-
Website
http://www.catscanman.net/blog/ -
Original page
http://www.catscanman.net/blog/2007/10/why-does-a-ct-scan-cost-so-much-in-the-usa/ -
Subscribe
All Comments -
Community
-
-
Top Commenters
-
Popular Threads
Really good work, Vijay. Excellent post.
US healthcare economics are part of another planet. A few years ago, a friend told me a radiologist who puts in a catheter into the middle cerebral artery for infusing TPA for acute strokes gets paid $10,000!
I couldn't believe it! Similarly, surgeries also cost more there than in India. However, their good days are also over, with major cuts in pay for procedures, and insurance hassles reducing take home checks.
Very good post, thanks!
Of course in Canada there would be no charge because of our medical care system but then we don't have so many machines so often you have to wait. I think you would find here that many people do not get a CT scan when they would for the same thing in the USA.
Very interesting post Vijay and good for everyone to realize this.
Yes, I totally agree with you. The cost of any medical treatment/check up is very high not only in USA but in other countries of Europe as well.
When I was in Switzerland, I once developed an eyesore..something like red swollen eyes. Not a serious one.
Now had I been in India, depending on the availability of time & seriousness, I could have either gone to any chemist for a bottle of eye drops (they usually know what to give), or would have visited an eye specialist and the total cost of the treatment would not have been more than Rs 500/-.
There I spent $95, only for the check up & a prescription w/o which I couldn't have bought medicine.
Good post Vijay. Especially, the cost of machines, the subsidy and comparision to ipod.
Allow me to clarify a few things. $6500 is the charge for a CT scan, but I'm sure it is nowhere near what the hospital has contracted to accept for this service from the insurance companies it contracts with. In most cases, it will receive somewhere between 300-600 dollars, I suspect.
Unless the patient has no insurance, in which case they are stuck paying the full charges.
The particular hospital in the CBS story has ridiculous charges, and I don't think these charges are reflective of what most hospitals charge, and certainly not what they receive.
Unfortunately, CBS got the story wrong. It is the story of bad ER care at an overpriced private hospital, not a story that represents US healthcare in general. (At least in my humble opinion)
I don't understand how the hospital can charge more than what it <span style="font-style: italic">has contracted to accept for a service</span>. Edwin Leap's post tried to explain the disparity between the actual cost of a service and the amount received from a patient and how it is justified.
<span style="font-weight: bold">Moof</span>: It's beginning to look like this is the same path that the private-sector healthcare in India, which is increasingly being paid for by insurance is headed in India. I agree that it is nauseating and scary.
<span style="font-weight: bold">Rambodoc</span>: I'm surprised to see you commenting on a healthcare related post while you are on holiday. Is it raining in Bali?! ;)
I agree that it looks like the 'good days' are over.
<span style="font-weight: bold">JMB</span>: It is not fair to charge the paying customer (or his insurer) more just because you are bound by law to give the same standard of care to the non-paying customer. The government should foot that bill. Take some of that $700 million per day that is being spent on a useless war and spend it on giving good healthcare to people.
<span style="font-weight: bold">Cuckoo</span>: I agree with what you say about the cost of treatment in the west, but I have to disagree with you on one point. It is totally wrong and illegal for a chemist/pharmacist to give any non-OTC drug to someone without a valid prescription. I'm not too sure if you realize that is wrong. That speaks volumes about the ethics of medical practice here in India.
<span style="font-weight: bold">ST Doc</span>: The one time that I visited the US, the first thing that my doctor friends advised me was to be sure to take a short term health insurance / accident policy. You should spend a few days in my department to really see how many people cannot afford even $9 for an ultrasound scan because the entire family's monthly income is less than $100. And the newspapers rejoice at Mukesh Ambani beating Carlos Slim to be the world's richest man.
But tell me, how many of us go to a doctor for general fever or cough & cold ? We directly head for the chemist shop who gives us the appropriate medicine. I have even seen people buying Espazine plus without any prescription !
So, don't disagree with me, rather agree to the fact that it happens right here. :) Wrong or right is another thing to debate on. :)
What is "quality of medical care"? I have had emergency treatment in the US after a lab-accident. The response was quick and efficient, no doubt, and I was in the hospital in six minutes flat, but the doctors who did the treatment (removing gazillion glass pieces from my upper body) did it mechanically like I was a machine that had broken down and they were mechanics fixing it, all the while discussing the party they had attended the previous day. My emergency C-section in India, however was different with everybody, from the ob-gyn to the nurse actually being very supportive and well, comforting.
Have you seen the movie "Patch Adams"? It portrays very nicely the ills of medical treatment in the US.
Because the USA is a capitalist country I believe the medical system there is treated like any other business - the bottom line being the almighty buck with the most expensive but thorough equipment used and everything accomplished in a very correct though cool and aloof manner.
Here in Canada the atmosphere is much warmer and caring for the patient with the downside being longer waits for the less common and more expensive equipment.
Perhaps a combination of these systems would lead to the most benefit for both the patient and the medical system in both countries.
radiology departments will be reimbursed for examinations carried out on NHS patients according to a "tariff".
The tariff for a CT scan ranges from £103 to £218.
The tariff for an ultrasound scan is £62-£92.
This seems like quite a good deal for the public, considering that the UK is quite an expensive country.
Ref:
www.dh.gov.uk/prod_consum_dh/idcplg?IdcService=GET_FILE&dID=150476&Rendition=Web
To give a reference point for this country in its 2nd largest city in a private hospital with near-US-quality of equipment, care, etc., I can get a complete abdominal CT w/contrast for $450-500USD without difficulty. I could go cheaper, but given what I'd know of the rest of the facilities, I'd be worrying about the quality of the equipment and how that would ultimately reflect on the imaging quality.
To Susana above: the next president, regardless of party, has no power over insurance companies--you should know that. Congress provides laws constraining the insurance industry and their wheels are so well greased, if you took away insurance lobbyists today, it'd still be a decade before the stench of their influence leaves DC.
reimbursement from Medicare is about 20 %, that makes 280 dollars.
That's all you need to know about it.
Interstingly, in case you are NOT insured you will feel the heat of this system, YOU WILL BE CHARGED 1400.;
after that, you go to the hospital and say, ok, I give you cash, but I can give you 20 % only.
The hospital will accept, because they do not want you to pay 10/months over 30 years to balance your bill.
I am now extremely worried how it is gonna be.
I was there for 3 hours, the doctor order a radiography, I though this was perfect but I saw a diferent machine, WOW, so diferent to a common x ray machine. they diagnose on me Kidney stones, and the doctor send me with a letter to a county Hospital for treatment, exactly the harbor UCLA, I went there to an emergency room, doctor detected a stomach infection, and he gave me pills, I got better and when I call to know my bill in the first hospital, was 7,992.00 dollars, now I'm suffering because I don;t have health insurance, I don;t have the money to pay that bill, and I have to add 640.00 for ambulance service. I'm absolutly agree about you are saying. Consumer affair, but I'm need someone who can help me to find a place to complain about excessive cost in this case.
CT ABD WO CONT $3,712.00
CT PELVIS LTD WO $3,368.75
CT 3D RNDR WO PSTPRC $112.50
Total Cost: $7,193.25
The 'two' CT scan costs were for a single image, however because the image covered both the pelvis *and* the abdomen the hospital felt justified in charging *twice* for the same image.
Also, this was the *actual* amount paid by my insurance company (with a large deductible by me) - not some type of marked-up and then discounted amount. Anyone who says that this is not a customary and usual charge ($6,000 ) and amount actually paid for a CT scan has obviously not been in a hospital in the United States in a long, long time....
Back to radiology for a second go. I got the bill today and it is as follows
CONTRST NON-ION 350MG PR 787.50
CT ABDO W/CON 1328.25
CT PELVIS W/CON 1328.25
Radiology Sevices 432.00
This comes up to $3876.00 for the the CT scan which doesn't include any of the other ER charges or professional services (doctor bill from ER) which was about another $1500.00.
The whole thing was inconclusive and the total bill was close to $5500.00. I am uninsured and trying to figure out how I'm going to pay this. At least I now know what was the most expensive drink I've ever had. I couldn't believe the contrast was almost eight hundred dollars.
CT ABD W CONT $4057.25
CT PELVIS LTD W $3765.50
(why add $.25 and $.50?)
The total cost for her several hour stay at Seton Northwest Emergency:
$10,605.75
My insurance is a high deductible plan. They paid $3,632.55. The hospital reduced the charge in accordance with their negotiated rates with this particular insurance company in the amount of $1590.87, leaving me to pay $5,382.33 for the several hours in the emergency room. (She had unexplained abdominal pain which was later determined to be psychosomatic--after 4 days in the Children's hospital and many more tests). A doctor (of Indian descent, coincidentally) finally gave it to us straight--there's nothing wrong with your daughter. She was under a lot of stress at school (at only 9 years old). The immediate move toward aggressive measures was wrong, and insensitive. It created a hysteria that probably exacerbated the problem. My daughter was given Ativan to "calm" her at one point during her hospital stay, and she had a terrible reaction that was difficult to watch as a parent. I was not impressed with the complete absence of a holistic (whole-person/situation) approach. Of course the concern was that it might be appendicitis at first, but there were no other indications, and apparently psychosomatic abdominal pain is not uncommon in 9 year old girls.
I agree the health care delivery system in the U.S. is broken, and it's not because we are litigious. Medical Malpractice law in Texas is now virtually non-existent due to reforms that have nearly wiped out the right to recover for the deserving cases as well as the undeserving. Plus, studies have shown that costs of litigation are miniscule in the health care system. In our culture, we do strive toward getting everything perfect, and that sometimes creates more problems than it solves, but I honestly don't think that it is what drives costs so high--I have some thoughts on it, but I really don't know.
Emergency rooms can't turn you away - but they don't necessarily have to do anything about your condition, either. When I was uninsured and needed my gall bladder removed, they wouldn't even perform the ultrasound to confirm it unless I could pay for it (which I couldn't). I was told many times to "come back with health insurance." The entire experience of needing a procedure done without health insurance and living under the poverty level was a harrowing one and has certainly made me aware of much needed reforms to our health care industry.
The administrative cost of health care i nthe US is about 40% of the billed amount.
Most health care insurance providers bill an amount that is roughly double of what they expect to actually get paid.
The biggest secret in health care billing is that when you get billed 4,000 for some procedure and pay only 2.000 you may just get away with it. you have to keep proving somehow that yo ucant afford to pay it all.
if Hillary Clinton's single-payer system would actually be implemented, 30% of those 40% of admin. costs would evaporate. it would also make the business of health care provision essentially unprofitable. This is why it will never go through congress no matter who is president.
I expect a dramatic shift in how US health care is maanged starting in 2015-2020 due to the extremely high percentage of US population in retirement age at that time. the cost-structure will spiral completely out of control, and serious changes will have to occur.
The end effect will be that US doctors will be paid substantially less than they are now, which will attract less talent into the universities, less money spent in research, and an increase in over-thr-counter drug use in lieu of professinoal treatment.
The winners are pharmaceutical companies with existing patents. The losers are health insurance companies, hospitals, and ultimately the sick patients.
We have fairly clear rules about when you can do which test, as the government won't subsidise anything. However, radiology clinics make a nice side business out of offering "whole body scans" for those who are willing to pay out of pocket. I can't believe people would participate in that if the scans were $6500.
Please tell me where is the best mildest climate in India. I'm moving to India right away!