Why does a CT scan costs $2,000?

[octothorpe]

I went to the hospital about a month ago because of some weirdness I had going on. They ran a few tests, one being a CAT scan that cost me $2,000. Does it really cost that much to run the scan? In addition, I got another bill for what appears to be for the doctor's time in looking at the results and what not (which in total came out to another $750). So I'm assuming that the $2,000 only covers the cost of running the scan (took about 15 minutes at the most) Does anyone know the actual costs associated with the tests itself?

hah oh yeah, the emergency room itself cost me $1,500 for about four hours. I also somehow racked up $90 in charges from the pharmacy, which seems a bit high considering the only meds they gave me costs well under $10. :/

I'm also not sure if I'll be able to get my insurance to cover it, because I justed started a new job at the time and the coverage didn't start up 3 weeks after. Either way, am I wrong in thinking these costs are highly inflated? wtf?

[sinkingfeeling]

1. I don't know why they cost so much, but most insurance companies require pre-approval of them.

[octothorpe]

5. I'm curious if they are legitimately costly to run.

[sinkingfeeling]

22. Well they cost hundreds of thousands of dollars to buy. It does require a fairly large number

of trained people to operate and when to compared to a hospital's $40 sleeping pill, $2K sounds reasonable.

[truedelphi]

51. Karl Denninger had a column recently about how

The Medical Industry is the only industry that can have one rate of payments for one group, and another set of payment schedules for another group of users.

This is an illegal practice in every single other industry except the medical industry.

However, lobbyists get things for this industry that most of us can only dream about.

Denninger also points out that the state of New jersey had gone after five or six medical professionals, including a doctor who charged a patient over 30,000 dollars for a single bedside consultation! The State Attorney General's office thought that the cases they choose were so egregious that they hope to win despite the Medical Industry's usual protection from such a lawsuit.

[anneboleyn]

60. Yes. I get two-three MRIs each year, and I have to do the pre-approval thing every time.

And every time the people who decide these things at insurance companies have to decide if the procedure will be funded, or not.

[RUMMYisFROSTED]

2. Because it can.

:think:

[pnwmom]

3. It's called, "what the market will bear."

And that goes for drug costs, too. The drug companies survey the market and decide what they think the most is that people will pay for it.

Ideally (from its point of view), a company hopes to produce only products that will yield a "healthy profit."

[Brickbat]

4. Why do you hate profit?

[octothorpe]

9. Clearly I'm an evil communist out to abort children and destroy christmas.

:P

[Brickbat]

14. Come sit by me, then.

:toast: :rofl: ;)

And welcome to DU, by the way.

[Capitalocracy]

12. I've got no problem with profit

Profit's great. But people's lives, health, and livelihoods are just a little bit higher on my list of priorities.

[rfranklin]

6. The machine costs about $1 million...

and it is also a profit center.

But the prices are probably based on the retail price which is not the price that insurance companies pay. If you do end up having to pay those charges, you may be able to negotiate with the hospital for a price break.

[JackRiddler]

48. Do you know more?

Is the million a legit price for what it costs to make?

How many scans per day is typical?

Maintenance and operating costs?

Cos it sounds like it should amortize in 50 days, at that price, assuming 10 scans a day.

[MedicalAdmin]

83. If you want to know why it costs so much ...

... ask the insurance companies. Their overhead is outragious (27% on average in the US) for administrative costs. But what is worse is that it takes a national average of 3 billing people for every doctor in the US. That is unfreakingly beleivably inefficient.

Compare the 3 billing people in the US working full time for every doctor who bills insurance and compare that to the one part time person who does it in Canada as part of their other duties. One of our colleagues is a doc in Canada and he has his nurse bill all of his claims at the end of every day - it takes half an hour for the entire office. Compare 1/2 hour a day to 24 hours a day (3 people full time) and think about that overhead.

Get rid of insurance companies as the primary insurers and you will see an across the board savings of at least 50% almost immediately. And that is for everything.

[and-justice-for-all]

66. That is correct...nt

[JCMach1]

78. Years ago they cost that much... Japanese ones are especially cheap these days

siemens ------------------200000 usd approx

toshiba -------------------180000 usd approx

beckam coulter------------250000 usd approx

sharp------------------------200000 usd approx

ge----------------------------300000 usd approx

phillips ----------------------140000 usd approx

Read more: http://wiki.answers.com/Q/How_much_does_CT_Scan_machine_cost#ixzz1JlXkU2HR

[RKP5637]

7. IMO they are all to high. What this country needs to get to the bottom of is

why medical costs in this country are 50% higher than the next down. Clearly our medical treatment isn't 50% better than anyone else on earth. That's what really gets to me is many politicians talk about how to cover rising costs. To me, they should be focused on stopping rising cost and cut the current cost by 50%. There is soooo much BS in all of this fueled by greed, pure and simple.

[octothorpe]

15. I think more people need to experience how ridiculous it is.

I'll be honest, I didn't know that the costs were this high until this happened. I knew they were high based on what I've heard, but I never knew it was this bad.

[RKP5637]

21. I had to go into the hospital unexpectedly last year, the cost for a couple of

days and an operation was about $27k. Then, several months later, I had another unexpected operation, it was about 25k and I'm a very healthy person. SH** happens. I was lucky, my insurance covered it. But these costs are just outrageous. Even doctors think the costs are outrageous for everything. The whole thing is a racket. And as you say, many people don't get it 'till it happens to them too.

[melm00se]

81. hell that's an easy one

why medical costs in this country are 50% higher than the next down

(and I know I'll get flamed for this but it is patently obvious)

Medical costs are so damn high because the average American long ago stopped acting like a consumer. Until recently, many people paid little or nothing out of their own pocket for the majority of healthcare. As soon as that happened, costs began to spiral upwards and the consumer had not skin in the game. No skin = no questions like "is this necessary?", "is there a cheaper but equally effective treatment?" and the like.

You can also see this in the costs of a college education. You have so much money available for a college education that a large proportion of students have no clue exactly how much their education costs (sure, they know how much in student loans they have after college but while in school?). And as soon as that happened...no more consumer questions.

the average American spends far more time researching their next big screen TV than they do their doctor...

[Incitatus]

8. Hospitals like to make money just like insurance and pharmacentucal companies.

They are just not targeted as much as the other two for their practices.

[reformist2]

10. CAT-SCAM is more like it.

I'm not saying they aren't incredibly useful. But I suspect they are being used WAY too often, when a simple (and cheaper) X-Ray would suffice. The reason? Big bucks.

[Maru Kitteh]

77. The difference between a CT and an X-ray is kind of like the difference

between an article in People magazine and a rich volume of meticulously constructed encyclopedias.

When a CT may likely reveal more critical information, it is ordered - especially in the highly litigious environment of healthcare. In each day you will interact with clients who are ready to sue at the drop of a hat, waiting really, for an opportunity to do so. Sometimes you know which ones they are and sometimes you don't, so you CYA and order the CT.

[cbayer]

11. A couple of things here.

First, hospitals typically have "rack rates" that are as much as three times what they actually get from major payers. If you end up having to pay this yourself, you should find out what Medicare would actually pay for the scan, the radiologist, the medications and offer to pay them that. There have been some significant class action suits in this regard, and the cases have been generally resulted in laws that prohibit hospitals from charging you more than they would normally get.

Secondly, hospitals have a lot of expenses they can't charge anyone for, including costs to comply with government standards, administrative costs, direct nursing care, housekeeping... the list goes on and on. These costs are distributed into charges, so everything gets inflated.

And then, if you were in a privately owned hospital, there are the grossly overpaid top administrators, corporate owners and stockholders.

[octothorpe]

17. I'm going to have to see what I can do to get this down if I can't get the insurance to work with me

I don't mind paying a fair fee or anything, but it doesn't seem fair right now.

[cbayer]

23. You can see what Medicare pays for each of these things in your region by

doing a search for the CPT code spreadsheets for 2011.

The CPT codes should be on the bills you receive.

It's not fair and you should challenge it.

[FLSurfer]

70. Wife had one a few months back.

Doctors understood before the procedurewe have no insurance. We were offered the ct scan for $500.

[donco]

19. i had one

two years ago and medicare(medicare advantage plan) payed $750 for it.

[cbayer]

25. Much closer to the actual cost of the test.

[AngryOldDem]

13. They charge that much because they know you need the test.

And when Tylenol goes for $10 a pill, the ER charges add up fast.

Before it's all said and done, a lot of people are going to go untreated and die because they weren't so much afraid of the diagnosis they would get, but rather afraid of how much it all was going to cost.

This country is just so damned fucked it's not funny.

[Oceansaway]

16. it's gone up since i

had mine....2002 they were $1600.00....here in illinois anyway...

[Lone_Star_Dem]

18. Because they do. Now stop rocking the boat and put on your peek-a-boo paper gown.

What you gonna do about it, refuse the procedure and die?

Geeze, the nerve of some people. Hello? We're trying to make an insane profit here at the expense of health insurance consumers everywhere. Duh!

[reformist2]

20. Serious question: Why do people get CAT-scans? I've never had one.

[wickerwoman]

24. Mostly cancer I think.

There's a good list on wikipedia:

http://en.wikipedia.org/wiki/CAT_scan

[AngryOldDem]

26. It can provide a more accurate view of abnormalities, tumors, etc.

Here's a brief overview.

http://www.medicinenet.com/cat_scan/article.htm

A few years ago my young son had to have one of his brain. Although it's no big deal (other than cost) compared to other medical tests, I can't imagine being rolled into that machine for several minutes. He was able to watch SpongeBob in there as a distraction, and the nurses/techs were great, but his Dad and I were stressing watching that machine and knowing our kid was in it the entire time. I, for one, probably could not hack it.

EDIT: Link now starts at first page of explanation.

[Quantess]

38. I considered getting one for my mysterious knee problem

because the general practitioner couldn't figure out what was wrong. Luckily I found a sports medicine specialist who correctly diagnosed the problem, so I didn't need a CT scan.

[Odin2005]

43. Too many docs are idiots that let expensive machines do the thinking for them.

High tech gadgets should only be used as a last resort when good old-fashioned non-invasive sign-and-symptom diagnosis comes up empty.

[Quantess]

49. No kidding!

I didn't have insurance, otherwise I would have gone ahead with the CT scan. So I remained crippled on crutches, until I got a chance to see a sports medicine specialist at a University hospital for a discount. All I needed was a few weeks of physical therapy, and I was running again.

A CT scan would have been useless, I'll bet.

[Quantess]

53. Not that the general practitioner didn't DO sign-and-symptom diagnosis...

it's just that the sign-and symptom diagnosis was above his level of expertise. Plus, he scared me by saying it was probably a torn/damaged ACL, which might require $30,000 surgery to fix.

Did I mention I had no insurance? Yeah. So I was extremely depressed for a couple of months, until I got the correct diagnosis. "No, you do not need surgery" were the sweetest words I ever heard. I actually cried tears of happiness when I could run again, a few weeks later.

[pstokely]

57. People demand to be scanned

It's true

[MedicalAdmin]

84. Differential diagnosis is a key part to every doctors training...

but there is a saying in medical school: What do you call a person who graduated 1st in their medical class? Doctor. What do you call the person who graduated last in their medical class? Doctor.

Not all doctors are the same. We keep getting patients come through our doors with serious long standing problems who have already seen lots of other doctors and they were misdiagnosed. Just yesterday our medical director was pulling out her hair because the tests run by previous doctors were proven by research to not diagnose the condition that was clearly indicated. We prescribed a course of therapy based not on new test but on the symptoms (our clinics motto is "Your symptoms are telling your story. We're listening") and within 2 weeks that patient was responding favorably and the symptoms that had bothered this young marine his entire life were going away. He had seen 15 other doctors to no avail.

It drives me insane sometimes. Don't get me wrong. Test are a good thing. We occasionally order labs and CATs etc, but only when we need to confirm something, not to find out what it isn't. The problem with the continued specialization of doctor training in this country is a bad thing. Most industrialized nations have a mix of 70% general practice and 30% specialist. The USA has 70% specialists and in my experience the more specialized the less usefull the doc.

Just my 2 cents.

[pipi_k]

50. Just by coincidence...

my daughter was in the ER last night with severe abdominal pain which she had experienced 10 days before but went away only to return.

They did an EKG (she had chest tightness), then did a CT scan and then Ultrasound.

I would imagine they were looking for all sorts of things that wouldn't show up on a regular x-ray...kidney stones, growths, obstructions, etc.

[anneboleyn]

62. Exactly. Each of those procedures could turn up something different. Did things turn out okay?

I hope she is doing better now. We have a relative who suffers from diverticulitis (basically, infected pockets in the colon that flare up) -- was this mentioned as a possibility? It can cause very severe pain like what your daughter was experiencing. Just an idea -- I am not trying to diagnose anything!

[pipi_k]

73. Well, they didn't find anything awful, let me put it that way...

apparently she has a cyst on one of her ovaries and her Mirena IUD has slipped a bit (due to be changed anyway).

She has a history of heart trouble on her dad's side (her uncle had multiple heart attacks, and his mom and brother...my daughter's dad...both died from heart failure) so I was VERY glad they did an EKG. That was one of the first things I was so worried about, knowing that heart attacks, especially in women, can cause referred pain.

I've had attacks of IBS myself, so it's quite possible that she could also be having them too, as she has anxiety and depression disorders.

Anyway, thanks for asking, and I just wanted to say I like your screen name...Anne Boleyn is one of my favorite people from the Tudor era, both in her own right and as mother to Elizabeth I. :)

[anneboleyn]

61. CAT scans and MRIs provide far superior imaging, and a radiologist can discern abnormalities

at a much better rate of detection than in an X-ray. My husband had an x-ray of his chest (for a lung problem) that showed nothing abnormal. The doctor followed up with a CAT scan as the symptoms were not going away, and the radiologist spotted a major problem that was not evident on the X-ray. If a person might have a form of cancer, he/she should definitely ask for a CAT scan or MRI of the possibly afflicted area as the quality of the imaging will be much superior.

[anarch]

65. I had pulmonary emboli

apparently the CT scan was the only way to really confirm that was what was going on. Between the ER and the pulmonary ward costs, even with insurance, it took me about two years to pay off the bills. But hey, I'm not dead, so there's that.

[quiller4]

71. High quality scans have reduced the need for invasive, exploratory

surgeries. That cuts done on the chance of infection. Scans can detect abnormalities of all sorts. Although scans are costly, they are considerably less costly than exploratory surgery. The machines cost in excess of $1 million for medical centers to acquire. Because imaging technology is advancing at a rapid rate, the useful life of these expensive machines is sort relative to some other kinds equipment.

[cascadiance]

76. I just had one a couple of months ago before some kidney stone lithotripsy I had...

... when they had to see and verify that one was stuck in my urethra between my kidney and bladder. Not all of the time is it for cancer, but it is needed at times when X-Rays don't give enough info. When I went to ER earlier, they said they would only do the X-Ray then, because they wanted my urologist to ensure that it was done later to properly diagnose and prepare for that surgery (it is non-invasive and just uses a laser through your tubes so it wasn't that unpleasant, except for the kidney stone itself and some pains afterwards).

I was told that CT Scans do also put a lot more radiation through your body than a regular X-Ray, so you don't want to get them that frequently, which is why they only wanted to do one.

As for the original post, a lot depends on who your insurance is through, and of course who's buying it with what kind of plan. if you look at the costs that doctor requests for a procedure and what the insurance company negotiates, it can be QUITE different and lower what they pay. So in effect, many people who are uninsured or have low quality plans that aren't one of the big companies, they wind up having to pay MORE to make up for what the big insurance companies negotiate down on their payments. Which is another reason why single payer is really necessary to bring costs down for people without the benefit of working for big companies without big insurance plans.

I was fortunate that I just recently had a job that even though I lost it, gave me COBRA to cover this. I wasn't about to sit around and leave it inside me when I might not get any new insurance coverage to cover it if they termed it a pre-existing condition before they end that limitation later some years from now.

[Amaril]

27. It's ridiculous, isn't it?

Especially considering Medicare only pays (depending on what area of the body it was and what locality you're in) between $150 to $200 for the technical component (the machine part) of a CT Scan and $50 - $100 for the professional component (the reading of the scan). Major medical insurance pays more (typically 2- 3 times what Medicare pays), but still........no where near $2750 for tech & prof combined.

If your insurance winds up not covering you, contact the business office at the hospital and negotiate with them. Before you do, call your insurance company and ask them for the allowance under your plan for each of the CPT codes (5 digit code that should be on the itemized bill) the hospital billed, and offer to pay the hospital the same amount.

[napi21]

28. It's th cost of the machine. I have a very close friend who is

financial VP at a very large hospical system, and we talked about this very thing. She explained to me that the scanner costs between $1.5 and $3.5 MILLION DOLLARS and they are routinely replaced with new technology every 3 years or so. She also told me about one CT Scanner that was replaced in only ONE YEAR because some great new technology was released. The amortization of that equipment is built into every scan.

It's much the ssame with the ER costs. So many people have to be kept available to cover almost any emergency, and lots of equipment is used on almost every patient. Did you ever notice the many tests that are routinely done on a visit to the ER v/s what would be done on a visit to your primary care doc? That's the main reason why some form of universal health care would save so much money. Far fewer people would use the ER as their onl source of health care.

[Vanje]

30. What do they do with the "obsolete" 2-3 yr old machines?

Who do they sell them to?
THATS where I want to go for tests.

[napi21]

34. I asked that question too. They are sold to facilities in very small

towns that don't have the funds to buy new machines. They're satisfied having ONE machine that works and not so much with new technology.

[quiller4]

72. They are also donated to medical centers in less developed countries.

There are several non-profit organizations that collect and distribute donated medical hardware.

[ddeclue]

32. Not very believeable...

Airliners cost hundreds of millions of dollars yet you don't pay $2000 for a 15 minute flight.


At 15 minutes there are 96 slots per day x 365 days per year =36500-1460=35040 slots a year x 3 years = 105120 patient slots.

If the machine costs 3 million dollars then the cost of the machine could theoretically be amortized across 105120 patients for a less than 30 dollar per patient cost. 2000 dollars is a hell of a mark up.

It's like that scene in National Lampoon's Vacation where Chevy Chase has jumped the Wagon Queen Family Truckster and blown out all the tires out in the middle of nowhere and he gets ripped off by the local yokel mechanic who asks "How much you got?" when Chevy asks how much the repair bill will be.

Doug D.

[napi21]

37. I doubt you'd find ANY facility ANYWHERE that could do 96 scans each day!

And they don't do scans on weekends or holicays unless it's reaally an ER. You're also ignoring the cost to operate the machine & the trained personnel that operate it and do a prelim review of the results to make sure they are perfectly readable for presentation to the Doc. Things don't happen in isolation.

[ddeclue]

39. Even if I'm off by one order of magnitude the price of a scan is still an order of magnitude too lar

ge...

And if it is a large facility with an ER in a large hospital I'm sure it runs most of the time maybe not 96 times a day but on the other hand I'm sure it's at least 15 times a day.

Doug D.

[JCMach1]

79. Once again, misinformation... they are relatively cheap these days

siemens ------------------200000 usd approx

toshiba -------------------180000 usd approx

beckam coulter------------250000 usd approx

sharp------------------------200000 usd approx

ge----------------------------300000 usd approx

phillips ----------------------140000 usd approx

Read more: http://wiki.answers.com/Q/How_much_does_CT_Scan_machine_cost#ixzz1JlXkU2HR

10-15 years ago, the price was that high... not now.

[LibertyLover]

29. I've been told that the inflated charges

help hospitals offset costs incurred by their treating people with no health insurance and no ability to pay for their care. I don't know if that's true or not. It's been a while since I was in a hospital, but my husband had a MRI about a year ago and the "cost" was roughly the same. Because we have decent insurance through my job, all I wound up paying was 20% of the discounted price my insurance company had negotiated with the hospital. If I recall, it was roughly $35.

[Vanje]

33. I have no health coverage at all

I dont see a doctor when I'm sick.

Yes. Clearly. Its my fault that medical scans are uber-costly.

Damn low income people with no insurance making medicine unaffordable for all.

[napi21]

64. It's not people like you who don't see doc when they're sick!

It's te people who use the ER as their primary care physician. You may no believe it, but there are people who go to the ER for a cold, a sore toe, etc. They usually bring their kids with them, and many times it's around 4-5 o'clock. The hospital is mandated to provide food for those who are waiting in the ER and it was long enough to have passed the dinner hour. I understand why a poor family would do that if they have no money to buy food, but those things add to the cost of everyone's HC because the ER can't turn them away and someone has to pay for the care. That's why mandating everyone buy HC ins. would save $$ long term. It woud be much cheaper to go to the local clinic, and much quicker for the patient as well. From all I've read, anyone who can't afford to buy a HC policy would be provided the funds to do so by the Fed. gov't.

[TorchTheWitch]

80. Hospital visits for the uninsured are NEVER free

I'm one of those people that's had to go to the ER a few times while uninsured. If you have no insurance, you get billed... and you get billed at a much higher rate than if you did have insurance. That bill requires payment just like any other bill, and if you don't pay it the hospital WILL go after you for it until you wind up in court and the judge forces you to pay it. The ONLY option of not paying it is filing bankruptcy. This is EXACTLY what happened to me, and it's not like I didn't try to pay the bills every time... they just weren't satisfied with how much I could scrape together to pay per month. They didn't care about the times that I had no employment and had no income at all or that when I did have employment I didn't have even $20 at the end of the month to spend on anything else. They wanted at the MINIMUM 1/3 of my pay (even during those periods when I had NO pay whatsoever) and never mind that meant that I couldn't pay the rent or utilities or buy food... they expected me to make myself homeless and starving in order to get what they decided was the minimum they would accept.

Why on earth does anyone actually believe that hospital visits are free when you don't have insurance??? Is it any wonder that over 50% of all bankruptcies are due to medical bills???

I'm sick to death of people blaming the uninsured for being uninsured and believing it's all or even mostly due to selfishness as if ANYONE would go uninsured if they had jobs that gave them health benefits or could otherwise afford health care. It's not like it's any damn secret that this country has an absolutely abominable health care system that's obscenely unaffordable.

And what's this crap about free food??? You have to PAY for that food either from their vending machines or in their cafeteria. Even if you faint at their feet they only give you enough food to revive you... like what happened to me and they gave me 4 ounces of skanky warm orange juice and two saltine crackers in a cellophane wrapper for which I was billed $52 and change for! After a YEAR of disputing that on the bill they oh so graciously offered to cut it down to $25! For 4 oz. of warm orange juice and 2 saltine crackers!

And here you are spouting the most grotesque REPUBLICAN talking points about what's wrong with our health care system!!!

[dixiegrrrrl]

45. People with no health insurance are billed HIGHER than people with coverage.

I checked.
Mr. d's hospital stay resulted in him being billed much higher than Medicare would pay..except for the hospital stay, which WAS covered by his Medicare A.
THAT was billed at Medicare rates, the hospital accepted that rate, we payed the deductible.

The ER bill, that was "outpatient", Medicare B covers 114.00, the ER billed 800.00, cause we do not have Medicare B.
He was in ER for under an hour.

The Dr. who saw him in the hospital twice a day, for 4 days, charged LESS than the ER charged us, but still not covered under Part A...we paid that, it was more than Medicare B rates.

Luckily, we had a medical emergency savings account.

[katnapped]

82. Simply brilliant!

Can't afford to pay for it, so HEY, we'll charge them more for it! That'll get em to pay up!

[Warpy]

31. They are padded. The quickest way to knock them down

is to tell them the four magic words, "I am not insured." Letting them know you just started a new job (after lengthy unemployment, of course) is another way to knock those charges down some.

You're being ridiculously overcharged on the CT scan. That's even more than the market usually claims to charge for an MRI scan, something with much more expensive equipment. Likely some coder made a mistake there.

The emergency room charge is about average. The pharmacy charge is also about average because you're not just paying for the drugs, you're paying for a buttload of paperwork including how you responded to them.

[walldude]

35. I have been through this... Although our 4 hour visit

cost more than $10,000. Wife was having chest pains. After all the tests and all the doctors the bill was over 10 grand.

What you want to do is get an itemized bill. Then start crossing off all the stuff they padded it with, if you don't know what something is demand to find out. We had an item on our bill called: MRS-$80 when I asked about it they told me MRS stood for Mucas Removal System.... Tissues. 80 bucks for a box of tissues. Then go to the hospital administration and negotiate the rest. You should be able to knock it down by about 30%...

Something else you may not know, when it comes to medical bills they have to take whatever payments you can make. They can't put you in for collection as long as you are sending them at least a dollar a month.

Hope this helps. Glad to hear you got insurance.

[jwirr]

36. I do not know how much they cost to run but I know they are very

expensive to buy. Much of that is purchase cost.

[raging_moderate]

40. the answer from an MD....

It's more about cost shifting than profit in most hospitals (at least the community owned non-profits). A huge percentage of patient care is underpaid (medicare, medicaid, VA etc), another large percentage isn't reimbursed at all (emergency services and care provided for those who cannot - or just don't - pay at all) and they have to overbill where they can get away with it to overcome that fact.

By law, no hospital can refuse emergency care due to inability to pay (which makes moral sense of course). All of this is a VERY strong argument for single payer universal health care.

I'd like to see those who feel that "mandated insurance" is unconstitutional then argue how making health care facilities and providers provide services to those who can't pay is not (or frankly why they don't think mandating car insurance to drive on public roads is not). Make them publicly pick one..... mandated coverage or no mandated care. The answer should be easy for anyone with a soul.

[anneboleyn]

63. Great post, raging_moderate, and I think you are new, so welcome to DU!

Or you may not be new (you may be a "lurker," like I was for a long time before actually chiming in) but welcome to the conversation regardless.

[True Earthling]

68. Enlightening post - of course this will disappoint those who believe it's all about greed

and how corporations want to screw the consumer at every turn.

[themadstork]

85. The tea baggers would choose to let the uninsured ER patients rot.

And they'd do it with a big fucking smile.

[Ozymanithrax]

41. 1 - They are very expensive and cost money to maintain...

2 - They require operators who are very high paid.
3 - You must pay doctors for spend the time too look at and evaluate the scan. Doctors are always high paid workers.
4 - They are a limited resource due to the cost and expense of purchasing them and paying the operators.
5 - Management must take its prophet of a minimum of 20%.

[Odin2005]

42. Those suckers are really expensive.

IMO the real problem is that they are used too often when less expensive forms of diagnosis are available. Part of it is doctors covering their ass because of fear of lawsuits and also because we have become a society of hypochondriacs.

[MedicalAdmin]

86. I would like to point out that the fear of lawsuits is not rational.

Nationally less than 2% of lawsuits that are threatened ever make it to court and less than that ever survive discovery. The fact is that lawsuits are a boogie man dreamed up by the insurance companies.

[REP]

44. No idea - they're 100% covered (no copay) with Kaiser; same with MRIs

[cbdo2007]

46. They're free in Canada.

The machines are free and are only run by volunteers.

[RightNoMore]

47. Because they can't charge $5000 yet.

But give them time.

[GSLevel9]

52. Piggish profit margin? Nt

[iris27]

54. No idea. Had one last month on a multiply-fractured wrist - hospital bill was ~$1600,

insurance's "negotiated price", which I paid 100% because I hadn't met my deductible yet, was about $500. Definitely go back to the hospital to ask for a price break if the insurance doesn't cover it. Though in my experience, you sign up for coverage with a new job in the first 30 days, then it is retroactive back to your start date, so here's hoping that'll be the case for you, too.

[exboyfil]

55. Part of the expense is because these machines

are readily available and used early on in diagnosis in the U.S. Contrast this with England which has single payer care.

Britain has fewer high-tech medical machines than Estonia and Turkey
http://www.telegraph.co.uk/health/healthnews/8413647/Britain-has-fewer-high-tech-medical-machines-than-Estonia-and-Turkey.html

"For CT scanners, there were 8.4 per million population, with Britain again trailing far poorer countries such as Greece (about 30) and the Czech Republic (about 15)."

"Hospitals reported wide variations in the cost per scan, from £84 to £472 in MRI and from £54 to £268 in CT scans."

" As a result, in some areas patients are having to wait longer than the recommended two weeks from referral for the scans to be carried out."

My daughter's CT scan was about $1300 a couple of years ago after she fell and hit her head. At $4500 deductible we can expect to pretty much pay for everything (we have never exceeded our deductible in the last five years). Still since our shop workers still has copay insurance, the doctors around here are pretty free about charging us (we have had to fight several bills including cases of mistaken billing). My younger daughter now appears to have a condition which is going to rack up the $4300 per year for the foreseeable future. This on top of the fact that my employer and I already kick in over $12K/yr for insurance premiums.

The problem with our insurance is that at $100 per office visit, it drives behaviors that are not optimum. I have to be really really sick before I will go to the doctor. I am more protective with my children, but I am willing to sacrifice myself. Since I get frequent ear infections the dollars rack up for getting a prescription I know I need. I have looked at trying to get non-prescription versions from Canada or Mexico, but I have not had much success.

[RegieRocker]

56. Japans ct costs vs good ol' e U S of A

http://www.checkupjapan.com/price-compare.php

[Shagbark Hickory]

69. So can one go to Japan and pay those prices or do you have to be a citizen of japan?

[RegieRocker]

74. Citizen

[anneboleyn]

58. MRIs are even worse, $5,000. I have to get two or three MRIs a year due to a chronic illness.

I can't even imagine, with what is going on now with all healthcare being destroyed (medicare and medicaid), what will happen in the future to every one who needs such a procedure. What will people do when they need these procedures, perhaps multiple procedures a year, if they are only allowed limited "vouchers?"

[sendero]

59. Because we have..

.. a "name your price" health care system in which the "providers" NAME THEIR PRICE. Their price doesn't have to be based on any kind of free market pricing because there is no free market in health care.

[Hugabear]

67. Because the health care industry and insurance companies are organized crime

It's all about fleecing as much $$$ as they can from you.

[Ilsa]

75. But with insurance, the doctor and the facility only get about half

of the "cost" reimbursed to them. But the uninsured get hit with the highest prices for the services. And the insurance companies make the real $$$.