones, office supplies, compliance staff, unpaid bills written off, and so on. Those costs get covered by what they charge for procedures.
Some departments like OB and diabetes care often lose money, and different hospitals cover that money from different sources depending on what they have. Maybe from oncology or orthopedic surgery or radiology. This accounts for some of the variation in cost for procedures.
So two things:
1) 3500 is the charge to insurance and it is a fake cost. Insurance will probably pay 700-900 bucks for it. That’s probably close to the “cash pay” price they would quote you if you told them you didn’t have insurance.
2) that cost includes the MRI machine which is probably about 1.5m to acquire and install. Consider the commercial real estate cost to rent the space. Consider IT infrastructure costs. Probably the biggest variable is labor costs including the receptionist, MRI technologist, and radiologist. Everything basically needs to pass muster when it comes to ACR accreditation.
It’s good to shop around in the US, but cheaper is not necessarily the best. The imaging center may run abbreviated MRI sequences, may have older equipment, or have less comprehensive radiologists.
If you go to a country where labor is cheaper it will certainly be cheaper.
whelp you see, the insurance companies gotta get their beak wet….
But yeah the machines can be expensive too,
Mri tech here.
The machines I run cost $3 million each. That’s just the machine, not the infrastructure around the machine, which includes super cooled helium at about $30,000 a tank, I assume very specialized electrical equipment to deal with the incredibly High voltages, and a troupe of very expensive, highly skilled maintenence people on call 24/7.
Each coil costs anywhere from $50,000 to $150,000– that’s the thing that wraps around the body part that we’re looking at.
So it’s not enough to just have a machine you also have to have: a hand coil, a foot coil, a body coil, a head coil, a shoulder coil, a breast coil, a spine coil. If you get more specialized scans or people with certain implants, you need *other*, more differenter coils and hey guess what they’re more expensive than the standard version.
Two weeks ago we had, to put it in the maintenance workers terms, “the thing that regulates a cooling thing” get stuck in some sort of way that required a new part. This part was about 400 lb and cost about $1,000 itself but cost slightly more than that to overnight ship it here from Germany. This is very small fix.
Last year we had the main gradient coil go bad on one of our scanners, and all our managers and even the usually loose lipped maintenence people refused to give us any sort of ballpark on cost.
Those are the big expenditures as far as I know. The smaller ones include–
us, the techs who run them, at about 35-60$/hr,
an on call nurse or radiologist to deal with contrast reactions should they occur,- idk what their hourly is,
gadolinium contrast which is about $30ish a milliliter, as far as i know, each patient getting 1 ml per 10 kilos. So is 60 kilo person will get 6 ml, at about 120$.
Eovist is more like $40 per milliliter and the rate is two times that, so a 60 kg person will get 12 ml.
So yeah the overhead is *a lot*, and these are very complicated very dangerous machines that are kind of always breaking because we are running them all day everyday, and this is Healthcare so we have to stop the second anything goes a little bit wrong to keep things from going a lot of wrong.
And because the overhead is so much and the liability is so high and there are a finite number of these very complicated machines, they’ve kind of been monopolized by extremely huge Healthcare entities that can charge whatever the fuck they feel like.
I would actually be super interested to see a cost breakdown because Imaging and MRI in particular makes Healthcare corporations *so much God damn money*.
Radiology is where the money’s at.
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